Educating myself via Reading

Below are tons of links to articles I found on the web when I was trying to understand what was physiologically going on. It wasn't that I didn't trust my vets and their advice, it was more that I felt very strongly that no-one had Raz's interests at heart more than I did. It's kind of like money: although you pay your Stockbroker to do a good job, in fact no-one is more committed to looking after it than you are.

Additionally, I am very strongly pro raw-feeding, which is not something most vets agree with (in my experience). I recommend they ask themselves why zoo-keepers do not feed their wild cats with tinned cat-food? In this regard, there is no physiological difference between the small and large cats! Therefore I wanted to really understand the problem so that I could keep tabs on what the vets were recommending, and why; and to take a different path if I felt it was the right thing to do.

Topics: ♦ Tail Trauma ♦ The Urinary Bladder ♦ Urine pH / Struvite Crystals ♦ Expressing a Cat's Bladder ♦ Castration ♦ Spraying ♦ Medication ♦ Catheters, Tube Cystostomy ♦ Constipation and Bowel Management ♦ Miscellaneous Stuff ♦

Tail Trauma

Sacrococcygeal injuries in the cat – MoveoVet.fr.
Sacral Fractures and Sacrococcygeal Injuries in Dogs and Cats – Confluence.Cornell.edu.: Kirk's Current Veterinary Therapy XIII, ed. J.D. Bonagura, pp. 1023–1026
Also see Kirk's Current Veterinary Therapy XIV
Fractures of the Pelvis – VetSurgeryCentral.com.: Some good xrays here, nicely labelled.
Cats with Broken Tails – Marvavistavet.com.: An absolutely brilliant article, and a really great website.
Spinal Injury and nerve damage – Petchat.co.uk.
The Spinal Cord – Cat Owner's Home Veterinary Handbook, Chapter 12.: The whole book is here in pdf format.
Cauda Equina Disorders – Neurologic Bladder, Bowel, and Sexual Dysfunction, Chapter 6.
Cauda Equina Damage and its Management – Neurology of Bladder, Bowel, and Sexual Dysfunction, Blue Books of Practical Neurology, Volume 23.

The Urinary Bladder

Urinary Bladder: Anatomy, Location, Parts and Pictures – HealthHype.com.
Inability to Urinate – eMedicineHealth.com.: Quite good intro to the human urinary system; clear language, easy to understand.
Urinary retention – Wikipedia.org.
Neurogenic Bladder – Urologyhealth.org.: A very good introduction, not too complicated.
The Urinary System – Fundamentals of physiology: a human perspective, Chapter 13.: Great description of the urinary system, including pictures and diagrams. Very easy to read and understand.
Neurogenic Bladder – eMedicine.Medscape.com.: A most excellent, in-depth article on the human urinary system and its interaction with the brain and the nervous system, with special reference to urinary disorders stemming from nerve dysfunction.
The Leakers: Disorders of Micturition and Continence – VIN.com, Atlantic Coast Veterinary Conference 2001.: Good intro to micturition disorders in pets; contains a list of medications suitable for the different neurological problems.
The Cat Straining to Urinate – Problem-based Feline Medicine, Part 4, Chapter 11, pg.173.: Very clearly written, some technical language.
The Incontinent Cat – Problem-based Feline Medicine, Part 4, Chapter 12, pg.195.: Very clearly written, some technical language. ToContents + Entire Book.
Bladder Management for Adults with Spinal Cord Injury (2006) – Metrohealth.org.: Extremely comprehensive review of bladder management methods.
Integrative control of the lower urinary tract: preclinical perspective – British Journal of Pharmacology.: Highly technical article on the regulation of micturition by the neural control system.
Overview of the Autonomic Nervous System – MerckManuals.com.: Excellent explanation of how the autonomic nervous system's two main divisions (a) the sympathetic and (b) the parasympathetic works.
Also see Overview of the Peripheral Nervous Systems > Neuromuscular Junction Disorders
Enervation of the Bladder – Neuroscience 3rd ed., Purves.: See p.493 "Autonomic Regulation of the Bladder"
Anatomy and physiology of the bladder, trigone and urethra, illustrated – Books.Google.com.: John A Hutch, MD, 1972, 198pp.
Bladder Anatomy and Physiology – Ivy-Rose.co.uk.: Good explanations and pictures.; Links: Urinary System, Bladder, Urinary Bladder, Urethra, Bladder Anatomy and Physiology,
Anatomy / Function of the Bladder and Penis – Urology-Textbook.com.: Good explanations; Links: Bladder Anatomy, Bladder Function, Penis Anatomy,

Urine pH / Struvite Crystals

Good Food For Cat With Struvite Crystals? – VetMedicine.About.com.: This (long) post was one of the most helpful sources of information, and provided both "for" and "against" arguments. IMO, it is a must-read. You can read it in .pdf format here, if it is no longer available on the web.
Urine Crystals and Bladder Stones in Cats: Formation, Diet and other Treatment – PetEducation.com.: Increase water intake.
Feline Urinary Tract Health: Cystitis, Urethral Obstruction, Urinary Tract Infection – CatInfo.org.: A really good discussion on the right foods to feed a cat who has urinary issues. Dr Pierson constantly says: "do not feed dry food".
Feline Cystitis – HomeVet.com.: No dry food.
Hills Prescription Diet s/d Feline Dissolution – HillsPet.com.

Expressing a Cat's Bladder

Expressing a cat is very difficult to explain by any method other than a hands-on demonstartion. My vet showed me how to do it at least four times, plus I watched very carefully when they did it - but I still had problems. It turned out that Raz was fighting being expressed, as even the very experienced vets had serious difficulty. But persevere!

Express a dog or cat – HandicappedPets.com MediaWiki.: Scroll down the page till you get to the Cats section. There are also lots of links to YouTube videos at the bottom of the page.
I need to express my cats bladder at least twice a day – JustAnswer.com.: One of the best explanations I have found.
Cat Urinary Track Obstruction – eHow.com.
Resisting Expressing – JustAnswer.com.: If you're watching their genitals and you palpate their bladder, you'll notice movement. This is especially true in boys that still CAN hold it. They mentally try to tell themselves "no, don't pee yet" and that's when you'll notice the smaller muscles around the penis moving...when the cat is trying to resist peeing.
Expressing Urine – Internet.: Should be done ca. every 8 hrs. To get it completely empty, rest for 2 mins between tries. Before starting, push bladder 12mm towards ribcage to straighten urethra out. Enfold/cup bladder in hand; squeeze like the ball on a pressure cuff.; Links: Users.Cyberport.net, HandicappedPet.net, HandicappedPets.com, HandicappedPets.com, YouTube.com, YouTube.com, YouTube.com - Pookie, HandicappedPet.net, FreeWebs.com, HandicappedPet.net, HandicappedPet.net,
Overcoming urethral resistance – Adult and pediatric urology, Volume 1, p.1132, by Jay Young Gillenwater.

Castration

Feline Neutering - All About Male Cat desexing – Pet-Informed-Veterinary-Advice-Online.com.: The single best information source I have ever seen on this topic.

Spraying

Feline Behaviour - Spraying – Excerpts from various websites..

Medication

Bethanechol: used to increase muscle tone to help the bladder contract.
Phenoxybenzamine: used to help relax the bladder sphincter.
Cisapride (Propulsid): used to increase intestinal motility.

Urinary Incontinence and Micturition Disorders: Pharmacologic Management – Kirk's Current Veterinary Therapy IV, p.955.: An absolute must-read; covers all the major the pharmocologic agents used in the management of urine retention and urinary incontinence.
Bethanechol Chloride (Urecholine, Myocholine) – MarvistaVet.com.: If you don't read anything else, read this.
Bethanechol Review – MedicaLook.com.
Urecholine (Bethanechol Chloride) – DrugLib.com.: Effects on the Gl and urinary tracts sometimes appear within 30 minutes after oral administration of bethanechol chloride, but more often 60 to 90 minutes are required to reach maximum effectiveness. Following oral administration, the usual duration of action of bethanechol is one hour, although large doses (300 to 400 mg) have been reported to produce effects for up to six hours.
Bethanechol (Urecholine®, etc.) – PetPlace.com.
Your experience with Bethanechol Chloride Please – HandicappedPet.net.
Urine Retention: Phenoxybenzamine, Diazepam, Bethanechol – The Merck Veterinary Manual.
Bladder and urethral function and supersensitivity to subcutaneously administered bethanechol in cats with chronic cauda equina lesions – PubMed.gov.: Research paper, very technical.
Phenoxybenzamine HCl – ElephantCare.org.: Phenoxybenzamine is used in small animals primarily for its effect in reducing internal urethral sphincter tone in dogs and cats when urethral sphincter hypertonus is present.
Phenoxybenzamine – PetMD.com.
Effect of Alpha-adrenergic Blockade and Anticholinergic Agents on the Decentralized Primate Bladder (phenoxybenzamine), 1985 – University of Michigan.: Research paper, very technical.
Management of the cat with cystitis – 37th British Vet. Nursing Assoc. Congress 2010, page 11.: Prazosin, Dantrolene, Diazepam, Glycosaminoglycans
How long for phenoxybenzamine to leave a cat's system – Handicappedpet.net.
Cisapride (Propulsid) – MarvistaVet.com.: If you don't read anything else, read this. Used to increase intestinal motility.
Cisapride (Propulsid) – PetMD.com.
Help with Bowel – HandicappedPet.net.: Cisapride, Lactulose
Lactulose – MarvistaVet.com.: If you don't read anything else, read this.

Catheters / Tube Cystostomy

Urinary Catheterization of the Male Cat – College of Veterinary Medicine, Washington State University.
Urethral Catheterization – College of Veterinary Medicine, University of Minnesota.: Step-by-step illustrated instructions on catheterizing dogs and cats.
The Blocked Cat – MarvistaVet.com.
Cat catheter – AllExperts.com.
Feline urinary catheters – British Small Animal Veterinary Association.: How to Choose a Cat Urinary Catheter, page 13
Long Term Bladder Issues (low profile gastrostomy button) – HandicappedPet.net.
Cystostomy: tube – VetStream.com.
Use of Cystostomy Tubes in Small Animals – VetLearn.com.: Compendium Vol.25, No.12, December 2003
Outcome of and complications associated with tube cystostomy in dogs and cats: 76 cases (1995-2006) – PubMed.gov.: Research paper; quite technical.
Minimally invasive inguinal approach for tube cystostomy – PubMed.gov.: Research paper; quite technical.
Tube cystostomy in the dog and cat – Wiley Online Library.: Research paper; quite technical.
Cancer in Dogs & Cats: Medical & Surgical Management, by Wallace B. Morrison – Internet.: See: page 236, Urinary Tract Obstruction; and page 237, Tube Cystostomy

Constipation and Bowel Management

Bowel management in incontinent pets – HandicappedPets.com MediaWiki.
Lobster Claw Massage (a) – HandicappedPet.net.: See post dated Oct 20, 2010 3:21pm, by CarolC
Lobster Claw Massage (b) – HandicappedPet.net.: See post dated Tues.Dec.22.2009 12:38am, by CarolC
Managing Feline Obstipation Secondary to Pelvic Fracture – University of Wisconsin.
Constipation in Cats – PetEducation.com.
Megacolon and Constipation in Cats – PetEducation.com.
Constipation and Megacolon – MarvistaVet.com.
Bowel and Bladder Function in the D.M. Dog – Ann Cooper.
Expressing Bowels (dog) – RiveraDogs.: At the bottom of this page are links to expressing the bladder.
How to Manually Express Your Dog’s Bladder (DVD) – Lisa Stahr from Scout`s House.: See comments on this DVD from HandicappedPets.net forum.
Constipation in Cats – Vetrica.com.
Constantly Constipated Cat – HandicappedPet.net.: A raw food diet plus a little Lactulose fixed the problem.
Cat Enema – Need, Administration and Relief – FloppyCats.com.: Great article, with pictures.
Treating Constipation in Cats: Enemas (Holistic Vet) – Dr Pollen.
Treatment of an Acutely Constipated Cat – FelineConstipation.org.
How do I give my constipated cat an enema. I am a nurse. – JustAnswer.com.
What Should I Do for my Constipated Cat? – WiseGeek.com.: Also see post no.32.

Miscellaneous Stuff

The following links are in no particular order; I have included them because each has a tiny bit to offer, but is not necessarily a "must read".

The Merck Veterinary Manual: Links: MerckManuals.com,
Atlas of radiology of the traumatized dog and cat: the case-based approach: Links: Google Books, Amazon Look Inside,; Lots of xrays of traumatized pelvis.
Urological disorders of the dog and cat: investigation, diagnosis and treatment, by Peter E. Holt: Links: Google Books, Phoenix,
Biofeedback - A Practitioners Guide: Link; Part VIII, Chapter 26, p.591: Urinary Incontinence: Evaluation and Biofeedback Treatment
Part VIII, Chapter 28, p.646: The Use of Biofeedback for Pelvic Floor Disorders Associated with a Failure to Relax
Transurethral Incision of the Bladder Neck in Treatment of Chronic Urinary Retention after Radical Hysterectomy: Links: tcs.org.tw,
Primary Surgery, Vol. 1 "Non-trauma", Chapter 13. "Urology", § Retention of urine: Links: Meb.Uni-Bonn.de,
Urodynamic Assessment: Leak Point Pressures and Urethral Pressure Profile: Links: WomensHealthSection.com,
Obstruction of the Kidney in Children: Links: Med.Wayne.edu,
Neurogenic Bladder > Mitrofanoff procedure: Links: Med.Wayne.edu,
Cubby Low Profile Gastrostomy Device: Links: MilaInternational.com,
Learning about low-profile gastrostomy devices: Links: FindArticles.com,
Urine Scald: Links: Handicappedpet.net,
Keep the urine off his skin - very corrosive. Bag balm - WWW.BagBalm.com; honey.: Links: Handicappedpet.net,
Cavilon: Links: HandicappedPet.net, Solutions.3m.co.uk,
Acupuncture (once a week): Links: HandicappedPet.net, HandicappedPet.net, HandicappedPet.net,
Assisted Feeding: Links: Pets.Groups.Yahoo.com,
Put food into side of cat's mouth: Links: AssistFeed.com,
Force feeding + Dehydration: Links: Answers.Yahoo.com,
Gerber's Baby Food, the lamb. Lamb is an easy meat to digest.: Links: City-Data.com,
Salmon / Tuna: Links: Answers.Yahoo.com,
Cat Health Guide (Bladder): Links: Cat-Health-Guide.org,
(Natural) Supplements for Cat Urinary Tract Health: Links: VetInfo.com,
Is There Any Way to Cure UTI in Cats? (Lemon Juice): Links: VetInfo.com,
How Effective is Apple Cider Vinegar (ACV) for Feline UTI Treatment?: Links: VetInfo.com,; 1/4 tsp twice a day; 1 tsp to 8 fl.ozs, store in fridge.
Add vinegar to make the urine less acid (re UTI):: Links: PreciousPets.org, HandicappedPet.net,
Anorexia: Links: MarvistaVet.com,
Hepatic Lipidosis - Fatty Liver: Links: http://www.marvistavet.com/html/hepatic_lipidosis.html,
Gastrocolic Reflex: Links: Dictionary.Reference.com,
Lactulose: Links: Harpsie.com, PetPlace.com, eHow.com, HandicappedPet.net,
Add Lactulose (2ml twice per day) to food (makes stools a bit softer): Links: AssistFeed.com, AnimalSehlter.org,
Ground Flax Seed: Links: DrPollen.Blogspot.com,
Bottled water: Mineral oil (not vaseline aka petroleum jelly)
Give extra water, as much as possible
Add bran and extra water to food (bran retains water, softens stools), but note this doesn't work for some cats
Homeopathic Nerve Remedies: Links: Forums.Hpathy.com,; Hypericum; drop one pellet into a small bottle of distilled water, without touching it. Shake vigorously 5x before every dose. Give one dropperful.
Dissection Diagrams: Links: Biology.Kenyon.edu,
Stents: Links: InfinitiMedical.com, AvmaJournals.avma.org, HillsPet.com,
Physiological and pharmacological basis for the chemotherapy of enuresis: Links: Journals.Cambridge.org,; Enuresis is a disorder of micturition occurring in the absence of an organic urinary tract lesion. To understand its possible causation, the mechanisms controlling micturition are described together with the possible sites of action of various anti-enuretic agents, particularly imipramine. It is concluded that further research into the central control of micturition is required before the precise actions of centrally-acting anti-enuretic agents can be elucidated. Knowledge of these may give insight into the nature of the defect causing enuresis.
Structure and Function of the Low Back (in humans): Links: SpinalMedical.co.uk,
The Sacrum + The Pelvis (in humans): Links: BecomeHealthyNow.com,
ProbertEncyclopaedia.com: Links: Sacrum, Coccyx,
Clinical Anatomy of the Lumbar Spine and Sacrum, Bogduk, 4th ed., 2005: Links: Link,; Nerves of the lumbar spine p.123; The sacroiliac joint p.173
The Nervous System - Spinal Cord and Peripheral Nerves: Links: Univ. of New Mexico,
Sacral spinal nerve 1: Links: Wikipedia.org,
Notes on Anatomy and Physiology: Spinal Stenosis: Links: The Tiger' Mouth, Sciatica,; Excellent large pics showing the cauda equina, spinal column and nerves
The Spine and the Nervous System: Links: PainFreeLife.net,; Great pic of the spine + explanations
Comparison of direct bladder and sacral nerve stimulation in spinal cats: Links: Rehab.Research.Va.gov,; Journal of Rehabilitation Research and Development Vol. 29 No. 2, 1992
Notes: Bladder activity after suprasacral spinal cord injury (SCI) is characterized by loss of control and contractions that do not completely empty the bladder.
Urethral opening and voiding was induced by Crede maneuver (p.18)
In three patients with central upper motor neuron lesions, voiding was difficult due to rigidity and fibrosis of the inner sphincter, but transurethral bladder neck resection was sufficient to allow for effective voiding. (p.20)
Higher urethral resistance and stimulation-induced high bladder pressure results in a thick hypertrophied bladder wall; The adverse urethral response is shown to be at the level of the membranous urethra (p.21)
Location of bladder preganglionic neurons within the sacral parasympathetic nucleus of the cat: Links: ScienceDirect.com,; Bladder preganglionic cells were located primarily in the intermediolateral grey matter of sacral cord segments 1, 2 and 3 and extended from the ventral end of the central canal to the inferior margin of the dorsal horn.
Fracture/Luxations of the Sacrococcygeal Area in the Cat: A Retrospective Study of 51 Cases: Links: Veterinary Surgery, Volume 14, Issue 4, pages 319–324, October 1985,; Abstract: Traumatic injury of the sacrococcygeal area occurs frequently in young cats of either sex. Case records of 51 cats with injury to this area that were treated at The Ohio State University Veterinary Teaching Hospital were reviewed. Injuries of other structures also were present in 84.3% of the cats. Temporary or permanent urinary incontinence was observed in 37 of the 51 cats. The prognosis was good for return of normal urinary function in cats that had anal tone and perineal sensation at the time of initial examination. Rear limb, tail, and urination dysfunction generally returned to normal within 1 month. Cats that were unable to urinate normally within 1 month after the injury did not recover normal urination habits during the 2 to 36 month follow-up period.
Diagnosis, therapy and prognosis of neurogenic disorders of micturition and defecation in the dog and cat: Links: München Univ. 1998,; Abstract: The most frequent reasons of neurogenic disorders of micturition and defecation in the dog and cat are traumatic injuries of the sacrococcygeal area and the thoracolumbar disc disease. They can be diagnosed by a careful clinical-neurological and radiological examination. From 1985 to 1997 276 cats and 112 dogs with a sacral fracture or a sacrococcygeal luxation were treated at the Surgical Veterinary Hospital at the University of Munich. The sacral and sacrococcygeal alterations were subdivided in abaxial and axial sacral fractures and sacrococcygeal luxations by means of radiographic findings. The careful neurological examination of the patient is very important for the judgement of the extent of damage o the sacral and caudal nerves. The more severe the neurological deficits are, the poorer the prognosis for the patient's recovery is. Concerning the micturition and defecation, of the 78 cats with an abaxiaI sacral fracture 72 patients (92,3 %), of the 125 cats with an axial sacral fracture 77 patients (61,6 %) and of the 73 cats with a sacrococcygeal luxation 44 patients (60,3 %) recovered. Of the 36 dogs with an abaxial fracture 34 patients (94,4 %), of the 64 dogs with an axial fracture 45 patients (70,3 %) and of the twelve dogs with a sacrococcygeal luxation seven patients recovered. A complete recovery of the disorder of urination and defecation even with severe neurological deficits is possible after three to four months.
Management of Pelvic Trauma: Neurological damage, urinary tract disruption and pelvic fractures: Links: Journal of Feline Medicine & Surgery, Vol.13, Issue 5, May 2011, pp. 347-361,; Cats commonly present with pelvic trauma following road traffic accidents (RTAs). A logical step-wise approach to diagnostics and subsequent management can significantly improve the prognosis in the majority of cases. This article provides a practical guide to assist decision-making and optimise management of these cats.
Affected cats may have sustained trauma to several body systems and, hence, their management can be complex, requiring good clinical, diagnostic and surgical skills (often both soft tissue and orthopaedic!).
Any cat allowed access to the outdoors is potentially at risk of being involved in an RTA and sustaining pelvic trauma. Young male cats are most commonly affected. Many original articles and textbook chapters have been published on aspects of pelvic trauma. However, to the authors’ knowledge, this is the first comprehensive overview of the assessment and management of the feline pelvic trauma case. The review begins by discussing initial triage and neurological examination, and then focuses, in turn, on assessment and management of the ‘tail pull’ injury, the diagnosis and management of urinary tract rupture, and the approach to managing specific pelvic fractures.