Manual Expression of Bladder

[Love4himies]

Puddles had her bladder expressed and now is in pain and blood coming out. Has anybody had this? The vet thinks it is from bruising.

They gave her a shot of Torbugesic for pain. Please tell me this is safe for cats

[krdahmer]

Oh no poor Puddles...I've had to have that done twice once with Smoke and once with Fagan, but I've never had a problem with blood afterward. I hope they didn't hurt her!

[Love4himies]

I know, the vet has never has this happen either. She was in pain and then the blood came out. Xrays show a normal bladder and no dark fluids around the bladder.

I hope I haven't killed her

[rainbow]

As far as I know Torbugesic is safe for cats.

I've never had a cat that needed to have its bladder manually expressed but I sure hope that Puddles will be okay.

[Love4himies]

Thanks Rainbow. OMG, I am not going to sleep tonight. So far no more blood, but she hasn't peed yet either.

[Rgeurts]

Originally Posted by Love4himies

I hope I haven't killed her

Poor baby
I will be sending lotsa & that she will be ok!

If he did hurt her, it isn't your fault in any way

[Love4himies]

Originally Posted by Rgeurts

Poor baby
I will be sending lotsa & that she will be ok!

If he did hurt her, it isn't your fault in any way

Thank you, Rgeurts, but I had the choice, using nosorb or manual expression, the problem with nosorb I can't get her to pee and if she does, the vet office is closed.

[Rgeurts]

Originally Posted by Love4himies

Thank you, Rgeurts, but I had the choice, using nosorb or manual expression,

You pay alot of money for vet care and assume they know what they're doing and would explain any risk so you can make the proper choice. If that wasn't done, it's not your fault at all, so you can't blame yourself


the problem with nosorb I can't get her to pee and if she does, the vet office is closed.

You made the only choice you could

[Winston]

L4H both Tabitha and Bomber have had the expression. I think it just depends on the vet and if they think there is enough urine in there to get a sufficient sample. I am curious though why he didnt opt for the cyntesis?? sorry not sure of the spelling but they draw the urine out with a needle. Its the most sterile way apparently.

Was the urine specific gravity 1.050? Bomber was given the same medication for pain when he was in the care of the vet. I saw it on his chart. The results for puddles are very similar to Bombers. With antibiotics it cleared up the bacteria and the blood. It also dropped the ph level a bit as well.

She may not want to pee for quite awhile and if she is one that can typically hold it your likely in for a long wait. Tabitha was not too anxious to pee after he expression. I guess they must feel some pain right? I know I would.

Sending you lots of good vibes and positive thoughts! you have to stay positive because they certainly know when your upset..

[sugarcatmom]

Poor Puddles, and poor you! Sorry to hear about your experience. I honestly don't understand why a vet would opt for manual bladder expression over cystocentesis, which is a much "cleaner" method of urine extraction. Here is some info for you: http://www.vet.uga.edu/vpp/CLERK/Sine/

Sample Collection

Urine should be collected in a clean, dry container that is free of any disinfecting or cleaning chemicals. Samples may be collected by free catch of voided sample, manual bladder expression, catheterization, or cystocentesis.2

Voided samples are the easiest and least invasive samples to collect. However, voided samples may have contaminants that include bacteria, epithelial cells, and white blood cells.1 Red blood cells should not be found in normal voided samples. Voided samples should be collected midstream to lessen contaminants from the vagina or prepuce.3,4 Collection of samples from surfaces such as floors, cages, and litter boxes should be avoided, since these will introduce environmental contaminants.

Manual expression of the bladder is another technique used in urine collection. In this method, the patient’s bladder is gently squeezed until urine is expressed. This technique may lead to bladder trauma resulting in hematuria, and in some instances (such as urethral obstruction) may result in a ruptured bladder.5 This method may have the same cellular contaminants as a voided sample.

Catheterization is performed by placing a small hollow tube into the urethra to the level of the bladder. Urine is then withdrawn from the bladder using a syringe. Catheterized samples have less contamination from the distal urogenital tract; however, contamination from the urethra may still occur. Contaminants include epithelial cells or red blood cells. Poor catheterization technique may lead to trauma or, less commonly, infection.3,4,5

Cystocentesis samples are collected by inserting a sterile needle through the body wall into the bladder. Urine is withdrawn from the bladder using a syringe. A lateral or ventral approach to the bladder may be made without causing severe trauma to any vital region of the bladder. Clipping or surgical preparation of the area along the body wall is not necessary prior to sample collection. Often a 1 inch or 1.5 inch 22 gauge needle is used attached to a 6 or 12 cc syringe. The bladder is manually immobilized and the needle is inserted through the abdominal wall into the bladder, and the urine is withdrawn. It is important to stop aspirating prior to withdrawing the needle as this may lead to aspiration of blood cells or epithelium from the bladder wall. Animals often tolerate cystocentesis very well and little restraint is needed. Contaminants that may be found include iatrogenically introduced red blood cells. 3,4,5 Rarely, enterocentesis may occur which results in a sample containing bacteria, intestinal villi and other intestinal contents.

[krdahmer]

when my guys had it done, they both didn't pee until early to mid day the next day....i think that's normal. hopefully the blood is just stress or something, and you said the xray showed the bladder was ok after the procedure right?

[Love4himies]

It looked like the bladder was OK.

He didn't do the cystocentesis because Puddles is not a good patient and it would be very difficult.

OMG, I am just so stressed.

[14+kitties]

I wish I could say something to make you feel better. I know it's not your fault in any way. Vets are supposed to know how to do these things properly. Meowzer had it done a couple of times. Once successfully, once not. He was not a happy boy either time.
and everything else I can think of mf.

[growler~GateKeeper]

Originally Posted by Love4himies

Puddles had her bladder expressed and now is in pain and blood coming out. Has anybody had this? The vet thinks it is from bruising.

Originally Posted by Love4himies

I had the choice, using nosorb or manual expression

Originally Posted by Love4himies

He didn't do the cystocentesis because Puddles is not a good patient and it would be very difficult.

How does this vet expect her to react the next time she sees him? If she was "difficult" before, she'll probably be worse now

I honestly can't understand how the vet thinks a cysto would be more difficult to do than a manual expression on a cat whose "not a good patient"

but what does he do w/cats that show signs of aggression

Originally Posted by Love4himies

They gave her a shot of Torbugesic for pain. Please tell me this is safe for cats

Originally Posted by Love4himies

So far no more blood, but she hasn't peed yet either.

The discomfort from having her bladder squeezed will certainly not make her want to pee, as well as the side effects of the sedation won't help that either

A conventional vet in 2009 gave Duffy a small dose of Torbugesic prior to a manual stool evacuation -after not allowing me to instead give her a homeopathic remedy she'd had before- I told them she had an appointment with an eye specialist in a couple of hours & I was told it would clear her system in about 2 hours & she would be fine.............12 hours later she was still loopy - totally out of it, unable to eat/drink/walk she was so unsteady. I had to bus out to the Homeopath Vet, 2 cities away, at 11pm after they were closed to pick up a remedy they left outside for me in order to counteract the effects, got home @ 1am to give her the remedy.

http://www.2ndchance.info/pain.htm
Some possible side effects are loss of appetite, vomiting, incoordination, and restlessness

http://vettechs.blogspot.com/2007/07...orbugesic.html
One of my biggest frustrations is the vast number of people who are sent home with nothing more for their pet's post-surgical pain than butorphanol, also called torbutrol or torbugesic. This is a drug that really has no place in the management of pain in dogs and cats, and I devoutly wish vets would stop prescribing it.

Often the sedation outlasts the analgesia. Canine studies have failed to demonstrate analgesia past 45 minutes[i],[ii]. Feline studies have failed to show analgesia past 90 minutes[iii],[iv]. In fact some studies have failed to show analgesia of any significance in dogs and cats[v],[vi].

http://www.drsfostersmith.com/Rx_Inf...utorphanol.pdf
Use with caution in animals with hypothyroidism, liver or kidney disease

http://www.drugs.com/vet/torbugesic-sa.html
Adverse Reactions
In clinical trials in cats, pain on injection, mydriasis, disorientation, swallowing/licking and sedation were reported.

http://www.ehow.com/about_5526834_si...trol-cats.html
Side Effects
•Sedation is common in cats when butorphanol is used in lower doses as an antitussive (cough suppressant) or painkiller; in higher doses, respiratory depression is common. Some cats may become so constipated they are unable to pass stool. Other cats will develop diarrhea. Bradycardia (lowered heart rate) can occur when butorphanol is administered pre-surgically, but veterinarians are aware of this side effect and commonly monitor the sedated animal's heart closely. With severe respiratory depression, a drug called naloxone can be used to reverse the effects of butorphanol.

http://www.vasg.org/perioperative_pa...nt_part_ii.htm
BUTORPHANOL (torbugesic, torbutrol) is a kappa agonist with moderate sedative effects capable of providing mild analgesia. Often the sedation outlasts the analgesia. Canine studies have failed to demonstrate analgesia past 45 minutes[i],[ii]. Feline studies have failed to show analgesia past 90 minutes[iii],[iv]. In fact some studies have failed to show analgesia of any significance in dogs and cats[v],[vi]. Interestingly, Lascelles & Robertson’s research in cats failed to demonstrate a difference in the analgesic intensity or duration as the dose was increased from 0.1 mg/kg to 0.8 mg/kg4. A significant number of these healthy cats demonstrated dysphoria when butorphanol was used as a sole agent.

**Dysphoria is defined as depression, anxiety, irritability, restlessness**

Butorphanol 0.2 to 0.4 mg/kg can be combined with either acepromazine or medetomidine in healthy patients to create an effective preanesthetic or procedural sedation combination. Butorphanol can also be combined with a benzodiazepine, either midazolam or diazepam, to sedate aged and less healthy patients. Butorphanol is not an effective analgesic when delivered by the oral route as butorphanol undergoes significant first-pass metabolism after oral administration. Couple the low oral bioavailability with butorphanol’s short duration of effect and you would have to give a dog at least 1.0 mg/kg every 45 minutes to gain any meaningful analgesia.

A logical companion for butorphanol is buprenorphine. Butorphanol’s analgesic onset is rapid but the mild analgesia is of short duration. Buprenorphine’s time to peak analgesic effect is quite slow even when given by the IV route but its analgesic duration can be quite long. When administered together, butorphanol’s short-term analgesia wanes as buprenorphine is reaching its peak effect.

One additional application for butorphanol is that of a mu antagonist. If a patient is exhibiting undesirable mu agonist effects while on morphine or hydromorphone (dysphoria, excess sedation, or excessive respiratory depression) butorphanol can reduce the unwanted mu agonist effects without total loss of patient analgesia.

In general, butorphanol does NOT give you much bang for the buck. Butorphanol costs about ten times more than morphine, per dose, while providing much more limited analgesia of much shorter duration.

[mike45]

My cat would not go on it for a whole day!!!
My vet gave me Kit4cat which worked out really great, just had to put it in the cat's litter box and he went on it as if it was is reguler litter, urine stayed on top and it was very easy to collect it - go Kit4cat

[Love4himies]

Originally Posted by mike45

My cat would not go on it for a whole day!!!
My vet gave me Kit4cat which worked out really great, just had to put it in the cat's litter box and he went on it as if it was is reguler litter, urine stayed on top and it was very easy to collect it - go Kit4cat

I have never heard of that, thanks Mike.