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Bladder surgery?

Species: Cat
Breed: domestic long hair
Age: 5-8 years
How painful/stressful is bladder surgery for a fearful barn cat? A few days ago I had my cat euthanized for his blocked urethra because I thought surgery and the stay in hospital would be too hard on him, and now I am afraid I was too hasty. Jerry was a barn cat who is very afraid of people and gets really worked up in a carrier or vet office. 3 weeks ago, he had a blockage and I took him to the large animal practice 5 miles away at midnight. The nearest small animal practice is 50 miles away. I helped the vet get the catheter in him, and he came home with me and I nursed him through the night. The next day his catheter was blocked and we went back to have it flushed, and again the next day. Because it was so stressful for him, I said just pull the catheter and give us some peaceful time til his bladder filled, but to our surprise he began peeing. Continued to pee the next 3 weeks though he sometimes wimpered and seemed to strain. The urine was no longer bloody after about 8 days. He would not eat the special diet so I was giving him DL methionine, 500 mg a day and his urine pH was 6.5. Three weeks later, I saw him trying to pee and nothing came out, and took him back to large animal practice. they said bladder was full, they were busy and siad he'd need to go 50 miles to small animal practice, and would probably need surgery to clean out the bladder since he had replugged so soon. My cat was making gutteral crying sounds and panting from fear and pain, and I was terribly distraught and thought the trip and hospital stay would be too hard on him and asked to put him to sleep. Within a day I was questioning my judgement. Why didn't I ask for a sedative for the trip, and would the city clinic be able to treat his pain and anxiety well enough to make him comfortable. Or had I saved him from a lot of stress and pain and the probability he would again plug down the road despite my best management efforts. I have 3 other male cats, and need a vet's opinion who doesn't have a financial interest in doing the procedure, or who wants to make me feel better because I bring my animals to them. Thanks for any help. I am just grief-stricken over this cat who was very special to me.

Online vet, Dr. Marie

Dr. Marie replied:

Hi Faythe...I'm really sorry to hear about Jerry. I just wanted to let you know that I will be typing a full response to you in the next few hours. I am a little behind on appointments right now. I want to be able to spend the time to give you a complete answer.

You will get an email once I have completed my answer to you.

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Online vet, Dr. Marie

Dr. Marie replied:

OK Faythe...sorry about the delay. It has been a really busy day in the office today.

Urethral blockages in cats are one of my least favorite things to treat because they are so frustrating. From what you have described to me it sounds like you made the right decision.

It sounds like you and your vet tried all of the options that were available to you. The next step, would have been to administer an anesthetic and flush the bladder out and keep him in the hospital for several days. However, there is no guarantee that he would not block up again.

Being a barn cat, it would be very difficult to control his entire diet and when we can't control a cat's diet (i.e. feed him special food to help maintain his urinary pH) they often will block again.

The small animal vet may possibly have been able to do a surgery called a urethrostomy in which they open the end of his penis so that he urinates like a female cat. However, this surgery is very expensive and comes with a high rate of complications.

It sounds like he was really in a lot of pain and even if you had gone to the small animal vet there was no guarantee that he would make it better.

I consider myself and this practice very advanced in surgery and medical skills and even with really good anesthetic, equipment and skills I still see cats that have recurrent urinary tract blockages and need to be put to sleep.

I am so sorry for your loss, but you did the right thing.

Dr. Marie.

Customer reply:

Thank you Dr. Marie
Thanks for your thoughtful reply. I'm not sure if I would have decided against bladder flushing surgery because of potential difficulty maintaining urine pH in a barn cat down the road. I have a female barn cat with chronic cystitis who tends to form crystals, and i have been able to keep it controlled with the DL methionine that I give to her in an oral bolus with a feeding syringe everyday, and it has kept her urine pH in a good range. I would have planned to do the same with Jerry in lieu of feeding the special diet, and then monitor his urine pH with my test strips to keep it from being too alkaline. Or in your experience, has this rarely worked long term?

I would still like to know if a good vet practice could have kept him comfortable, ie manage his anxiety and pain while he was in the hospital for flushing of his bladder. That was my main fear, that if he had the basic bladder flushing surgery, he would suffer during post op because of his anxiety and fear of surroundings. Were you telling me that even with great anesthetic and technique, you have had to put cat to sleep during the Post Op period because they keep blocking up while they were in the hospital or shortly after discharge??

Thank you for helping me with this. I can't change what I did for Jerry, but I have 3 other male cats, and may face this problem again.

Online vet, Dr. Marie

Dr. Marie replied:

You're very welcome.

These days there is often more to maintaining urinary tract health in a cat than just keeping an acidic urinary pH. In fact, we are starting to see a number of cats now that have calcium oxalate stones (different than the struvite stones we used to always see) because their urine is TOO alkaline. That being said, it certainly could have been possible that you could manage Jerry's diet even if he was a barn cat.

To answer your specific question, yes, in most cats we can keep them relatively comfortable with medications while they are in the hospital for urinary blockages. However, they still will have some discomfort. It is hard to say what level of fear these animals have. They generally tend to seem uncomfortable and unhappy, but most cats seem to do ok on the correct medications.

And yes, you have understood me correctly that even with good anesthetic and technique number of cats end up being euthanized within a few days of surgery because they continue to block. These cases are so hard because we often wish that we had not put the cats through the hospitalization and discomfort that is associated with it.

It does sound like Jerry was in quite bad shape and I still think that you did the best you could with the amount of vet care that was available to you. It still does sound like you made the right decision.

I hope that helps. I will be heading to bed shortly, but if you have more concerns I can reply in the morning.

Dr. Marie.

Customer reply:

Dear Dr. Marie,
Thank you so much for your help in resolving my guilt over putting Jerry to sleep. I was in such torment, but now I do think I can let him rest peacefully in my mind, and know what to do in the future. He tended to have bad luck, maybe because he was a black cat! and my gut instinct said he would not do well with surgery. I think I was lucky I had 3 extra weeks to give him all the love and attention he deserved.
Faythe Weber

Online vet, Dr. Marie

Dr. Marie replied:

You're very welcome Faythe and thank you so much for the generous bonus!

I put a lot of value on "gut instincts" as I find they are often right.

Jerry was priviledged to have you for the time he did!

Dr. Marie.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.