@kristamagnifico Please help advise on PU v Cystotomy urgently
Hello all,
I wanted to follow up on my question about Mercury from two months ago. He had been suffering from recurring urinary blockages, and after several ER visits, I scheduled him for a PU surgery at The Bridge Clinic, a non-profit vet hospital in Bensalem and Philadelphia. The surgery was done on Aug 14th, and the surgeon recommended doing the PU first to see if the stones would pass naturally, which they did. The surgery cost me $1,181.
Unfortunately, the issues didn’t end there. Mercury seemed to recover for about three weeks, but then he started frequenting the litter box and peeing only small amounts, sometimes not at all. He also began peeing outside the litter box and seemed very uncomfortable, especially at night, so I took him for a follow-up on Sep 12th. An X-ray and urinalysis were negative for stones or infections, but crystals were found, leading to a diagnosis of FIC/FLUTD. They suggested Gabapentin for pain and more water fountains and litter boxes (this visit cost $191).
Despite following their advice, Mercury’s issues persisted, so I scheduled another appointment on Sep 19th. The vet confirmed FLUTD and suspected a possible infection at the surgical site, so he received a Convenia and Buprenorphine injection (visit cost: $134). Still, no improvement.
I then took him to his primary vet at Telford on Oct 3rd, where they suspected a different bacterial infection and prescribed Clavamoxin, though I declined a urine culture due to cost (this vist was $170). I also put him on a strict urinary diet (he was on dryMetabolic Urinary food and regular wet food which I diluted with water). He showed some improvement, but then, last Monday, he seemed blocked again. After giving him Amitriptyline, he was able to urinate, and Telford said their only recomendation is a urine culture, and they don’t have any time to see him that week, so I reluctantly agreed to. (Urine culture + 7 Amitriptyline + 14 Clavamoxine was $323), today the results from the culture came back clean, meaning I spent $273 for nothing.
What’s frustrating is that I haven’t spoken to the vet directly since the first visit, only through techs and nurses, and I’m running out of time and money. Mercury is still in pain and struggling to urinate, and I don’t know what else to do.
So if you have any insight or recommendations to what I should do next please let me know because I am at my wits end and have no idea what to do. (I’ve attached the visit’s summaries and the receipt from my last time at Telford to this post)
Comments
[Very Urgent] Advise on Cystotomy vs PU
My 8 year old cat (male, neutered, American short hair) was diagnosed with bladder stones and underwent a cystotomy in February 2024 to surgically remove the stones from the bladder. Unfortunately, the surgeon left behind 3-4 stones in the urethra during the surgery, which were later pushed back in the bladder. These stones blocked him again in May 2024 – he was unblocked via a catheter and the stones were pushed back into the bladder during catherization. He again got blocked a couple days ago and has been unblocked again via catherization with the stones pushed back in the bladder. The X-rays do not show formation of new stones in the last few months and the urinary analysis do not show any crystals.
We are considering three surgical options to remove the sones now: 1) cystotomy 2) PU 3) Cystotomy + PU. Please see X-rays after the cystotomy in February, the one from May and the one from last night and advise on the best course of treatment
Comments
I could really use some advice about my 7 year old cat, Squeak. I posted a comment on Dr. Magnifico’s YouTube video about a cat named Bear that had ear polyp surgery but thought I’d post here, too. I am an emotional wreck right now because yesterday morning I got some very bad news regarding Squeak’s cytology results from a FNA that was done at a specialty hospital. Sadly, my poor boy was diagnosed with malignant melanoma for the 3rd time in two years! I’m heartbroken… The trouble started at the end of December 2022 when I noticed a small lump on his right pinna. My primary vet did a lumpectomy and sent it off to be evaluated. Came back malignant melanoma. Excision was complete with clean but narrow margins. All was well until September 2023 when I found another lump at the base of the same ear. My vet advised me to go for a consultation with an oncologist and it was recommended that Squeak get a TECA-BO done. I was told that this procedure can be “curative” in some cases. The cost was astronomical but I wanted to do the best for my cat. He means the world to me! I began calling specialty vet hospitals to schedule the surgery as soon as possible but none near me were able to fit Squeak in. I finally found one in Pennsylvania and made an appointment for a surgical consultation. The surgery was done on September 25. My boy was a real trooper and recovered well. He did lose the blink reflex in his right eye but it resolved in about 2 weeks with me putting moisturizing drops in his eye daily. I was thrilled with Squeak’s progress and I thought we might have won the fight even though there was no guarantee that he’d be out of the woods now. I had to take money out of my retirement savings to pay for this surgery (it was actually more than $10,000!!) but it was worth it to save my cat’s life. Recently, I noticed that Squeak had been shaking his head and scratching where his incision was. I had an appointment scheduled with my regular vet for a checkup and to get some chest x-rays to make sure all was well. While there, I mentioned about the scratching and head shaking and asked if maybe it was scar tissue causing the reaction. My vet wasn’t concerned and just said “Maybe he feels something.” X-rays were clear and showed nothing concerning. I was told to come back for a recheck in 6 months. However, the symptoms gradually became more frequent and I brought Squeak back to the vet. This time, thinking it might be an infection of some kind, he prescribed Baytril and prednisolone for a course of 2 weeks. There was no improvement and this was very concerning for both the vet and myself. He said that it would be beneficial to get a CT scan to find out what we were dealing with. I was beginning to panic because I had a feeling where all this was leading. I took Squeak to the same hospital where he had his oncology consult. He was examined by a veterinary surgeon first and she did a FNA . Unfortunately, the CT scan could not be done because their machine went down. I got the cytology report yesterday morning. The pathologist’s interpretation was “Lymphocytic proliferation and many atypical multinucleated cells; suspicious for lymph node with metastatic amelanotic melanoma.” The vet that did the FNA said she would consult with an oncologist and get back to me with options for “treatment”. Surgery, radiation and/or chemo was mentioned . Meanwhile, I have been scouring the internet for any information I can get to help me make the right decision about what to do next. I have also posted on numerous cat health forums but only got one response from a vet in Virginia. He said that radiation would be recommended if there was a concern about margins but chemo would not be a good choice for this kind of cancer. He wanted me to keep him posted so I told him about the cytology results. I have not heard back from him yet. Can I please ask for your opinion about all this? I posted this in hopes that Dr. Magnifico would see it because she has done a similar type of surgery for a cat. Can anyone give me some guidance about how I should proceed? I will be discussing this on Monday with my regular vet after he reviews the report that was sent to him. I know I should just calm down but I’m basically a mess! Any information about a way to extend Squeak’s life and keep him comfortable would be SO much appreciated. Thank you!
Comments
My son’s dog need surgery. A very expensive surgery. I have been trying to find a place that will help with this with no luck. If my son’s dog doesn’t get the surgery he will need to put him down. There is something wrong with his jaw and now having a hard time eating. Someone plz help me save my son’s dog.
Comments
Hi Dr. Magnifico,
Our adopted cat (former stray cat, now 100% indoor) has always shown all of the signs of a nasopharyngeal polyp (about 4 years now). I didn’t know what it was until I saw videos of cats with similar breathing noises and eventually saw your YouTube polypectomy videos.
Three short videos of his breathing sounds (turn up your volume) follow:
Called our vet for a surgeon referral, but they’ll only refer for a CT scan ($2000) before they’ll refer to a surgeon. Surgeon’s websites all indicate that they will only accept appointments by referral from a general Vet, so I can’t just make an appointment for examination by a surgeon (which I’m happy to pay for).
Bottom line, looking for a second-opinion / consult (happy to pay!) on whether it’s really necessary to do a $2000 CT scan *before* being referred to a surgeon for (a probably $2000) surgery. I’d rather just have a surgeon put the cat under anesthesia, go in, look for the polyp, and remove it if they see one. Happy to pay $2000 for just that surgery, even if it turns out there’s no polyp.
Thank you in advance for any response.
Comments
My 1.5 year old high energy goldendoodle had her front leg amputated almost 3 weeks ago due to a brachial plexus injury. She developed a seroma that was confirmed by the surgeon and she said warm compresses and rest. I have read that these can take weeks to go away and the only way to keep my girl quiet is trazadone, otherwise she wants to run around and play (and due to the amputation, she hops). Is there anything else i can do to speed up the absorption of the seroma?
Comments
My cats are patients of Jarrettsville Vet. I am reaching out please to get information for my friend. They are located in Michigan and Her 7 year old indoor cat hurt its back leg. Her vet told her that she needed to see an orthopedic specialist because the cat tore a ligament. They made an appointment and were told it would run $250 for the visit plus whatever they needed to do to identify the problem and surgery could cost up to $8000. They are a young couple with a small daughter, and are looking for other options. I thought I had seen a video that Dr. magnifico did regarding anti-inflammatories, pain meds, and cage rest. Can you please Point us in the right direction as to what she should do. I recommended that she contact her vet to see if those options were available to her through them and she could try that route first before seeing a surgeon. I am so blessed and grateful that Jarrettsville Vet is close to me and offers options such as those. Any and all advice would be greatly appreciated! Her appointment at the surgeon is tomorrow.
Comments
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.
Hello Community. I have a wonderful 7-YO spayed female snowshoe named Poppy. Poppy has been the picture of perfect health since I first got her with her litter mates. at 7-8 weeks. She is an indoor/outdoor cat who leads an active social life, and has always had a healthy appetite powering her Alpha status in the household of 5 cats. She and her housemates only get the best food possible and carbs were cut out completely about 1.5 years ago. She currently eats Dr Elsey’s wet food (Turkey or Duck/Turkey), Stella & Chewy’s freeze dried raw morsels, along with some lightly roasted chicken meat with a multi-organ/glandular freeze dried blend for added nutrition.
Last week I noticed Poppy had a hard lump on her left hind leg on the outside of the upper thigh about 1 inches below the hip joint and just outside the leg’s leading edge. It is a hard mass about a dime in size, raised and moves with your finger just a little bit. It is under the hide and above the muscle and feels attached to the muscle or sinew tissues. I took her to her vet last week and they attempted to aspirate but got no fluids, and so have recommended surgery to remove the cyst and biopsy the tissue. While I await their cost estimate I got a second quote from a local board-certified surgeon and that came back at $2500-3000 not including any imaging, biopsies or panels.
I am asking if anyone knows what a likely market price is for such a surgery or has recommendations on alternative treatments? Poppy is behaving normally and has had no change in diet or activity, and does not react at all to touching the cyst. The cyst was first noticed about 10 days ago, and I am constantly handling this cat so it has developed very rapidly. I had first thought it must be from a playful bite from one of her wrestling matches with my 2-YO male, but there are not external signs of any such play. Any insight is appreciated. Especially a means to get this cyst removed and biopsied at a price much more reasonable than that already quoted.
Comments
I have a 5 week old kitten I’m fostering that broke it’s leg last night at the elbow. We saw a neighborhood vet that said we could take it to a surgeon, which would be very costly. Or just let it heal on its own. He said if we let it heal then we shouldn’t put it in a splint or anything because of where it’s broken. I feel it should have a splint. Thoughts?
Hello,
I applaud your dedication and devotion and on your cat. I’m sorry it has been such a long and arduous road.
I’m sorry but I also think these cases need lots of time to resolve. They are usually complicated and multifactorial. So expecting or hoping for a quick resolution is often not feasible.
I do think that it is hard to manage a budget and a complicated case. I don’t know if anyone has done xrays or an ultrasound but these are also still on the list of possible places to look for your answer. If you are running right on funds than lean harder on pain medication and anxiety medication.
I like long term gabapentin and fluoxetine. I also offer lots of options in the litter and litter box department. I like a big, shallow uncovered box with potting soil, or play sand. Don’t remove what you have just add something like this and see which box they choose to use. Also add anything that you can to help keep him relaxed and calm.
I also like feliway and lots and lots of toys.
I hope this helps. Please let us know how things are going.
Good luck
Krista.