When I first saw the little stray with the deformed tail in my yard, I was saddened; just filled with pity and sadness. But only for an instant. The sadness, the sorrow for this tiny little kitten whose tail was obviously deformed, and whose entire backside was covered in her own urine from complete lack of nerve supply to her bladder , completely gave way from pity to love as we took her in and got her treatment.
We named her TeeTee Sprinkles, and despite her dribbling urine and stool everywhere on a regular basis, she was a wonderfully healthy and happy little cat. TeeTee had no idea she had such a birth defect, and at times, even I forgot she did. As she grew, the dribbling of urine remained the same, but the bowel accidents started to lessen in frequency, and I assumed that she was improving with age. After all, the vets who saw her never once indicated that bowel problems were a thing I'd have to watch for in her future. Unfortunately, it was.
Just a few months ago, I was in the middle of my daily routine, cleaning up after the cats, etc., and somehow, on a whim, I went to do an abdominal check on TeeTee. I don't know why I did; but I did, and I was instantly shocked, and almost a little nauseated, when I pinched at the skin on either side of her back and felt a HUGE mass there.
At first I thought it was cancer. I mean, she had been feeling great; no signs of illness. Nothing to indicate something was obviously wrong, so I wondered if this was some tumor. But as I felt at it, pinched, and prodded, I realized that this mass was where the colon probably was, and then I thought about something I'd heard about before: Megacolon; a condition where the colon no longer functions properly, thus enlarging and making it impossible for stool to exit the body.In record time, Tee was in a carrier, and I was frantically on the way to my vet.
My regular vet took her out of her carrier, took a pinch of the abdomen, then tried to insert a thermometer into her hind area, and when it wouldn't even go in an inch, he looked at me with this hopeless look and started to tell me about Megacolon, ending with "I'm afraid it's terminal, and euthanasia is the humane thing".
I panicked for a second!!!! My mind went blank, and I had no idea what to do. There was this tiny little thing sort of tugging at me, saying "Wait a minute......there's something you remember, something that disagrees with what this man just said", yet my mind couldn't bring up just what that something was.
In the same instant that the vet finished telling me to put my girl to sleep, and at the very minute my mind was nagging at me to disagree with his suggestion and to remember something hidden in my brain, little TeeTee looked up from that surgical steel table at me and let out this profound "MEOW!", as if to say "NO, MOM!!! Remember!!!!!! "
And then I remembered. I had a friend with a cat who had this condition. I had read a little on the subject because of that, and from the information I'd read, I knew that megacolon WAS treatable. It was BY FAR no death sentence! In that tiny yet urgent meow, I knew that TeeTee wasn't nearly ready to go to the Rainbow Bridge.
So, I told my vet "NO!" to the euthanasia, and went home to start doing research. I quickly found out that megacolon was indeed treatable, managable, and with a certain surgery, even curable. I checked other vets around town out, and finally decided on one who'd told me they'd had experience treating megacolon, and that they could see TeeTee immediately, and decide on the next step of her treatment.
Common sense told me that TeeTee's megacolon had to be a result of her birth defect; from poor nerve supply to her entire end area. I also knew that it would be impossible to put new nerves where non-working or non-existant nerves were, so I researched the surgery, called colectomy, further, talking to people whose cats had been through the surgery, as well as reading all the literature on the procedure that I could. So, by the time TeeTee and I walked into our new vet's office, we were armed with information, and were leaning towards the surgery.
The minute I took her out of her carrier and placed her on the vets table, the Vet took a look, took a feel, and called in another vet to come and see this. Neither one had seen megacolon in a cat so young, nor had they felt a mass this large. And her tail deformity had them looking in awe at her little hind area. At first, I was terrified they were going to tell me the same thing my first vet had said, but I was pleased to hear them both tell me they could unblock her with a couple of enemas, and that her stay would be short. They also told me that they knew a veterinary surgeon they could bring in who'd done megacolon surgery before if I opted to have her colon removed. So, I gave consent, and TeeTee was on her way for bloodwork to make sure she'd be okay to anesthetize for her enemas. In the meantime, I went home to make the final decision on whether or not we'd try surgery or try the more traditional methods first.
I had two choices, removal of TeeTee's colon or medical management. With medical management, special diets, stool softeners, and medications that increase the urge to push stool out are tried. And when those don't work, home enemas are the next step. I didn't have a problem at all doing any of this, even the enemas, but as I thought more and more about it, I decided that a diseases inflamed colon that would never have nerve supply would never respond to this treatment, and if it did, it wouldn't respond forever. Odds are her colon would have continually gotten worse and treatment with medications would ultimately fail. On the same note, TeeTee was young, healthy, and was in shape to handle the surgery now as opposed to what shape she might be like in a few years. So, the next day, I talked to the vet, and lined up having the surgery done. TeeTee made it through three enemas, and was cleaned out and ready for the big surgery, and I was a complete wreck wondering if my decision was the best one and wondering if she'd make it through the procedure okay.
Well, here's what's supposed to happen: The colon is removed, then the small intestine is reattached to the rectum, at which point the cat is monitored and kept hydrated until bowel sounds return and the cat starts to eat on it's own. From all the research I did, complications from surgery didn't happen often, but if they did, they were likely to happen on the third post-operative day, the time leaking from the incision area is most likely to occur. After the third day, if all is good, things are supposed to be smooth sailing from there.
TeeTee came home on the second post operative day. She was eating and drinking on her own, was hydrated, and energetic, and had had one bowel movement all on her own the day I picked her up. She was sent home with a drug called Bethanechol and an antibiotic to prevent any infection. That night she was fine, but on the third post operative day, TeeTee began drooling, refusing her food, sleeping too much, and making a horrible rasping noise when she breathed. In a panic, she was taken right back to the vet hospital, where xrays were done, blood tests, and I was told that she just needed a little more monitoring at the vet hospital. They said that TeeTee was having a slightly harder post-surgery recovery, but that they were confident she'd do well given a few more days.
One week and another thousand dollars later, I brought TeeTee home, only to have all the same symptoms return a day after she'd come home. At this point, I was in tears, frustrated, angry, and wondering if the original doctor wasn't right after all. I was exhausted from worry; from looking at my beautiful little girl, drooling, not hungry, and not pooping, and at that point, I seriously considered euthanizing her. None of the research I'd done; none of the people I'd talked to, had had anything even remotely similar to my experience. Theirs were all stories of fairly uneventful recovery and incredible cures. I really feared I'd put my girl through extreme needless suffering, and that somewhere in all the research I'd done, there was something I'd missed, something I should have read.
At this point, I never wanted to see another vet or vet clinic ever again, but after one more night of a sick TeeTee who didn't want to eat or poop, I tried to get all my strength together and contacted a third vet whose clinic I'd been to before. I went in fully expecting that I was going to get the worst possible news, and that all of this would have been for nothing; but the veterinarian, Doctor MacMahon, helped turn my entire experience around from the minute she walked in the exam room door. She was thorough, listened to me, asked a ton of questions, and admitted to me that her experience in this matter was good, but not as good as she'd like, so she wanted to consult a surgery center about TeeTee before doing another enema on her. I gave her the consent, and went home to wait for more news from Dr. MacMahon, and was shocked when she called back a few hours later.
It turns out that the vet who did TeeTee's surgery left a large portion of non-working colon behind when he should have removed it all. So, no matter how much shorter her colon now was, what was there didn't work, and immediately enlarged and got impacted again. Secondly, the bethanechol they'd sent home with her was not effective for helping her to push her stool out, and not a regularly prescribed drug for this purpose. Dr. MacMahon admitted she didn't understand why they gave her this since it's side effects were nausea and drooling, symptoms that TeeTee had that directly explained her lack of appetite and overall looking rotten. And her hoarse breathing was from repeated intubation tubes being put down her trachea for anesthesia.
Dr. MacMahon had TeeTee unblocked and feeling wonderful by that evening, and after a good long talk with me and how to go about Tee's future care, we were both home and feeling better than we had in quite awhile.
To this day, TeeTee still needs alot of help. Dr. MacMahon had originally put Tee on Lactulose, a stool softener, but as time's gone by, I find that her shorter colon makes her stool soft enough that she doesn't need any medication. Her ability to push her stool out is the problem, but we deal with it. Sometimes Tee is able to have her own movements, but I still have to help her two or three times a week. I also drain her bladder twice a day to keep it empty and to keep her from getting bladder infections.
And on the flip side, opting to not have the surgery done is an equally good choice. If you have the know-how and the love to work with your kitty, and a great vet who'll help you figure out which medications, which diets are best, and one who can show you how to give enemas if needed, you can make sure your critter has a long, full, healthy, and happy life:) And once you've got a routine down that works for you, it really won't feel any harder than it does caring for a non-challenged pet.
Megacolon is not a death sentence; don't ever let a doctor tell you that. The numbers of cat deaths due to megacolon are almost exclusively because owners chose to euthanize rather than try medical management or treatment. It is absolutely NOT terminal, and it is far more manageable than you'd think. I look at my TeeTee now, and even after all we've been through, I thank God every day that she's here in my life:)
NOTE: Unfortunately TeeTee passed in her sleep at the age of 11 in Fall 2010. Considering she was expected to live only 2 years, we consider that quite an accomplishment for such a wonderful kitty.
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