Medical Management of Tail Pull in a Cat

Re: Medical Management of Tail Pull in a Cat

Gareth Dowdeswell — Tue, 14 Oct 2014 19:49:33 GMT

I've got one of these cases at the moment too, this thread has been very helpful! How long do people wait before assuming there'll be no return of anal function?

Re: Medical Management of Tail Pull in a Cat

Malcolm Ness — Sun, 12 Oct 2014 09:16:56 GMT

[quote user="Anthony Todd"]

Key thing IMHE is to express, or try to, bladder where the cat usually urinates. Bladder sphincter tone is strong even under GA [when spaying expression] so I always taught owner how to do it at home, in the cat's usual time and place.

Trick is not extra pressure but extra time; gentle generalised pressure and count slowly to one h u n d r e d.......

It can take weeks! I never found drugs made any difference

[/quote]

Agree completely - the tip about slow, sustained pressure is key. Most owners can be taught to do this and I have known several cats that have never regained bladder control but were maintained for years by diligent bladder-squeezing owners.

Re: Medical Management of Tail Pull in a Cat

Anthony Todd — Sun, 12 Oct 2014 09:09:42 GMT

[quote user="Iain McAllister"]bladder expression has become easier [/quote]

Cats don't do anything when in a hospital cage, so they have to go home ASAP. [sorry for the balance sheet]

Trick is not extra pressure but extra time; gentle generalised pressure and count slowly to one h u n d r e d.......

It can take weeks! I never found drugs made any difference but there may be better ones now,

It is amazing, to me, how reluctant cats, with a very overfull bladder, are to relax the sphincter and.urinate; and totally in an unfamiliar environment or mind-set!

Re: Medical Management of Tail Pull in a Cat

Iain McAllister — Fri, 10 Oct 2014 12:28:26 GMT

Thanks for that - bladder expression has become easier since moving to prazozin and dantrolene - expression takes the form of applying moderate pressure (but not increasing it) and waiting for about 20 -30 seconds and then the bladder releases - on 5mg myotonin (cat is 5kg) - not showing any side effects at present

Re: Medical Management of Tail Pull in a Cat

Yantha Smyth — Thu, 09 Oct 2014 21:42:34 GMT

I am following this with interest, and am keen to glean any tips on how the bowel can be managed in a home-care friendly way too.

I am dealing with a similar case at the moment and am at day 6 and struggling a bit. Tomorrow may be D-day. Mine is a 12yo MN DSH with bilateral sacroiliac luxations and a sacrocaudal luxation good HL motor function and reflexes. Absent anal tone/perineal reflex and flaccid tail.

His bladder was easily expressed for the first three days, then day 4 became difficult and has remained so. With having to use more pressure to express the bladder, he then gets uncomfortable- assume because then indirectly hurting his unstable SI luxations. There was a delay in obtaining phenoxybenzamine, so he has only been on that 24hr, and I understand it can take 3 days to work.

I have resorted to passing a urinary catheter the last 2 days but withdrawing it straight away, but I think perhaps having an indwelling one would be a better way to go in the short term if they decide to give him a bit longer.

With this case there is no funds for stabilising the SI luxations, and this would not influence if the neuro function returns anyway. In the same vein placement of a cystostomy tube is not possible either. The owners are willing to manage bowel and bladder at home to give things more time but only if a workable regime can be sorted out.

I am not sure if prazocin and phenoxybenzamine can be used together, or if it is meant to be one or the other?

I am currently using phenoxybenzamine, bethanecol, vetergesic, metacam

I have avoided laxatives so far because I really didnt want to cause diarrhoea and inevitable leakage, though things are clearly building up and pretty firm.

Re: Medical Management of Tail Pull in a Cat

listhestar — Thu, 09 Oct 2014 14:43:15 GMT

[quote user="Andrew Kent"]If it is and it is difficult to express then keeping an indwelling urinary catheter for 3-5 days may be a good idea to keep the bladder completely empty[/quote]

Would second that. The last tail pull injury took 3 weeks to get back right but initial urinary catheter helped immensely.

Lisa

Re: Medical Management of Tail Pull in a Cat

Andrew Kent — Thu, 09 Oct 2014 12:51:22 GMT

Hi Iain,

Using prazosin and dantrolene to relax the urethra seems a good plan, whether the dantrolene adds much is open to debate but they are frequently used together.

I would not add bethanechol until you have achieved urethral relaxation (i.e. you can easily express the bladder) otherwise you are forcing contraction against a constricted urethra which has been reported to cause bladder rupture. But I would certainly use this once urethra relaxed, start at lowest dose possible as frequently causes side effects.

It is very important that the bladder doesn't get over-distended. If it is and it is difficult to express then keeping an indwelling urinary catheter for 3-5 days may be a good idea to keep the bladder completely empty. I would also be generous with the analgesics.

Hope that helps,

Andy

Re: Medical Management of Tail Pull in a Cat

Andrew Kent — Thu, 09 Oct 2014 12:51:21 GMT

Hi Iain,

Using prazosin and dantrolene to relax the urethra seems a good plan, whether the dantrolene adds much is open to debate but they are frequently used together.

Hope that helps,

Andy

Re: Medical Management of Tail Pull in a Cat

Anthony Dennison — Thu, 09 Oct 2014 12:35:44 GMT

I'm afraid I can't help with the medical side of things, but would a cystotomy tube be useful in this case? So there's not pressure on the bladder/urethra from repeated expressing.

Re: Medical Management of Tail Pull in a Cat

Iain McAllister — Thu, 09 Oct 2014 11:49:18 GMT

I was wondering about this combo

bethanechol to help contaction

hypovase to relax smooth muscle

dantrolene to relax skeletal muscle

does anyone have experience of using this combo and possible drug interactions?

thanks