older cats heart and urinary problems

Hi. I have a 14-year-old male indoor cat with a history of urinary crystals. Recently he became blocked with what our vet has told us is oxalate and sulfate crystals. In the past he has only had sulfate crystals, which he was on a diet for. We took him to the vet immediately and she told us that he needed surgery to clear the crystals. She checked his heart and noticed a murmur and warned us it might affect the surgery, but besides weighing him and checking his bladder she didn't do any other tests. After the surgery we went to visit and were told that the cat didn't do well during surgery that his blood pressure went up and down and it wasn't until he heard our voices that he woke up from the anesthetic. She called later to ask if we wanted a blood test done to see if the cat had a heart problem. We agreed to the test and the results were that the cat appeared to have damage to the heart muscles. After a few days she let the cat come home, but told us that the cat because of how he responded to the anesthetic is not a candidate for any other surgeries, although crystals do remain in his bladder and we’ve again changed to a new food to help with this. When he came home we noticed he had a very high heart rate even at rest and was very congested, although the vet has said that he no longer has a murmur and his blood pressure is normal now. It just seemed that he came home is worse shape with the fast beating heart and congestion, and the vet has said that since we have decided to let nature take its course since he’s an old cat he will more than likely suffer a major heart attack. She also wants to test his urine again, and said the best way to do this is to lock him up overnight away from his box and then bring him in the morning to the clinic and they can get a sample. However, we are reluctant to do this because we don’t want to place undue stress on his heart by having have to hold his urine in for a full night.

I was wondering if anyone might now from their own experiences if my vet should have given the cat a blood test before the anesthetic, so as to rule out an existing heart problem that would have gotten worse with the surgery since he is an older cat? And also if the remaining crystals due again lead to blockage anyone know of any options for us since he’s not able to have further surgeries? And is there a less severe way to get a urine sample for the vet without having to cause him stress? Thanks, we're just feeling a little desperate and wondering if we've done him harm by putting him through all this.

 

you can get a urine sample by simply leaving his litterbox w/out litter. He may not like it but he'll probably pee in it anyway.
His heart murmur simply went away? That sounds odd
I once had a cat who was suffering with renal failure and a heart murmur, and dental problems. I had to get her teeth cleaned 2x/year as if an infection set into her gums then it would affect her heart, yet with every cleaning (anesthesia) she was at risk of not waking up. I continued to get the cleanings done as I felt it was better for her to pass away while under anesthesia than die slowly from a gum infection. I kept my fingers crossed everytime she had a dental. Luckily she passed away in her sleep on a bed.
If your cat got a blockage from stones that is very painful (had it happen to a dog). Personally (and this is simply my opinion) I would rather have a pet pass away while under anesthesia and numb to all that is going on than be in pain for fear of the pet passing away during surgery.
My dog was 9, and not in great health, when she had surgery to remove the stones from her bladder and the ones blocking her urethea...and it took a long time for her to recouperate. But I couldn't let her be in pain.
Sadie was also on prescription foods and a holistic vet had me add kale to her diet to make her urine more acidic so the stones would reform (and they didn't). Not sure how to get a cat to eat kale but it's green maybe your cat would enjoy gnawing on it - does he likes veggies?
I would seek out the advice of a holistic vet if you have one around...they seem to have a good handle on options other than surgery.
Best of luck to your kitty - you must love him very much

 

If you cat was completely blocked then the vet had no choice but to do surgery, without it your cat would have died and its an extremely painful way to go.

I dont understand though why a blood test wasnt done before the surgery...I worked in emergency for a long time and even if we didnt have time to wait to get blood results back (the basics take about half an hour if you have in-house testing available (can take a day if you have to send the blood samples out although every place Ive been in has always had the equipment to do some very basic testing)....we still took a blood sample and would have the results before the pet comes out of the anaesthesia.

The murmur Im not sure about, if a pet is in shock or is suffering trauma it can have an effect on the heart and all organs and then after you 'fix' the problem, if there has been no permanent damage things will start to get back to normal. This may have been a factor with your cat (but Im not a vet). Heart murmurs are caused by a number of things though including heart disease but the only way to find out exactly what the cause is would be by ultrasound....and sometimes then its not conclusive but if there is heart disease present that is causing the murmur then many of these diseases can be treated medically to a point, meaning they wont go away but gives the pet a better quality of life sometimes for a few more years. Then again a pet can have a heart murmur that never causes a problem, I had a dog that had a heart murmur from when I first got her when she was 3 years old until she passed away from cancer at almost 17, the murmur never caused a problem for her. I know someone whos dog had a heart murmur, the dog was obese, went on a diet and after about 9 months the vet couldnt detect the murmur.

As you can see, with a heart murmur there are a lot of things that need to be taken into account.

I would be concerned with the congestion, its actually not that uncommon after anaesthesia especially if the pet was intubated, but if it were me I would be keeping a close eye on it and making sure it doesnt get worse. Theres always the risk of an anaesthetized pet inhaling some fluid when waking up....but again there are other factors, underlying heart condition or the stress itself on the system could open the cat up to infection.

Why does your vet think that your cat will most likely suffer a massive heart attack? Theres only 2 things that come to mind, either there is an underlying heart condition or you have said you wont have the surgery done if he blocks again (is that what you mean by 'letting nature take its course?).
I really wouldnt do that, like I said a urinary blockage is extremely painful and while death is inevitable (if completely blocked) without treatment it can take the best part of the day or a little longer to actually die.

As for getting a urine sample, the last thing I would do with a cat just recently blocked is try and prevent it from peeing, I agree with Mary, leave a littler box down with nothing in it, make sure its cleaned out first. The other way is the vet could just do a small procedure to obtain urine, it doesnt require anaesthesia and only usually take a few seconds (depending on how the cat tolerates it but most do fine).

 

Thank you both for your replies.

I still have no idea why a blood test wasn't done before the surgery. She said there was no need when we signed the consent forms, but then afterwards she decided to do one.

We know that he needed the surgery done I just felt guilty for I don't know making him worse off then he needed to be. Its hard to think that maybe I had done him more harm than good in the long run.

The vet mentioned sending him to a specialist for his heart, but when I wrote that we were going to let nature takes its course I meant with regards to his heart. He is an older cat so we ultimately want him to be comfortable and happy and if there was any indication that he wasn't we would do whatever needed of course.

He seems a lot more like himself more and more which is encouraging, with the exception of the conjested noises he makes when he gets stressed and the elevated heart rate for a cat, which seems to make him tired a little faster. Otherwise hes taken to this new food pretty good and hes gotten his personality back it seems.

I will try and see if he takes to using the box with nothing in it. Even if it doesn't work I'd like to try as many different things that cause as little stress as possible.

 

It is unfortunate, that , having gone to a vet, your cat not only has the same problems he started out with, but some additional ones besides. To what does your vet attribute the fast heartbeat? A reaction to anesthesia and certain medications can cause tachycardia, so can stress and an inadequate supply of blood to the heart. Why your cat did not have this before surgery but had it after surgery is interesting. So is the congestion because intubation which means placing a tube down the esophagus into the lungs, is supposed to prevent any type of fluid either reaching the lungs or backing up elsewhere. Interesting too that surgery was required to remove the crystals. They are not oxalate and sulfate stones, they were crystals and unless there is something you are not mentioning, catheterization and flushing the crystals out is usually sufficient. The problem with tachycardia is that, in an elderly pet, at some point, not enough blood may be able to be pumped to the heart because of the speed with which the heart is beating , and a heart attack can result, especially in elderly pets, Maybe, once the anesthesia is out of the system this may correct itself. However, it can take days, weeks, and even months for the effects of anesthesia to wear off.

 

Your splitting hairs kis, placing a urethral catheter to unblock a cat is a minor surgical procedure, you dont necessarily have to cut through tissue to call it 'surgery' and I wouldnt expect someone not in the business to refer to it as a 'minor surgical procedure'....but rather just 'surgery'. :wink: