# Cat taking a long time to recover from Ketamine



## Katawampus (Aug 30, 2014)

Hi everybody - posting this in case somebody can offer some advice immediately as not getting much luck from internet searching.

My cat underwent a procedure earlier today to remove a blockage from his urethra, the vet told me she used Ketamine along with another drug, the name of which I have forgotten. I left him at 11am and collected him at 12noon (when the surgery closed for the day) and was told to expect him to be very groggy until 5pm when he would start to come around.

He's still a complete zombie - I put some water beside his bed and he proceeded to alternate between drinking and falling asleep with his chin in the bowl, he then got up, vomited seemingly his entire bodyweight in water and went straight back to bed and he's been listless and completely unresponsive ever since. 

I phoned the out of hours vet service who, whilst very nice, wouldn't really give any opinion on whether he is in danger from an adverse reaction to the Ketamine or has some kind of electrolyte poisoning(? - I believe high potassium levels could be a risk here). The problem is I can't really be spending £100+ on top of the procedure this morning, unless he is in danger and not just taking some extra sleepy time. 

Sorry for all this rambling - could anybody kindly offer me some advice? Obviously I'm monitoring him myself and shall just take him if he seems to deteriorate.

Many thanks in advance!


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## Soozi (Jun 28, 2013)

I am so sorry your cat is so unwell after the procedure today and I can't help at all! I hope one of the Vets on here might be able to reply or one of the members that will have the knowledge to give you some advice! I would be concerned too if he has vomited all the water he has drunk. If he is not better soon I would be inclined to get him back to the Vet tonight! You can gently grasp the fur/skin on his scruff to see if the skin springs back to place if it doesn't then he is dehydrated which could become a serious problem. Sorry I can't be of more help! I do hope he recovers soon.


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## carly87 (Feb 11, 2011)

I do notice that mine take much longer to come round when Ketamine is used. I have one that is completely loopy for about 12-14 hours, then just snaps out of it. She doesn't vomit, but then I don't know that she eats that much because she's so busy sleeping. It's a difficult one, but I'd say that, due to the lack of water intake and the fact that he had a urethral blockage cleared, I'd be reasonably concerned.


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## Polly G (Apr 30, 2013)

Sorry I can't offer any advice except if it were my cat I would want a vet to check him over for reassurance. I hope he is soon back to normal.


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## Katawampus (Aug 30, 2014)

Thanks Soozi. He doesn't seem terribly dehydrated from the skin pinching thing, he's just still so listless. Its especially disturbing as hes normally such a big old spirited, robust thing - he seems so poorly. I'm watching him like a hawk, he did just lean his cheek a little into a gentle fuss, which is an improvement. Hoping he wakes up a bit soon!


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## Katawampus (Aug 30, 2014)

Also thanks Carly and Polly, your replies came in as I was writing the other message. Fortunately the vets is open 24 hours and not too far away so while hes not getting worse I'm holding out a little. He seems to be properly unblocked as I'm having to replace the towel he's lying on every couple of hours or so.


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## Ang2 (Jun 15, 2012)

You really need to speak to the vet for advice.


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## nicolaa123 (Mar 30, 2012)

If I'm reading this correctly he was there at 11 am and you picked him up at noon same day??

Mine has not had same procedure but when he has been knocked out they keep him until fully awake.

I would be calling the vets and asking about it


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## huckybuck (Jan 17, 2014)

nicolaa123 said:


> If I'm reading this correctly he was there at 11 am and you picked him up at noon same day??
> 
> Mine has not had same procedure but when he has been knocked out they keep him until fully awake.
> 
> I would be calling the vets and asking about it


I didn't like the sound of that either but I'm guessing it was because the practice closed early on a Saturday???

I've tried to send a message to one of the vets who posts on here so hopefully she'll be along soon. Does his breathing seem ok and how old is he out of interest?


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## nicolaa123 (Mar 30, 2012)

huckybuck said:


> I didn't like the sound of that either but I'm guessing it was because the practice closed early on a Saturday???
> 
> I've tried to send a message to one of the vets who posts on here so hopefully she'll be along soon. Does his breathing seem ok and how old is he out of interest?


I guess I'm lucky mine is open seven days a week! But even if they do close surely they have room to keep longer or have a sister practise, just seems to quick to me to send home


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## Ceiling Kitty (Mar 7, 2010)

Hello hello,

I would imagine the other drug combined with the ketamine is a benzodiazepine - diazepam or midazolam. This combination can sometimes cause a 'spaced out' recovery with confusion and wide eyes. But obviously the diazepam/midazolam aspect will cause sedation which can be variable depending on the patient. In addition, higher doses of ketamine are associated with prolonged recovery times. Ketamine is excreted via the kidneys and he was blocked, so it might take a bit more time for it to clear from his system.

Is he cold? Hypothermia is, in my experience, the most common reason for slow recoveries in kitties. If you have a thermometer and feel comfortable doing so, taking his temperature would be helpful. If not, try feeling his ears and paws - are they warm or cold? Have you got him in a warm place?

Electrolyte disturbances are a possibility, though less so than being chilly. Did he have any bloods taken at the time to assess his renal function and electrolytes? Potassium and calcium abnormalities can cause muscle twitching/tremors, seizures or heart rhythm disturbances.

When cats are unblocked, they go into what we call 'post-unblocking diuresis'. They tend to pee lots and need to drink lots to replace the fluid loss, so dehydration can be a concern. Make sure he drinks plenty.

If he's warm but still not coming round, it would be worth seeing the vet. You'd want his temperature checking and possibly some bloodwork to check his electrolytes and hydration status.

I hope he comes round soon xxx


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## Katawampus (Aug 30, 2014)

In my opinion the vet at the surgery was very good - they were able to see him immediately and must have worked on him pretty much straight away. They close at 12noon so I had to collect him then, I know that usually they will keep your animal until they are back to their shouty self again. 

The out of hours surgery is a different one to the vets I take him to in the daytime, so they will have no knowledge of the procedure carried out on him earlier, they have just listened to me recount what's happened and been very much on the fence, which is understandable.

He's 2 and otherwise extremely healthy, so I presume he wasn't deemed to be at risk from the use of Ketamine. His breathing seems generally good, a little shallow a couple of times that I've looked at him, whilst trying not to disturb him too much. I don't really know what it should be like though, sometimes when he's napping on a normal day I have to give him a prod because he looks completely motionless (not just him, all cat's I've known seem to go properly still sometimes).

I know it's better to be safe than sorry but I really don't know the difference between a post-anaesthetic sleepy cat and one that's not doing well.

Thanks all for your replies.


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## nicolaa123 (Mar 30, 2012)

I can only say if it was me, but the tiniest doubt and he would be at the vets, I do know mine pretty well and his behaviour so anything I was unsure of I would get checked out..


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## Katawampus (Aug 30, 2014)

Hi Shoshannah

I'm doing really badly at keeping up with these posts!

I don't know if they took blood samples, they definitely took urine samples but that was obviously to assess the cause of the blockage.

His ears are cold, yes. Also he had urinated a lot after bringing him home, which had soaked his while side while he was lying there, so I took him out of the box and wiped him down with luke-warm water on a cloth. I rubbed him dry as much as I could whilst trying to be extremely gentle and I've had him lying on a towel which I have changed a few times so he's pretty dry now but I was concerned being damp would make him cold. I had put a hot water bottle in the box with him (bottom half of a cat carrier) with warm water in it, but not right by him so he could choose whether to snuggle with it or not. I don't think he knows what he wants at the moment though. I don't have a thermometer I'm afraid. I can definitely make the water bottle up with warmer water and add another blanket though, see if that perks him up!


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## nicolaa123 (Mar 30, 2012)

Be careful with hot water bottle as they get cooler they can take heat from the animal. Better with some warm blankets or fleeces if you haven't got a heat pad


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## Katawampus (Aug 30, 2014)

I've laid an old tshirt over him and tucked a water bottle down the side of the towel he's sleeping on to radiate some heat through it. I'll be careful of it getting cold - he's right in front of me and I'm checking on him very regularly. He looks so cute all tucked up in bed bless him


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## Ceiling Kitty (Mar 7, 2010)

Katawampus said:


> Hi Shoshannah
> 
> I'm doing really badly at keeping up with these posts!
> 
> ...


If you're using a hot water bottle or heat pad, make sure you wrap it in a blanket or towel so it's not in direct contact with his skin - it might cause burns.

Please give the vet another call if you're concerned; it can be difficult to differentiate a 'normal' slow recovery from an abnormal one, but it should not have to be your place to make that call, it's the vets' responsibility. xx


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## Katawampus (Aug 30, 2014)

Yes, there are a good few layers of towel between the bottle and him, and I haven't made it up with scalding water.

Thank you everybody for your responses, they are very much appreciated. Not ten minutes after ramping the warmth of the water bottle up he's gotten up and gone for another drink, without just flopping his face into the bowl. I think he's on the up!


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## Polly G (Apr 30, 2013)

That's good news! Hope he continues to recover x


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## Soozi (Jun 28, 2013)

Obviously he needed that extra bit of warmth! It all sounds a lot better already! Good news so far!


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## huckybuck (Jan 17, 2014)

Keep coming back to see how he's getting on..pleased he's nice and warm and drinking, hope he's on the way up now


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## Katawampus (Aug 30, 2014)

He's still pretty dreary but he got up a couple more times for a drink and he responded for the first time when I called his name from the kitchen whilst topping up his water bottle. Going to keep the hospital bed close by all night so I can keep checking on him!


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## carly87 (Feb 11, 2011)

It can be quite scary the first time this happens. I have to say that I'm perhaps a little too blasé with post anaesthetic cats. As soon as mine are awake with regular breathing and heart rhythms, I'm happy to take them home and nurse them there, although I think it helps that firstly I've done it on humans many times, and secondly, I've had quite a few cats now with varying levels of sedation, and I'm well set up with heat pads, thermometers etc. My vet is only round the corner too, so is close-by if something does go wrong. Generally, I'll do the same as your vet did with you, and will take them home if surgery is closing or about to finish. Mine are always willing to keep them in, but they're going to be on their own there until the night-time check, so they may as well be at home and being nursed.

I do remember the first time they used ketamine though, and how scary it was for me. We had the confusion that Shosh has mentioned, and my girl was completely loopy-loo.

Really glad to hear he's on the up.


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## Kathyvet (Aug 24, 2014)

Just read this thread! How is he today? 

Kathy BVMS MRCVS


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## Britt (May 18, 2014)

Glad he seems to be recovering. Keep us posted!


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## Katawampus (Aug 30, 2014)

Morning everybody! 

Pleased to report that Alfonso is much chirpier this morning. He is moving normally (if a little slowly), been up to use his litter box, jumped on our bed for a fuss and had a little wash. His pupils are still massive so looks like he's still a bit high but I'm confident I have a nearly mended pussycat.

Thanks again everybody for your concern and advice. I am now a little wiser when it comes to kitties on the hard stuff!


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## Kathyvet (Aug 24, 2014)

Glad he is better- is he going back to the Vets for a check up tomorrow? Have they advised on how to try and prevent a blockage re-occurring ie wet food, encourage water intake, minimise stress etc?

Kathy


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## Katawampus (Aug 30, 2014)

Yep, vets tomorrow!

They results of his urine analysis will be available Tuesday/Wednesday so they'll know exactly what sort of diet he should have going forward, but in the meantime no biscuits (poor guy, he adores Almo Natue with sardine) only wet food and water. Fortunately he's greedy enough to eat anything if it's the only thing on offer for a few hours. We haven't really touched on the stress thing because he's an indoor boy, no other pets to fight with, who thinks he owns the place so I'd be surprised if that's a factor. Not sure though. Will ask about environmental improvements tomorrow.


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## Soozi (Jun 28, 2013)

So pleased alfonso is recovering well! Bless him he gave us a bit of a scare last night!
I think the vet will say wet food only it seems to take a time but I'm gradually getting my girl slowly weened off dry! 
Give your lovely boy a cuddle from me! Hey! How about some photos of him?


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## Charity (Apr 17, 2013)

Really glad he's brightening up, very worrying yesterday. I did look this drug up after reading your thread that it said it can take up to 24 hours for some cats.


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## huckybuck (Jan 17, 2014)

Really pleased he's brighter todayhe might be a little sore later as the pain killers wear off so may seem a bit subdued. But as long as eating, drinking and going to the loo - all good signs


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## Ceiling Kitty (Mar 7, 2010)

I'm glad he's back on his feet!


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## Katawampus (Aug 30, 2014)

Hopefully the pics I tried to attach are visible? The second is when I tucked him all up on Saturday night. The other two speak for themselves (he's never actually tried to ingest a pineapple leaf he just LOVES crunching them). Difficult to photograph a completely black cat :\.

Been for a check-up at the vets today and he's all good again  we have painkillers and antibiotics so hes a happy munchkin - back to his spirited ways!


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## Ceiling Kitty (Mar 7, 2010)

Katawampus said:


> Hopefully the pics I tried to attach are visible? The second is when I tucked him all up on Saturday night. The other two speak for themselves (he's never actually tried to ingest a pineapple leaf he just LOVES crunching them). Difficult to photograph a completely black cat :\.
> 
> Been for a check-up at the vets today and he's all good again  we have painkillers and antibiotics so hes a happy munchkin - back to his spirited ways!


Aw, he's gorgeous!  xxx


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## Polly G (Apr 30, 2013)

So pleased that Alfonso is nearly back to his old self. He is gorgeous


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## huckybuck (Jan 17, 2014)

So glad he's recovering well - what a lovely boy! Xx


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## spotty cats (Jul 24, 2012)

Glad he's doing better. I wouldn't have a vet use ketamine on my cats and always ask, it's not commonly used here.


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## Katawampus (Aug 30, 2014)

Hi again everybody.

I'm afraid 'Fonsie had to go to the vets again today as he was having problems again and weeing a lot of blood (including on the bathroom floor)  I took him to one of the Pets at Home in-store vets as they were open as usual on a Sunday rather than paying the hundreds of pounds the out of hours emergency vet would have charged. He's been given another antibiotic shot, some tablets and some Metacam painkiller.

The analysis done on the sample the vet took last Saturday showed Struvite crystals so they sold me a bag of the Royal Canin S/O prescription dry food, which he doesn't like much, so I'd been serving a little wet food as well to keep him hydrated and eating - I suspect carrying on with the wet food led to this second problem - the remaining wet stuff will now be donated to friends' cats! A drinking fountain is also being ordered today to encourage him to take on more water (hopefully).

I've been looking for other brands of prescription food for his condition, and I'm quite alarmed that people on various forums seem to think the ingredients are questionable at best! Does anybody feed their cat a specific diet for kidney/urinary problems and is there a particular food you would recommend? I have seen people mention feeding them pure meat diets (cooked chicken etc) does anybody have any knowledge in that area? Obviously my priority is a healthy and happy pussycat but I'm concerned about the ethics of the manufacturers of the popular prescription foods. I was conscious of only buying foods that were produced relatively locally, no animal by-products or "filler" ingredients, responsible approach to impact on the environment (to that end, I now have a useless bulk supply of Almo Nature - cheers mate )

Sorry for the ramblings again, I feel rather at a loss for what to do. To add to the pressure, we go on holiday on Friday night, so he's spending two weeks at the cattery. I'm going to have to have a big chat with them tomorrow to ensure they don't mind keeping a special eye on him and giving him the rest of his medication.

Thanks for sticking with me on that one, and for all your support and well wishes thus far


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## Britt (May 18, 2014)

Sorry to read about Fonsie's being at the vets again. He's gonna need a diet to prevent him from getting those crystals. I know that everyone here hates dry food but your cat's health comes first.

BTW Fonsie is adorable :thumbup1:


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## Ceiling Kitty (Mar 7, 2010)

Katawampus said:


> Hi again everybody.
> 
> I'm afraid 'Fonsie had to go to the vets again today as he was having problems again and weeing a lot of blood (including on the bathroom floor)  I took him to one of the Pets at Home in-store vets as they were open as usual on a Sunday rather than paying the hundreds of pounds the out of hours emergency vet would have charged. He's been given another antibiotic shot, some tablets and some Metacam painkiller.
> 
> ...


I'm sorry he's in the wars again. The antibiotics were almost certainly unnecessary but hopefully the Metacam should help his poor bladder settle down!

I certainly wouldn't be throwing the wet food away yet. I would always rather see a cat with crystalluria on any wet food rather than dry s/d, but that's just my opinion. As you say, hydration is key here as supersaturation of concentrated urine is a major factor in the formation of struvite crystals. You need to try and get his urine as dilute as possible, and get him emptying his bladder as often as possible.

I don't use prescription diets very often, but two conditions in which I do are CKD and crystalluria. There are wet versions of s/d and c/d available which would be infinitely better than the dry versions, though it will work out more costly unfortunately.

High meat diets can help acidify the urine, thus reducing the formation of struvite crystals, but you need to watch you don't get oxalate crystals instead as these are trickier to shift.

Are the vets planning to do any scans or X-rays for bladder stones?


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## Katawampus (Aug 30, 2014)

Shoshannah said:


> I'm sorry he's in the wars again. The antibiotics were almost certainly unnecessary but hopefully the Metacam should help his poor bladder settle down!
> 
> I certainly wouldn't be throwing the wet food away yet. I would always rather see a cat with crystalluria on any wet food rather than dry s/d, but that's just my opinion. As you say, hydration is key here as supersaturation of concentrated urine is a major factor in the formation of struvite crystals. You need to try and get his urine as dilute as possible, and get him emptying his bladder as often as possible.
> 
> ...


Hi Shoshannah

My regular vet didn't mention X-rays, they just wanted him to do the prescription diet for a month and then take further urine samples to see if it had had a positive effect, although they don't know about this second episode yet.

Would you mind explaining what s/d and c/d are? And what the S/O on the Royal Canin stuff means? I'd like to order him some more wet and dry food tonight so that it'll be here in time for his trip to the cattery so, for now, want to make sure I select ones that are correct for his problems.

Many thanks


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## Soozi (Jun 28, 2013)

I do hope that they find what the problem is! I would think that stones would definitely show up on Xray? I'm no expert but surprised they haven't Xrayed him by now. Wishing your boy better very soon! try not to worry they will find the cause of his pee problem I'm sure and get him back to fitness soon! X


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## Ceiling Kitty (Mar 7, 2010)

Katawampus said:


> Hi Shoshannah
> 
> My regular vet didn't mention X-rays, they just wanted him to do the prescription diet for a month and then take further urine samples to see if it had had a positive effect, although they don't know about this second episode yet.
> 
> ...


s/d and c/d are Hills prescription diets for crystalluria.

s/d is a dissolution diet, designed to dissolve struvite stones and reduce the formation of crystals. It is only designed to be used for a few weeks and is not suitable as a long-term diet.

c/d is a 'milder' (not quite the right word but the only one I can think of right now) form, which can be used long-term as a maintenance diet to prevent crystal formation.

There is also a new form called c/d Urinary Stress, which is basically Cystophan mixed in with the regular c/d.

RC S/O is Royal Canin's equivalent - does the same job.


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## Katawampus (Aug 30, 2014)

Right-o, thank you! I've ordered a case of the S/O wet food to see him through his trip to the cattery - hoping he will eat it (he's pretty greedy and not overly fussy, fortunately). Quite excited about the arrival of the water fountain - looks pretty jazzy!


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