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View Full Version : Post Op Care / Mgmt after Perineal Urethrostomy and Cystotomy


jekaiser via CatKB.com
February 7th 06, 07:31 AM
My cat (5 yr old Neutered Male) suffered a pretty bad blockage two weeks ago.
It was extremely difficult to cathetarize him. He also had stones in his
bladder (stone analysis isn't back yet but I suspect oxalate since his ph is
6 and there were no crystals in his urine). My kitty underwent a perineal
urethrostomy and cystotomy. My kitty is currently 12 days post-op and seems
to be doing ok (all things considered). My main concern now is what can I do
to help his post-surgical recovery and management? During the Cystotomy, the
GAG lining of the bladder was found to be fairly damaged as well as his
Urethra. I have been supplementing my cats diet with two tablets daily of
Cosequin (some research has shown that the glucosaminoglycans may bind to the
GAG layer and reduce permeability). I am also carefully monitoring his
incisions. For the most part, I leave them dry, but in a few cases, I've had
to clean them (my cat had a runny fecal episode and I didn't want the fecal
bacteria to enter his newly constructed urethra or upset his incision). When
I did so, I spritzed his stiches with providone/idodine (diluted 10:1), then
rinsed with a saline solution. After that I applied a light coating of
bacitracin. My kitty receives 150ml of SubQ fluids daily in an attempt to
keep the urine dilute and ease irritation to his bladder/urethra. He is also
day-boarded at his Vets office during the day so that he doesn't jump around
while I'm at work.
While I'm fairly certain that his stones are calcium oxalate stones, we wont
be certain until the stone analysis comes back so in the meantime I'm feeling
him Royal Canin SO (balanced, moderate PH formula).
In summary, kitty seems to be feeling ok, his sutures will be removed soon
and he's receiving cosequin for aid his bladder regeneration, daily sub q
fluids to keep his urine dilute, and I watch his incision/sutures carefully.
My last (and worst) worry is the possibility of stricture. What can I do to
reduce the risk of urethral stricture? I know that strictures are usually
avoided by meticulous surgical technique (which I believe he had - my cat had
an excellent surgeon and has a great vet who referred him to the surgeon and
is now closely monitoring his post-surgical recovery), but I would like to
know if anyone else has been in my situation and if so, what else can be done
to avoid the risk of urethral stricuture?
In summary, What can I do now to reduce the risk of stricture formation?
Also, what else can I do (besides the fluids and cosequin) to aid in the
healing of his bladder and urethra (both were in bad shape when he went into
surgery)?
Thank you in advance for any advice / experiences that you can share with me.

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Phil P.
February 7th 06, 01:34 PM
"jekaiser via CatKB.com" <[email protected]> wrote in message
news:[email protected]

> In summary, What can I do now to reduce the risk of stricture formation?
> Also, what else can I do (besides the fluids and cosequin) to aid in the
> healing of his bladder and urethra (both were in bad shape when he went
into
> surgery)?

There's not much you can do to prevent urethral stricture. The likelihood
of stricture formation depends almost entirely on the surgical technique.
The Wilson PU technique is associated with the fewest post operative
stricture in cats.

Your primary concern should be UTI. PU reduces urethral closure pressure-
so, the cat's protective host defenses could be impaired It takes a few
weeks to a few months for the cat's urethral closure pressure to return to
normal- so you *must* keep the litterboxes *immaculately* clean.

The best way to prevent post-op PU UTIs is to keep the litter level low so
it doesn't come in contact with the cat when he squats and throw out the
litter after every use. This isn't as much trouble as it sounds. You can
use litterbox liners or you can put a disposable aluminum baking pan in the
litterbox covered with about 1/2" of non-clumping litter. Don't use
clumping litter because even though you can scoop up the waste, bacteria and
viruses still remains in the litterbox. During this time when you cat is
very vulnerable to infections, its best to throw out the litter after every
use.

If you decide to use clumping litter, don't use a litter scoop- use a
child's small toy shovel or gardening shovel and scoop up the waste *with*
all the litter around it.

Best of luck,

Phil