Post suture removal

11/19/11 - Well our last night was fine.  He didn't get up once to pee - slept through the night.  His pees have been normal and yellow/clear - no blood; he's not straining or running to the box a lot.  The 'urge' sensation must have been coming from the irritation/sensation from the stitches and the newness of the surgery - swelling - pain - irritation.

All of his shaved spots

I am still using the cone,  if he cleans himself  just one or two stokes of his tongue, he bleeds big red blood drops.  So I am still cupping over the area and allowing him to clean himself, but the cone goes back on.  Need to call the clinic and talk to a nurse and find out when this should end.  He doesn't mind the cone, probably because he's free in the house and go into any room, sit in any window, sleep on the sofa, Sadie's bed, whatever he wants.

We have an appointment with our homeopathic vet on Monday so that we can return him to balance and wellness; hopefully he can give us something to help his new pee area callus or thicken over so that he doesn't make himself bleed when he cleans.

He's back to his 'old' self.  figured out how to jump on the counter with his cone and up to the top of the cabinets.  He's sleeping with his cone, and still on me or next to me.  We are both sleeping through the night.

Our lives are returning to normal.  I actually left the house and walked Sadie, went to the trash, went to town.  Something normal.  Got home and sleeping on sofa with his cone.  Must not mind it - he's able to do what he wants (just about) when he wants and his pee area is not bothering him anymore!  A sigh of relief.

We are stitch free!!!

11/14/11 - It's been two weeks and a day and we are now stitch free!  The procedure only took about an hour - anesthesia - suture removal - wake up and we are off and heading home.

We will stay in the study one more night - tonight - and then he's allowed around the zoo!

Don't let him 'go after' himself (licking/cleaning) too much or he will bleed and could develop scar tissue.  The area looks clean and the surgical nurse said things look great, he looks great and we should be just fine.  We can go back to our regular litter - oh goody, I don't like Yesterday's News as you can't put that much in box because you have to dump the whole thing in order to clean the box - doesn't scoop.

PHEW!

He hasn't eaten yet today and I know he's hungry,  but a little out of it from the drug.  He'll sleep most of if not all of the way home.  He can return to normal activity, running, jumping, cleaning, etc.  This is a relief.  Just one more night!

Stitch removal tomorrow!

11/13/11 - Yeah!!! We are almost there.  We have to get up early tomorrow as we have to be at the vets at 9:30 - which means we leave the house at 6:45 a.m.  Must prepare the car and his crate, extra towels, litterbox for the car, water etc.  Can't do it early in the morning,need to do it tonight.

I allowed him to lay outside the crate in the sun on the floor today.  This way his Shadow buddy can sniff him and lay right next to  him.  I'm hoping that we will have tomorrow night as has been and then on the 15th he can be around the rest of the zoo!

It's a long two weeks!

11/8/11 - It's been a week.  Another week to go before suture removal.  We continue our daily routine of eating without the lampshade, cleaning, meds, and the crate.

We are sleeping well in the study and settle down each night as usual - I'm really trying to maintain our pre-surgery routine.  He's either sleeping on my chest, next to me in the 'nook' or between my legs towards my feet.  He is having fewer pee breaks during the night - remember I have to dab his bum when he goes otherwise he'll drag his bum on the sheeted floor and irritate the stitches - and we can't have that!

11/9/11 - Today is his last day of antibiotics and he finished his painkillers on the 7th.  He has stopped going crazy in the crate as I have him conditioned to when he goes in the  crate he gets little piece of elk jerky.  I don't want him to think I'm 'punishing' him.  I'm sure he's aware that something drastic has happened and that he is not well, but getting better.

11/11/11 - And so it goes.  Today plus 3 more days before stitch removal!  It has been necessary for me to give him a few drops of Dr. Bach's Rescue Remedy to calm him as I think he is still in a little pain or is irritated by the crate.  But I need a break from the 12x12 study and there's laundry and other household tasks to do.

My friends and neighbors are being phenomenal!  They are coming and getting my dog, the Sadie girl, everyday for her afternoon walk.  It's great that she gets an hour or so walk/play time with a puppy pal.  It's been snowing and Sadie loves the snow.

We are maintaining and I'm getting a lot of work/paperwork done at home.  Paying the bills, writing thank you notes, etc.

Settling into a routine

So it's now Saturday and we've been home for a few days.  We are finally settling into a routine of when we get up. Eat in the study and then move to the 'crate' out in the living area for a bit so I can eat and clean up the coffee and breakfast of the morning.  He needs to get his pain killers and antibiotics as well.

It's sunny so I move the crate into the sun.  Most cats love their sun!  This makes him sleepy and he settles down.  His 'brother' Shadow settles next to him on the floor.
Today I also notice that he seems to have developed a 'diaper' rash!  Call the clinic and speak to a nurse.  So it goes that this can happen as they are peeing differently now and they must get used to that and will eventually squat a little differently.
They give me permission to use the MelaGel I have (natural product and has a little tea tree oil in it) because I don't have a baby thus no baby diaper stuff -  poor little guy :(

Sunday 11/6/11 - I decide that the only way he is going to be able to 'cure' his rash is to allow him to clean himself - safely.  So he will eat his breakfast without the lampshade and be given 20 or so minutes to clean himself.  I cup my fingers over the suture area so he cannot clean that area and irritate it, but he's happy and when he settles down to rest I put the lampshade back on.  We do this at dinner too.  I continue to dab his bum when he leaves the litter box.  He's finally having bowel movements, they are solid.

Cats create their own enzymes and I think that allowing him to produce these enzymes through licking activity is extremely helpful in his recovery.  It also appears that this may help him maintain his personality - cats must be cats!

Homeward bound and all the stuff to get

It's Nov. 3rd and we are homeward bound, finally.

1. More antibiotics and pain killers 2 times p/d.  They are liquid.

2. Keep him as quiet as possible, no running or jumping.  

3. Handling, only what he wants, but don't disturb the stitches.

4. ABSOLUTELY no licking or cleaning of himself in his genital area (he has a cone on)

5. Feed as normally would, every 12 hours, BUT only wet food.  I can feed organic meats.

Prior to his return I did lots of interneting.  The one suggestion I found about recovery was to sequester in a room covered with sheets in case of bloody urine seepage/dripping.  Off to the store I go.  

Inexpensive sheets, a dog crate so he can hang safely with his buds, 'Yesterdays News' cat litter, piddle pads, Earthbath grooming wipes so I can clean his fur, a pedestal food dish and water dish, little bolster sided cuddle bed so he has a place to lay his head and cone, soft sided comfy cone replacement, low sided litter box.  And the dog needs food too.

We're home.  Come in and put him in his soft sided cone and in the crate and he turns into the tasmanian devil.  Flashing his head about and spinning in circles, throwing litter pellets all over the place!  Man alive!  Ok he hates the cone. It's black and he can't see shadows in his periphery.  Change cones, back in cage.  Still crazy.  OK hates the cage, he's spent so much time behind bars already.  He must have been saying "what! You get me home and lock me up again! No way!"  So back to the study he goes.  There's a sofa in there I plan on sleeping on so he has his people company and can walk around and look out the windows.  Aaah! that's better.  He quickly beds down for a nap and is a lot calmer.  Thank God! And this was the first 30 minutes.  Let's hope that was the only event.

I'm home alone. My husband is at work and the dog needs walked.  Ok, he's asleep.  He has his cone on so I creep out for a short walk.  I wasn't gone for more than 30 minutes.  I walk back in and immediately check on him and he's got his cone off! He's licking himself!  Vasco NO!  Must have just happened.  He didn't get any stitches, but there's blood.  He's not supposed to lick himself, could cause scaring or worse pull a stitch and back to the vet we go; providing he doesn't bleed out before getting there.  

The Cat tree in the study and sofa I slept on

Cone back on, assess the situation.  Use a wipe to dab his bum.  Get cell phone to call the clinic and speak to a nurse.  Where's my phone.  Darn it's on the kitchen counter.  Quickly leave study and grab phone.  No sooner did I scamper 10 feet and come back in and he's jumped on the cat tree.  Darn!  Last time he came home, took him 3 days to jump again and we've only been home less than an hour!  I thought I'd have time to take the platforms down.  Call the clinic.  "Don't let it happen again or you've spent thousands for nothing."  Yes mame.  So he's up there, 8 feet in the air and sleeping with his cone on tied really tight.  I'll take the platforms down and then get the 3 step ladder and get him down.  No sooner did I get him down, he pees in his box and then proceeds to scooch his little bald bum across the sheeted flood and leave a streak of faint blood.  Eeek! Vasco No!  Grab the wipes and dab him.  Call the nurse again.  Have to dab him every time he comes out of box since it's natural for a cat to clean itself afterwards and now he can't.  The only good sign is that scooching tells us the healing has begun, but don't let him do it.


Realization quickly sets in that he is going to have to be watch 24/7.  He can't be trusted to be left alone, hence he gets his collar off somehow and his bum should be dabbed for cleanliness and to ease his discomfort with not being able to clean himself. 


Oh Boy! I have two weeks of this.  I tell myself it's only two week of a very long life yet to be lived and we must set a routine.  It's only Thursday and the weekend is coming and my husband can relieve me periodically during the day while I try to ease him into the crate out front.  Need to boil some organic chicken breast for this.

The Beginning

A philosopher once said "if you don't know where your going, how do you know where you are?'  I say 'if you don't know where you've been, how do you know where your going?'  I believe the previous is true also, but we must know our histories. So this post will be a little long, but necessary for those of you reading.  It will get funny, I promise.


So, Vasco was found on a rocky 'beach' on Madeira Island, Portugal October 2, 2007 while we were on vacation.  We were in the middle of no where and just couldn't leave him there. So I grabbed him up and off we went to find his home or hand him over to a shelter.  Later that evening my husband, being it was his birthday and 'people should get what they want for their birthdays', decided that he wanted to bring him home to the United States.  So the adventure began.  And an adventure it was. I managed to make it happen, legally, and he has been home with us and his other companions ever since.


Vasco got his 'vasectomy' in January 2008; approximately 6 months of age and the remainder of his shots.  He has not received any other booster shots since that time and has had no health issues during this time either.  Why, he's inside and if he were allowed to wonder around outside he's nothing but a snack for a mountain loin, lynx, coyote or bear!


I eat mostly organically and try to feed my pets accordingly as well.  They eat a mix of wet food and a tablespoon of dry food 2 times per day.  The foods I purchase are Before Grain, Wellness, Instinct, Halo, Evo, AvoDerm and occasional other natural brands.  They drink only mountain filtered water.  They get baths monthly to keep their skin clean and keep the pet fur down around the house.  I can bath all three of my cats inside of 20 minutes!  Of course, only a 50/50 mix water/natural aloe shampoo and away they go to groom all day.  Never dripping, but still wet as everything at this altitude (9200 feet) dries up like a sea sponge.


So, how do we get to the PU?  My husband and I were on vacation in Ireland with a girlfriend house sitting and taking care of the pets.  On October 2, 2011, I got a call from my house sitter that Vasco was sick and not acting right.  She was going to watch him closely, but she wanted me to know.  He had thrown up, not something he does, and seemed to be hiding, not something he does either.  He has the biggest personality and is very verbal and always in the kitchen if you are.  One of his favorite places is on top of the kitchen cabinets peering down at everyone. I'm always amazed at the 4 foot vertical leap he makes from the counter; which I am incessantly wiping down.  I got a message from her the next day that she found him laying in the litter box the next morning and rushed him to a local vet.  I did not see any abnormal behavior before we left.  My other male cat had a blockage 6 years ago so I know the signs to look for and didn't see any of them.


So began the month long saga.  He had been blocked with what appears to have been a struvite crystal but the local rural vet only treated him with Sub Q fluids and not an IV and a cath for only 24 hours.  I did call from Ireland and inquired and was surprised at his response and in hindsight should have had my girlfriend/house sitter move him to my 'regular' vet; who we will call Drs. M.  While on layover I called the rural vet and 'had it out' with him, so to speak.  I wanted my cat at home so I could transport him the next day to Drs. M some 70+ miles north.  I got home (10/9) to instruction that he had only 1/2 'expressed' his bladder and I would have to 'express' his bladder later that evening.  I knew what he was talking about and was not pleased.  'Expressing' a cats bladder is not difficult, but is painful to the cat and can cause damage to the bladder or worse cause it to burst.  So I called a neighbor who is a certified vet tech to help.  When she arrived she too was appalled and said his bladder was too full and may rupture if she tried.  She brought everything to do a cynthesis (process of pacing a needle through the abdominal and bladder wall and extracting urine/blood) but he was too full and she couldn't draw enough out to wait until morning.  He was clearly blocked again and this was an emergency.  So off we went to another rural vet at 9:00 at night and an hour away.  We made that drive in 35 minutes.  He did the cynthesis and pulled 87 ml of very bloody urine from him gave him an anti inflammatory to make him comfortable so we could get to Drs. M vet the next morning.  We got home at midnight.


10/10/11 - Up early for the hour and half drive, 70+ miles, and we're there at 8:15 a.m. Right when Drs. M opens and they were expecting us. 


So, I received a call the following day (10/11/11) from one Dr. M and was informed that Vasco would probably be better served in a veterinary internal clinic another 40+ miles north and they would make the arrangements and I should start my drive.  So I did.  I have to say that I was impressed with Drs M. and their humility.

Vasco and I arrived at the clinic with his catheter still in place and they took us right away.  I met with the vet not too long after they took him from me.  His records had already been transferred and reviewed.  We needed to do an ultrasound to see what the spot was in his bladder on the x-rays Dr. M took.  It was blood clot and it was the size of his bladder and it was big!  He would need continued hospitalization and a change from the 'tom-cat' catheter [picture the inside of a pen except really little - hard plastic] to a 'french red rubber' catheter as it is less likely to kink and kinder to the urethral tissue.  I liked that I was requested and permitted to help hold Vasco during the ultrasound as they use no drugs for this procedure.  My little guy was so good and just lay there as they shaved both his sides and began the procedure with me holding his front legs and paws.  He didn't fight one bit.  I do believe that they know when you are helping them during a time of suffering.


Vasco stayed at this clinic until Oct. 14 when he was permitted to come home.  His blood clot was smaller and he was peeing on his own and things looked well enough to them to let me continue his recovery at home.  Vasco was to receive 100cc of fluid every few days just to help in continuing to flush his system.  So my friend came back to help and to teach me.

Return home from 1st Internal Clinic stay

A followup appointment was scheduled for 10 days later (10/25).  We did another ultrasound and things look great.  The blood clot was a lot smaller and there were no other issues.  Except they did notice some mineralization around his bladder wall.  I never asked what mineralization is and if it could drop or come loose and they didn't say.  Everyone was really pleased with his progress.


Well darn if we didn't get to five days later (10/30) and he blocked again.  It was a Sunday.  My friend came up to help me give him fluids and I told her I thought his bladder had urine in it and he was searching for a place to pee all over the house.  We could see something on the end of his penis.  She didn't know if it was swelling or 'sand'.  He kept trying to pee in front of us, but nothing.  She did a cynthesis and pulled out 30cc of slightly pink urine and off we went to the 24/7 emergency clinic attached to the internal clinic 100+ miles away.

They pulled the plug (mucus plug), as it was called, and I would need to return the next day at 7:45 a.m. for the patient paper transfer and see the doc.  So I stayed with a friend of a friend whom I've met numerous times.  Very gracious and kind of this person; Ms. V.  We had a lovely evening getting to know each other better.


10/31/11 - Up at 6:30 and out the door.  This was the day we were scheduled to see Dr. F, our homeopathic vet who has worked wonders on our dog and our other cat when he had is issue 6 years ago.  But, we would not make it.  No chance to even give homeopathy an opportunity to work.  Now we are talking surgery, three strikes and your out they say, especially when they [the blocks] are so close together.


I can attest to the value in homeopathy and that it does work.  I've seen it and I believe that one should combine the two philosophies, western and traditional medicine.  After all, where do you think western medicine got it's start?  Do your research, penicillin.... simple basic plants, extracts, accidents all that eventually became chemically reproduced en masse for the masses.


So now we are making the decision.  Do we treat him medically and homeopathically and when he blocks again, we are back here again and he has suffered once more.  This is a very hard decision to make.  Surgery comes with risk.  Sure he can never block again, providing he doesn't develop a stone.  But surgery opens Pandora's box.  It is the last resort and are we at the last resort?  Will he survive the surgery?  What are the complications/risks?  We are turning him into a girl, a transgender?  But it has greater potential to save him from further suffering, thus saving his life.  At what point does one person decide enough money spent; can't afford it anymore and he must be euthanized. Euthanization because he can't pee?  I don't have kids, I don't have to pay for college or all the other expenses that come with having children.  These are my children per se.  I need to at least try and give him a chance.  If it doesn't work and we are in that God awful place at least my conscience will be clear that I tried everything and his life was just not meant to be any longer, right?


So that Monday, October 31st, All Hallows Eve, Vasco had the Perineal Urethrostomy or PU for short.  We anatomically turned him into a girl with his Portuguese peanuts in tact - I think.  They say most folks who don't know what happened won't be able to tell the difference - when his fur grows back.  He won't know, ya right, and he will live a happy normal life.  The surgery went 'swimmingly' and the surgeon said it was nice to work on a healthy weighted cat instead of a fat cat and that his urethra tissue was healthy and that helped to make the surgery go easier.


So stay with another friend and get the 9:30 p.m. call from the surgeon about bleeding at the site and his red blood cell count and a possible blood transfusion.  Good Lord!  Then the 6:45 a.m. (11/1/11) call from the surgeon that they had to do the blood transfusion at 4:00 a.m. and that when she gets in at 9 and does an evaluation she will call.  She calls and says come visit and things went well and I'll get the new blood count when I get there.  He's messy, bloody and looks like he's on deaths door.  Can't clean him up yet they say, need to make sure the clots stay clotted and I agree.  But he recognizes me and lays his head on my arm and stares at me with those golden eyes.  What are they saying?  "Thank you?"  or  "You should have let me go?"  So I depart and cry in the car.  I tell a friend on the phone that I have never prayed so much in my entire life; she knows that I am a spiritual person but not a religious person, I believe there is a difference.


Self doubt descends upon me now, did I do the right thing?  At what point does the human stop producing tears?  When do we stop feeling so desperate?  Interesting how we attach ourselves to such small creatures that only serve to give us emotional pleasure (and maybe mousing).  I'm a social worker you know, so I think about these things.  Self-evaluation.  Am I putting him though more pain and suffering just so I can keep him around for another hopeful 10 or more years? Am I being selfish? Am I transferring some other guilt about some other experience or event on this poor creature?  These are all perfectly normal questions to ask yourself and only you can answer them.  But one must follow ones heart with pragmatic information about our realities.  Thank goodness I am in a place where I can increase my hours at work and I will pay for it.