Care of Spinal Cord Injured Cats

There are many ways a pet cat can be injured which result in damage to the spinal cord. Most of these injuries occur in cats who are allowed to roam freely outdoors. Cats are hit by cars, caught by dogs, shot by humans.

If you have found this website because you have been searching for information on how to care for your own cat who has been injured, then please accept my sympathy. I am sorry for your pain, and your pet's pain.

Your vet may have already told you that your cat's chances are not good. Your vet may have recommended you put your pet to sleep. You may have heard the words 'there is no hope' or 'we can try but...'

I can not give you any promises. What I can give you is information that your vet may not have. Very few vets have contact with clients who have successfully maintained a paralyzed cat, so there is little information commonly available.

I am making the assumption that you have already done life preserving and diagnostic procedures such as emergency care, x-rays, MRI's, surgical decompression and repair (if possible) and that your pet is not in immediate medical danger.

If not, then log off and get your cat to a vet or emergency vet right now. This page will still be here.

This is written for the lay person, for the pet owner who knows little about anatomy and medical terminology. This is not meant to be a definitive medical document.

Not all spinal cord injuries are survivable. If the injury is high enough (towards the high chest), your cat may not be able to breath, because the nerves that control breathing are damaged. Injuries that destroy all mobility may not be survivable. Tumors, illness, 'saddle thrombus', strokes, 'thrown clots' may not be survivable. This is for owners of cats who have had traumatic injury to their spine.

Most who find this page will be several days to several weeks or months post injury, looking for something, anything that can give their pet a chance.

Each pet is different, but if you are here I will assume that you want more than anything else to try to give your pet a chance at adapting to living paralyzed. This information is for those cats who post injury have little or no use of their back legs, and no ability to urinate. If your pet can urinate on it's own, and has feeling in it's legs, although you will get care ideas from this, this information is geared for more severely injured animals.

During the initial healing stage your cat may not be able to use their back legs at all. They may drag out behind them, or have random movements.  Random movements can fool you, you may believe you are seeing thought and desire generated attempts at steps. Be patient, and also be pessimistic. Many random movements are muscle spasms, or random signals coming from the spine below the injury, not from the brain. There may be no feeling or awareness associated with these movements. Because your cat can not feel, you must provide them with a soft protected surface. What I use is a collapsible playpen, lined with a thick soft blanket (for traction) then lined with adult flat diapers. You must provide a soft confined area, because 'wear sores' and other limb injuries can occur.

At this time you will need to work with a veterinarian, or skilled veterinary nurse. You will need to locate by feel your cat's bladder, and learn to empty it. It takes a while to learn this. Most veterinary nurses can not find and feel a bladder, and can not empty it until they have practiced many times. Hang in there, keep trying and keep getting help. Your cat must be able to have it's bladder emptied no less than once every 24 hours- and most cats do not do well if they care not emptied every 8 to 12 hours. This is where owners give up, unable to believe they can learn to locate and empty a cat's bladder. Well, you are not much different from a beginning nurses assistant in the veterinary field. We all start by knowing nothing and we all learn. You are no different than us, so if you can, try to hang in there. If your vet can't or won't help you, find one that will.

The bladder feel like a firm but flexible ball towards the pelvic bones. It will slip and slide out of your hands. You may have a hard time learning to feel the difference between a  full bladder, a kidney and a stool filled colon. Bladders are not 'water balloons', they are much thicker, stronger and stiffer. When you have a bladder in your hand and put pressure on it, your cat's genital area may 'twitch', as bladder signals run to the muscles that control urination.

My preferred bladder emptying position is with one of my cats in my left hand, my left arm under their belly and my left hand 'gripping' their abdomen with thumb and finger tips reaching up toward the spine. My right hand is on the top of their back, just in front of their hips, open and pressing down. Both my right and left hand are reaching up towards the spine, and around over the spine to isolate the bladder, and manipulate it. I am right handed.

Once I locate the bladder I grip it in my left hand and put steady pressure on it to tire the muscles out, and press the urine out. Aim into a litter box, or somewhere you don't mind cleaning up. It's hard to aim well, so be prepared. Wear old clothes the first few times until you get the idea.

My goal is to empty the bladder as completely as possible. Retained urine is a breeding ground for bacteria. Bladder infections can kill these guys.

Alternate ways to empty the bladder include sling walking less injured cats, so the pressure of the sling puts pressure on the bladder and triggers reflex urination, and also using 'baby wipes' to stimulate the genital area to trigger reflex urination much like when a mother cat grooms her kittens to make them pee.

Plot complications. I have found that if a cats colon is full of stool I can not empty them. Keep your cat regular by adding fiber to their diet and keeping them as active as medically advised. Fiber can be added by mixing a tablespoon of canned pumpkin or baby food winter squash, or baby food yams to feline wet food. Most cats eat pumpkin well. Freeze canned pumpkin in ice cube trays and defrost a cube as necessary. You may need to learn to give enemas occasional as well. Once you have a food that works to keep your cat healthy and keep his or her colon empty enough, do not change foods.

Bladder care also includes monitoring your cats urine for infections or other imbalances. Both of my spinal cord injured cats are male, both have had problems with urine PH, struvites crystals, infections and so on. Both have had a surgery called a urethostomy (P.U. surgery) to make the exit from their bladder large and easy to 'squirt' through. This larger opening is also easy to see from the outside and if I need to I can pass a sterile urinary catheter, using sterile technique.

This is not a 'cheap' surgery. Often a veterinary specialist/ surgeon is needed to do it. If you have this some, please let the surgeon know your cat is paralyzed (sometimes a surgeon only sees the pet once it is on the surgery table, anesthetized. If no one tells them they may not know the pet can not walk) and the goal is to give the largest opening possible. The recovery is about 14 days. The healed site must be kept clipped free of hair and kept clean.

Medical considerations.

Anesthetics.

Both of my cats require additional care when they are anesthetized. Pumpkin can breath on his own under anesthetic, Boogar needs to have assisted breathing, as his break is higher and interferes with his reflex breathing under gas anesthetic. Inform your vet that while under anesthetic, your cat may not be able to breath on his or her own, and that a nurse may need to breath for him. This is called 'bagging', or mechanical ventilation.

Boogar can not be 'masked down' well. This is where gas anesthetic is given by a mask so a cat breaths it and falls asleep. Because Boogar can not take full deep regular breaths when he goes under, he can not fall asleep easily and can not get enough oxygen for this type of anesthetic. Some cats will have this problem, some will not.

For safety, require that your cat have an IV catheter placed for any and all anesthetic procedures. 

Long term medications.

Both Boogar and Pumpkin are on a urinary acidifier nightly, to keep the PH of their urine unfriendly to bacteria. This is lifetime.

I have found Bethanicol to have no functional on triggering reflex urination, however it does increase the tensile reactivity of the bladder wall, making the bladder react to pressure a little better. It also seems to help activate the colon, helping with defication. Because of it's cost and lack of measurable effectiveness on the bladder I do not use it.

Smooth muscle relaxants. No measurable effect on urination, however they do make adult injured cats calmer  and make them able to learn to adapt to daily manipulation better.

Antibiotics. Culture the urine every 6 months AND at first sign of bladder infection, prescribe antibiotics as MIC indicates, re-culture post antibiotics. These cats are at risk for antibiotic resistant bladder infections. If they are catheterized frequently culture them regularly. MRSA is no joke and it is an emerging problem in veterinary medicine. Antibiotics may distrub the gut, and if your cat's gut is disturbed (gas, diarrhea, etc) it may be difficult to empty the bladder.

Wound care. These cats are at risk for pressure sores, scrap and rub sores and burns as they do not feel heat or friction on areas of their skin. Clean and wrap foot wounds, and culture them if they do not heal. I use honey wraps on foot wounds. Pumpkin at this time needs no foot wraps, Boogar has one foot wrapped all the time for protection.

Limb injuries. These cats are at risk for dislocations caused by catching a numb limb and pulling it out of joint. They can also break limbs. Also, the longer they live the higher risk they are for degenerative joint changes. Boogar is 10, and because he ' frog hops' to walk, his real knees, hips and hocks are damaged to the point the joints are too lax and too arthritic to support his weight.

Pain management. Sometimes these cats hurt. As the spinal cord regenerates and goes through it's changes, there are times these cats will have excruciating nerve pain. Medicate them. Tramadol has worked well for Boogar. Bladder pain from infections can be present as well, amitryptilan seems to work to diminish bladder pain in these cats.

Wheel chairs for pets. Although Boogar and Pumpkin both used a wheelchair (K-9 Carts makes them) and gained a better understanding of how to 'walk' in them, for household use they are impractical. They are a training aid, helping to teach walking position to cats who are recovering and either re-learning walking or learning to spinal cord reflex walk. They are expensive and require a custom fit. An alternative is to frequenlty 'sling walk' your pet.

Transitions, adult cats who are hurt. An adult cat who has been accustomed to walking, running, playing and jumping may not be happy being unable to do those things.  It is up to you to evaluate that. Adult cats who are injured get depressed, struggle with physical challenges and react to changes just like people do but without the ability to think their way through things.  Be prepared to train your cat to permit you to handle them in ways they have not been accustomed to. Training a cat takes time, constancy, repetition and rewards. For example, Boogar knows several commands. "UP", means wait for me to help him up on furniture. "Pee" means wait for me to pick him up to empty his bladder. He has also learned to solicit his bladder being emptied and I have been 'trained' to recognize his signal, which is for Boogar to tug on a bed spread or couch cover with his teeth. So it goes both ways.

End notes..

I could write much more, but these are basics. As I have said before, I will consult with pet owners and veterinary staff.

My background includes 30 years of veterinary nursing, with focus on feline medicine, avain and exotic medicine, emergency nursing and specialy surgical (neurosurgery & orthopedic) nursing. I have worked with the best doctors and the best veterinary surgeon on the west coast.