Struvite (Ammonium Mg Phosphate) Stones left behind following my cat’s Cystotomy

My initial question : https://www.pawbly.com/question/hello-i-live-in-san-jose-california-and-need-urgent-help-with-my-male-7yr-old

Update: My cat went through a cystotomy on Friday, the surgery went well and he was sent home the same day. Unfortunately he was still blocked as the surgeon did not remove the stones in his urethra (He did not take any xrays after the surgery and also discharged my cat without making him pee on his own). I rushed him to the ER as he was very restless and trying to pee, the ER doctor immediately unblocked him with a catheter and while doing so, she was able to push the stones back into the bladder. Xrays (attached) were taken which shows three stones in the bladder. As the cost of ER was adding up and the surgeon who did his surgery was not available over the weekend, I decided to shift him with the catheter on to the hospital where his surgery was done. I would like to add that in the initial surgery, the surgeon successfully removed all the stones in his bladder but the stones in the urethra were left behind even though he said he flushed them. The ER doctor is very certain that she pushed those stones back into the bladder while unblocking him the second time when he landed in the ER post the surgery.

My cat is currently doing well, he is on Ivy and has a catheter on. He is on CD food since two days. The urine color has improved from bloody to fairly clear. Urinalysis results showed struvite (Ammonium Mg Phosphate) crystals . I will be meeting the surgeon tomorrow and need your advice on what should be the next steps for my cat. Which of the following would you advise?

1. Re surgery to remove the remaining three stones from the bladder. After the initial surgery, the surgeon had mentioned that my cats heart is weak and hence he had to adjust the anesthesia to a lower level (1 instead of the usual 2), though the ER doctor does not see why would that be the case as there is no murmur seen in his reports and he has taken the sedation well while he was unblocked twice in the ER.

2. CD food therapy: Urinalysis results showed struvite (Ammonium Mg Phosphate) crystals. Should we remove the catheter, make him pee on his own at the hospital and then get him home. Watch closely for re blockage while continuing his CD diet. What are the chances of his re blockage? Will the bladder have greater chances of rupture if he gets re blocked since he just had surgery?

Please advise.

@KristaMagnifico

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