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URGENT: Nerve Damage in Bladder and Bowel

Discussion in 'Cat Health and Nutrition' started by Eckily, Jun 21, 2015.


  1. Eckily

    Eckily PetForums Newbie

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    Hi everyone,

    I'm in need of some urgent advice.

    On Thursday, my cat Loki had his tail run over by a car and his tail has been pulled away from his spine completely.

    Since then, Loki hasn't urinated or pooed by himself - we've been taking him to the vets, getting him sedated and expressing his bladder this way. The muscles in his bladder are apparently contracted, so he won't urinate while conscious.

    My vet has told me to say goodbye today as he recommends putting him down tomorrow if there is no sign of improvement. So far, he has had 2 steroid injections to try and heal the damaged nerves. I feel like he's not giving him enough time to recover at all.

    He has also given us the option of referring him to specialists for MRIs, but there is a possibility they can't help us and we have been told this could cost up to or even more than £1000.

    Loki is only 2 years old and I've heard of some miracle stories where the nerves have recovered after a few weeks.

    If anyone has any advice to prevent my baby from being put down I'd much appreciate it.

    Thanks,
    Emily
     
  2. moggie14

    moggie14 PetForums VIP

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    Hi Emily, so sorry to hear about poor Loki :(
    I have also heard of cats recovering from this sort of injury - hopefully our lovely vet @Shoshannah will pop by soon with some advice.
    Sending hugs x
     
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  3. Ragdollsfriend

    Ragdollsfriend PetForums VIP

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    Hi Emily, welcome to our forums. Poor little Loki. Maybe a veterinary acupuncturist can help in the case. Have a look at this website to find a certified vet in your area who can do acupuncture on cats and dogs.
    www.abva.co.uk

    I had a nerve damage in my lower back last year and it took me months to recover, with physio etc. Sending lots of healing vibes to Loki. I hope he recovers soon xx
     
    #3 Ragdollsfriend, Jun 21, 2015
    Last edited: Jun 21, 2015
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  4. Ceiling Kitty

    Ceiling Kitty Hides away from much through humour...

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    Hi lovey,

    I'm so sorry to hear about Loki. :( Tail pull injuries are so horrible. :(

    Unfortunately, it's really hard to predict which cats will recover and which will not. As medicine stands currently, we don't have any criteria that reliably predict prognosis so there is always an element of faith involved. How long you can leave a cat is very dependent on the situation: how well the cat copes with having their bladder and bowels managed, how well you cope with it, how much money we have in the pot etc.

    The best prognostic indicators we do have (and even they are not 100% reliable) are perineal sensation and tail sensation.

    Ascertaining whether or not a cat can feel their tail may help us predict whether or not they will regain the function of their tail in time. It is very important to assess the ability to feel the tail at the base, just where it joins the body. Most of these cats have lost feeling at the tip of their tail, but if they can feel a firm squeeze or pinch at the base, the chances of their tail eventually going back to normal are greater.

    In cats whose tail is not recovering or is unlikely to do so, amputation is often recommended. This is because a paralysed tail is prone to damage from being dragged around, and some cats suffer a 'pins-and-needles' sensation in it which leads them to self-mutilate. In addition, a heavy limp tail can stretch the damaged nerves and hinder their healing.

    Obviously, it is the return of bladder and bowel function which much more important than tail function. Again, modern medicine has not yet been able to find ways to always predict which cats will recover the use of their bladder and bowels, but the most reliable indicator we have to date is perineal sensation. This focusses on whether or not the cat can feel their anus and the skin around it. This is assesses by poking their anus (sorry, kitty!) and pinching the skin around their bottom with tweezers. The anus should twitch. And they should let you know that it hurts when you pinch the skin.

    Based on an old study (published back in 1985), I tell owners that cats who can feel their bottom have a very good chance of regaining control of their bladder and bowels. 75-100% of them will make a good recovery (though some lose their tail). However, cats who can't feel their bottom have only a 50-50 chance of regaining normal bladder and bowel function.

    Cats that do recover take time - longer than a few days - but it's important to set a time limit for the cat's sake as well. The average time for return of bladder function - if it's going to return at all - is about two weeks (thirteen days, to be precise). Importantly, research has shown that cats that haven't recovered within one month are EXTREMELY unlikely to recover at all. So, on that basis, I usually tell owners we'll give it a month. If there is no progress, it's usually time for the discussion about euthanasia.

    What is the worst case scenario here?

    There are some cats out there who never recover full control of their bladder and bowels after pelvic or spinal injuries, but they survive because they are managed by their owners. These owners learn how to check and express their cat's bladder to make sure it never gets too full, and have to manage faecal incontinence and/or constipation where it occurs. some cats require stool softeners and enemas to make sure they can continue to pass faeces. It can be a messy business, and I don't know of anyone personally who has taken on this commitment indefinitely, but I have heard of it.

    As for what to do now, cage rest is important to let the injury form scar tissue and heal. I'm assuming Loki is on some sort of pain relief? Keeping the bladder small is important because if it remains full then the muscles can be stretched beyond the point of no return and never recover. This is usually achieved via regular expression - which in Loki's case seems to be possible only under sedation - but many experts advocate the placement of a cystostomy tube. This is a tube placed into the side of the bladder surgically and used to drain the bladder while it recovers. This is removed once the cat is urinating on their own - usually a few weeks. Remember that a few cats will never regain voluntary function.

    There are medications that can be tried in some cases to improve bladder function, such as prazosin (Hypovase) and dantrolene (Dantrium). There are other drugs available as well. Which drugs to use, if any, depends on several characteristics of the bladder and varies based on the individual case. Drugs may or may not be appropriate for Loki.

    Is Loki insured? MRI scans are expensive, but if going for an MRI scan is an option then it may well be worth investing in a consultation with a veterinary neurologist instead. They will be well placed to provide the best prognostic information as they obviously see cases like this every week and will be experienced in their management.

    Good luck xxx
     
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  5. Ceiling Kitty

    Ceiling Kitty Hides away from much through humour...

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    I do hope the OP comes back and lets us know what has happened.
     
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  6. moggie14

    moggie14 PetForums VIP

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    Me too hun x
     
  7. Shauna Dennison

    Shauna Dennison PetForums Newbie

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    Hi Emily,
    Sorry to hear about poor old Loki. I had a cat who had a spinal injury four or five years ago. We don't know exactly what happened to him except that he was found by someone on our road who took him to the vet as he had lost the use of his back legs. At first we thought it was a car accident, but it transpires it was some kind of 'stroke'. Anyway, like Loki, he also lost the use of his bowel and bladder functions. As I was insured, I took the option of having him referred to a neurospecialist. I figured I had to give him the best possible chance - to cut a long story short, at the time of transferring him his back legs were completely paralysed, but over the course of the following week some sensation started to return. About 8 or 9 days after admitting him, he weed on his own for the first time - which was fantastic. As for his bottom, as Shoshannah says above, it comes down to the 'pucker' factor - i.e. if the skin is slack around the area then there is little or no feeling - in Paddy's case it also returned for the most part and so I was able to bring him home.
    What I would say though is that although Pads made a recovery of sorts, he was always a bit incontinent afterwards, mostly in the number 1 department, but especially when he was asleep.
    I do hope that Loki makes a recovery but i would agree with the poster above in that if no sensation has returned within a few weeks, then it is unlikely to return.
    I had three more years with Paddy, and sadly I had to put him to sleep eventually (he was 19) as the incontinence simply got too much - but that further three years was really worth it.
    Good luck!
     
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  8. Eckily

    Eckily PetForums Newbie

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    Hi everyone,
    Sorry for the delayed response. Hectic couple of weeks.
    So last Monday I decided not to put Loki down, so we got him referred to the specialists. We took him up and the vet we saw was confident in the possibility of recovery. He checked Loki's anal tone and all looked well apart from no pain around his bum.
    We went to see him on Saturday and he was over the moon! He even tried to use the litter box when we were there.

    Updates from today, 1 week later: Loki pooed either yesterday or this morning. His catheter was removed so hopefully he'll start to pee again. If he doesn't pee by Wednesday, then he will need a cystomy tube.

    If anyone knows any charities that offer financial help for vet bills, that would be much appreciated.
     

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  9. Soozi

    Soozi PetForums VIP

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    I'm not in the UK so can't help regarding charities but want to say I am so please Loki is doing OK and you are doing everything you can to save him! He looks as though he loves you very much too! I do hope you can get some help with the Vet bills and Loki makes a full recovery. Hugs! XXX:Kiss
     
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  10. auspiciousmind

    auspiciousmind PetForums VIP

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    Hi,
    So glad to hear Loki has improved long may it continue!
    I don't know of any charities but earlier this year I was in a similar position as you with vet bills coming out of my ears and no insurance (silly me!).
    I have a pretty good credit rating so I took out a 0% PURCHASE credit card out (there are plenty of sites like Money Saving Expert that can help you find the best deal) - This allowed me to pay the bill at the vets and meant I wouldn't incur any interest charges for 12 months) essentially you spend say £600 and aslong as you make the payments every month it will only cost you £600. Obviously you're going to have a large sum of money to pay off so if you can't pay it back within the specified 0% interest period you can than do 0% balance transfer and start the process all over again. It does mean you have to be fairly switched on with money etc though.
     
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  11. moggie14

    moggie14 PetForums VIP

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  12. Charity

    Charity Endangered Species

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    I'm really pleased to read Loki is improving so well, wonderful news. I don't know any charities who will help unless you are on certain benefits. I would agree the best thing is to take out a credit card with 0% interest for as long as possible.
     
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  13. maisiecat

    maisiecat PetForums VIP

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    I have only just seen this and am very pleased you didn't give up on Loki. I adopted my boy 10 years ago, he has no tail at all, just a little dip at the end of his spine. It was amputated shortly before we got him, due to an 'accident' which we believe was not an accident but we will never know.

    He has constipation which is mostly under control with lactulose and plenty of water in his food, no dry food except for treats. He struggles a bit when he is constipated as he isn't sure if he needs to pee or poo, so there is sometimes a puddle and he drips a bit, but he is getting on in years now.

    When we got him we had him checked over and x-rayed, the vet at the time said there may be nerve damage but none of us were ever convinced that the peeing wasn't a behavioural issue.

    He must have been in a similar situation to Loki at one time, and he has led a good and happy life with us.
     
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  14. Eckily

    Eckily PetForums Newbie

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    We're very torn at the moment. We just took Loki home from the vets. We've been told one thing by the nurses and another by the vet. Our hopes are being raised and crushed.

    So far we've had to fork out £600. Loki is absolutely not himself anymore and its breaking our hearts. We feel as though we're being selfish putting him through this with minimal improvement and are considering euthanasia.
     
  15. Soozi

    Soozi PetForums VIP

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    Awww I am so sorry Loki's condition is so erratic. You really need to speak to the Vet again and ask him/her to rate his chances 1 to 10 of full recovery and also his level of pain and suffering this might cause. I would do anything to save my cat but there is always a time when we have to look at the cat's quality of life so you need to have that convo with the Vet before you make any decisions either way. I am so sorry Loki is so poorly and we have to think of their feelings not our own. I pray he has a good chance of getting well again. Hugs and healing vibes being sent. XXX
     
  16. SaraCat

    SaraCat PetForums Junior

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    What do you mean by ''not himself anymore''?
    Tell us more about him and his problems and we might be able to give out tips and advice.
    I've lived with a few disabled cat and met many during my life.
    Most of them conduct very happy and healthy lives and live many years playing, eating and being naughty as any other cat does.
     
  17. moggie14

    moggie14 PetForums VIP

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    Poor Loki :( Is he weeing and pooping by himself now? What meds is he on?
    It's only been 16 days since his accident, it can take time to recover from such a horrible event. What has the vet (and nurses) said? Big hugs xx
     
  18. Eckily

    Eckily PetForums Newbie

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    Hi everyone,

    So Loki has been on Prazosin for over 20 days now. Initially he was pooing and peeing uncontrollably, but eventually he started using the litter tray and expressing himself outside. We aren't seeing evidence of as much poo though. His tail is still attached, he has a wound near the tip that keeps getting infected so we need to book him in for a check up asap.

    However, Look came home again last night and jumped up onto the kitchen chairs and cried. When mum picked him up, he made it obvious he was in pain. So we don't know if his back end got hit again or if nerves are regaining feeling? I'm going to take him to the USPCA in an hour to see if he has broken or bruised something. I'll try and keep you all updated, life has been so hectic, as you can see..!
     
  19. Soozi

    Soozi PetForums VIP

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    Why are you letting Loki out when he's not healed yet? You really need to keep him inside until he is 100% I'm sorry Loki is in pain again and sees the vet asap. In the meantime please keep him where he is safe and cannot injure himself again.
     
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  20. Eckily

    Eckily PetForums Newbie

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    The vet said he would be able to go outside.
     
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