Howard Battles Urinary Issues

Sometime after Carnival, I noticed that Howard was going in and out of his litter box much more than usual, with no result. Not passing urine is a major concern for anyone, animal or human, so after almost 24 hours I called the nearby veterinary clinic, associated with St. George’s University, to tell them that we were on the way. We packed Howard into his “travel house,” and dinghied over to Prickly Bay Marina, where a man named Bernard was always waiting in his taxi for a fare.

We arrived at the clinic, checked in and prepared to wait, since we hadn’t made an appointment. Almost immediately, a vet came out to talk with us, and when she confirmed that Howard hadn’t passed urine, took us back to a room for an exam. Now unfortunately, Howard is not the best patient; in fact, he’s a terrible patient…lots of hissing and growling. So much so that there’s a “Caution” sticker on his file at our home vet back in Baltimore. There wasn’t much need for an exam it seems, as the vet quickly decided to keep Howard, and catheterize him. Ugh. Howard would be catheterized for at least two days, so we were sent home, and told that we were welcome to visit the following day.

The next afternoon, we took the dinghy over to Budget Marine’s dock, and made the quick, but hot walk to see Howard. The road leading to the clinic doesn’t get a breath of breeze, and in the middle of the day, it’s definitely “hot-sun walking.” (As a local said to Scott, with respect, while passing him on the road in Grenada, during peak heat hours; Scott received a fist bump, for his hot-sun walking).

We arrived, wiped off the sweat and cooled down in the air conditioning for a bit, before someone came to escort us back to see our cat. As soon as he heard my voice, Howard chirped, and perked up. He had a catheter tube coming out of his penis, that was taped to his tail. An iv tube was taped to his front leg, and there was a cone around his neck so he couldn’t chew at any of the tubes.

The preferred treatment for a urinary blockage is to place a catheter for three days, while giving a drug that relaxes ureter. Unfortunately, the clinic didn’t have the drug in stock, and there was none on the island; so instead, Howard was given Valium in his iv, along with a painkiller. Despite being a bit loopy, he was happy to see us.

By day two, Howard had enough of wires and tubes. He managed to get the cone off, and remove both the iv and catheter. He had to be put back under sedation to reinsert everything, and an additional sedative was added to his iv meds. With the addition of the third drug  in the mix, we noticed that Howard was much more mellow, and not as responsive at our next visit..

Everything looked great after three days, so the vet removed everything and waited for Howard to pee on his own. He couldn’t, so another catheter had to be inserted. When they sedated Howard, they found some mucus blocking his ureter. It was physically flushed out, a second catheter and iv were inserted, and an additional calming/sedative drug was added to his iv meds.

By the time we visited on day seven, Howard was almost completely unresponsive. He had so many drugs in him, and had been sedated so many times, I cannot believe he wasn’t drooling on himself. His condition had me in tears, and the vet on the case decided to cut him off of all the drugs, and send him home with us.

Back on board the boat, Howard was a mess for the next 30 hours. He had several bouts of what we thought must be his body detoxing the drugs. His temperature shot up, and he moaned as he was breathing. We laid him on an ice pack that was wrapped in a towel, and covered him with towels soaked in ice water, while a fan blew on him.

When he began to growl while in the litter box, I realized that we may have to take him back to the clinic. The thought of Howard having to start that whole process over again turned my stomach, but he needed help. We broke down and decided to go back to the clinic, which thankfully is staffed 24-7.

With no idea how to get a cab after midnight, Scott headed over to Prickly Bay Marina in the dinghy. As luck would have it, there was a Meriweather vs. “Someone-I-don’t-know” fight going on, so the tiki bar was open later than usual. Scott informed the bartender that we had a vet emergency, and asked if there was a cab in the area. She immediately came from behind the bar, and went into the crowd to talk to a man who immediately went to get his van to take us. Scott explained that I was still on the boat with our cat, and he agreed to wait (Again, Grenadians, the friendliest people ever).

During all of this, the heavens had opened, and Scott came back to the boat soaked and dripping wet. We loaded Howard into his carrier, and went to the dock..in the still-pouring rain. The van took me to the clinic, while Scott went back to get dry clothes and raincoats. He then motored the dinghy to the far side of the bay, and walked to meet me.

Once the vet arrived (he too was out watching the fight), he had me hold Howard, so that he could feel his bladder. It was full, and as he felt it, urine leaked out. Realizing the Howard wasn’t completely blocked, the vet manually emptied the bladder (much pressing and squeezing). Howard was very angry, and growling, but quiet off and on, as I think he realized the doctor was relieving his pressure.

As I continued to hold Howard, the vet was able to do an ultrasound of the bladder. Satisfied that there were no crystals or stones, he opted to put Howard on anti-inflammatory pills for five days, and sent him home, not wanting to re-start the drowsy-drug carousel. Scott and I were both thrilled, and headed back to the boat with our cat.

Unfortunately, Howard still wasn’t able to pass urine, and was also still growling when in the litter box. We had to again return to the clinic, where they inserted another catheter and iv. We felt so bad for our boy, that he didn’t understand what was going on. It broke my heart that he went to sleep, and woke up with a catheter and iv back in. We visited every day, and Howard would just want me to rub and scratch his head and face, especially the area where the cone lay against his neck.

I cannot say enough about the veterinarians and staff who helped us. The clinic was large, clean and bright, with all the facilities you’d expect in the U.S. Howard was in a cage located in the main treatment area, where people were near him all day. They all just wanted to pet and love Howard, but he was not having it. It made me so sad, as I’m sure he’d have felt a lot better getting love and attention all day, and not just during our visits.

After several more days, the doctors again felt sure that there were no crystals or stones in Howard’s bladder, but sent his urine out for further testing, just to be sure. We again brought Howard back to the boat; however, if he blocked again, we’d be facing the fact that there was a good chance that surgery was in his immediate future. The procedure involves cutting off the penis, and changing the route of the urethra, so he would urinate like a female cat (they have a shorter, and more wide urethra), allowing any stones or crystals to pass through. The recovery is challenging, and the risk of recurring urinary infections is high…oh joy.

Because Howard was so wobbly and loopy (20 mgs of Valium per dose!), we were now on round the clock shifts, so one of us could constantly be with him. We’d follow him back and forth, from the couch to the litter box, checking for progress, and all surfaces in the saloon were now covered with trash bags and towels, to keep up with the dribbling of urine.

The clinic contacted us to say that Howard’s urine test showed an angry infection, most likely due to the several catheters that had been inserted and removed. We were given an antibiotic, and hoped for improvement.

The clinic was still unable to get the preferred drug for relaxing Howard’s ureter, so I contacted my vet back in Baltimore, who ordered it for us. I then contacted our friend, Christine, to see if she would mind picking up the drug and shipping it to us. She immediately left her desk at work, went to the vet and then straight to Fed Ex…a life saver! The package was scheduled for a three- day delivery, but the coming weekend meant a delay for picking it up in Grenada.

Worried that Howard may block again before the drug arrived on the island, Scott and I reluctantly decided to take our poor cat back to the clinic, so he’d be on site, just in case. It meant another catheter and iv for Howard, and this time he wasn’t in the main area, but down the hall in a room by himself. While it may have been more quiet for Howard, there was no way the staff could keep a good eye on him there.

The first day we arrived to visit, Howard’s bedding was wet, as he’d obviously leaked urine on it. Most of the staff were too scared to go into the cage, so Scott and I changed the wet blankets out for dry ones.

The next day, in addition to being wet, the bedding also had poop on it. Sigh….we again cleaned his cage. During our visit, we noticed that whenever Howard was in the litter box, he would arch his neck, mouth wide open and move his head side to side. After passing only a few drops, he’d come out and lay on his side. His whole body would curl up, and he’d release a small puddle of urine onto the bedding. We were obviously upset by this, and alerted the staff, who told us that it was a reaction to the pain of the urinary infection….hmmm.

We arrived on day three to a pitiful sight. In addition to urine, and poop, there was blood on Howard’s bedding….blood?!? We managed to flag someone into the room, who told us that Howard had again managed to get his iv out (the fourth time, for Houdini Howard), and it had bled for awhile, before they’d noticed and replaced it. I brought to their attention that his current iv paw was very swollen, and we helped to re-tape it. Our poor cat now had parts of all four paws shaved, from so many ivs. Howard’s mood was so depressed that he just lay in my lap with his eyes closed. It was time to take him home, I’d risk a blockage.

Back on board, Howard was still doing the strange head wobble, open-mouth thing while in the box, and curling his body to release urine while laying on his side after. Scott recorded video if this, and took it to the clinic for the vets to see. They were immediately concerned, and Scott was told that Howard was having seizures. I was more than miffed upon hearing this news, as we’d tried to call their attention to it previously. Scott came home with an anti-seizure med.

We were now dealing with constipation, due to all the drugs and sedation. We took Howard in for an x-ray, that showed he was full of poop..which I’d already tried to explain. The vet administered an enema, which Howard didn’t release, and suggested we take him home where he’d be more comfortable. We also came away with some laxative, to keep things moving.

We made the ten minute walk back to the dinghy, with Howard in his carrier, and then headed for the boat. Just as we were tying to the swim platform, Howard became very agitated, so I got him on board, out of the carrier and to the litter box as fast as I could, with a trail of liquid poop behind me. I left him to finish in peace, and cleaned up the poop trail….poor animal.

The muscle relaxer drug arrived, taking the number of meds that Howard was getting to SEVEN: anti-imflammatory, Valium, painkiller, antibiotic, anti-seizure, laxative and the muscle relaxer (most all causing drowsiness). Because poor Howard was so drowsy, we were able to administer the barrage of meds with little trouble.

We were still on round the clock watch, keeping an eye on the litter box, and making sure that Howard wouldn’t hurt himself. The poor animal just wanted to feel normal, and would wobble to the door of the saloon, wanting to go outside. I would carry him out into the cockpit, and we’d look at the water, his head laying over my arm.

Soon, the vet was ready to begin weaning Howard off most of the meds, which we were thrilled about. Over the next several weeks, we whittled down, until Howard was only getting the muscle relaxer twice a day. His mood, and balance improved, and although not completely normal, he was passing much more urine each day.

We had a trip home scheduled, that had to be postponed three times. It was to be Scott’s first trip home in two years, but there was no way we could leave Howard in someone else’s care while he was so sick.

After seven weeks of hell for all three of us, Howard was thankfully doing much better, and began to wander out to the cockpit on his own, to look for fish, nap and oversee boat projects.

Notice the “poodle paws”

He even began to feel good enough to climb onto his dinghy “jungle gym.”

We could finally breath easier, but I still felt terrible for all our poor cat had been through. Scott tells me that Howard is young and tough, and won’t remember this, once he’s back to his old self. I hope it’s true.

“Shells Sink, Dreams Float. Life’s Good On Our Boat!”