Neurogenic bladder managment in a cat post RTA

RE: Neurogenic bladder managment in a cat post RTA

Lucy Fleming — Wed, 15 Jun 2016 17:53:42 GMT

This is a bit vague as I have never placed one and no real experience apart from inheriting one from another practice but what about an indwelling cystotomy tube? Might be easier for the owners to empty than expressing, while waiting to see if any recovery. Added bonus I guess of allowing normal urination while the tube is in (compared to an indwelling catheter)

RE: Neurogenic bladder managment in a cat post RTA

Anthony Todd — Wed, 15 Jun 2016 16:40:08 GMT

[quote user="Isy Marshall"]If anyone has any advise regarding long term prognosis[/quote]

Long term prognosis is good in these with a functioning sphincter, but training the owner to express the bladder manually, together with the current cat's attitude, will not be easy, but gets better with time and they, both owner and cat, will get the idea.

I tried to avoid catheters at all cost because [IMHO] they always seemed to result in a stricture +/- infection and weren't well tolerated as you have found.

You may find, as I usually did, that infusing the urethra with local each time seemed to make manual expression easier [anything to avoid an in-dwelling catheter!] An 22G venocath worked well [take out the needle...] This almost seems to numb the sphincter!

I often did this twice daily..... although

The trick with manual expression was to try and get the owner to do it at the cat's usual urination spot and be learn how to apply low, but persistent, pressure till the cat gets the idea.

Er, this can take a few weeks until the cat recovers which, as the sphincter seems intact, sounds very likely.

I didn't use any drugs but the modern ones available now may shorten recovery.

RE: Neurogenic bladder managment in a cat post RTA

Martin Atkinson — Wed, 15 Jun 2016 16:16:14 GMT

[quote user="Isy Marshall"]I will look into seeing if we can order some bethanecol in.[/quote]Trade name Myotonine. My experience however is that it doesn't work well if there is denervation but I suspect that your cat has just had an over-stretched bladder. Use with caution however if you suspect there is a urethral obstruction as you don't want a bladder contracting on a blocked urethra.

RE: Neurogenic bladder managment in a cat post RTA

Isy Marshall — Wed, 15 Jun 2016 15:07:23 GMT

Pelvic and spinal X-Rays were clear no sign of any fractures and using tail well. Thanks I will look into seeing if we can order some bethanecol in.

RE: Neurogenic bladder managment in a cat post RTA

Martin Atkinson — Wed, 15 Jun 2016 14:13:30 GMT

Are you sure there is no pelvic or cauda equina injury?, sounds odd to have a non-obstructive urinary retention otherwise. You could try phenoxybenzamine or diazepam instead of the prazosin and dantrolene with bethanecol. I would have no problem with leaving in an indwelling catheter for up to a week but would use a Jackson with side ports rather than a Slippery Sam with an end port which tends to be more traumatic. Irregardless, as we both know, the long-term prognosis for an un-neutered male that is allowed to roam is not good