Reply #10: UPDATE (caution, medical details):

[kestrel91316]

I did surgery on Kitty (not his real name) this AM. I first sedated him, then gave him some ketamine which knocked him down and cooperative, but not asleep. Thus disabled, he was a good boy while I placed an intravenous catheter in a front leg. Through this I gave him more ketamine and some valium. He was then out enough for me to place an endotracheal tube for him to breathe anesthetic gas through. A few minutes spent shaving his tummy, and off into surgery he went.

With him tied to the surgery table and his gas hooked up and running and his IV fluids running, we got to work. My trusty assistant kept an eye on his depth of anesthesia and followed my instructions when he needed more. I did what I do best: CUT. We have a saying in vet medicine: a chance to cut is a chance to cure. So that's what I set about to do. I cut a 2 1/2" incision in his abdomen (south of the belly button), packed off the undesired innards, and brought the bladder to within reach. After placing a couple of stay sutures (anchors for manipulating tissue) in the bladder, I opened it up and was easily able to find and remove the HUGE bladder stone (1 cm x 1.5 cm x 1 cm). Rather than prolong his surgery with poking around (known as an exploratory laparotomy) I opted to close the bladder and then get the heck out of his tummy as his compromised condition made him increased risk for complications. So I sewed the bladder closed (not easy, the wall was over 1/4" thick!!!) with absorbable suture, then closed the abdominal wall and then the skin with more of the same absorbable suture. I use a buried suture pattern in much of my abdominal surgery so the cats can't pull stitches out amd make trouble.

I finished up around 11:30 AM. We pulled his trach tube around noon. By 3:30 PM he was up and demanding to be fed. He got two small meals of Prescription Diet A/D and then a few crunchies over the following 3 1/2 hours and when I left at 6 PM he was a little unsteady on his feet still, but one VERY happy kitty. He fidgeted a little when I capped off his IV catheter for the night, but not so I couldn't do the job.

I am very happy with how he is doing so far post-op. Because of his low albumin level and the anemia, he will bear watching the next several days. Low albumin can result in poor wound healing, but with the high protein diet he is on I am not too worried. He is still on antibiotics, but they agree with him so far. I hope the anemia is just what we call Anemia of Chronic Disease, which should self-correct as he recovers from surgery.

All-in-all a fun and interesting case, and a really sweet cat.