Your veterinarian will perform a complete physical and neurologic examination to assess your cat's injury. The neurologic examination usually focuses on the sensation and motor to the tail and anus. Other tests your veterinarian may recommend include chemistry profile and CBC.
A urinalysis may need to be repeated frequently if your cat is not urinating completely.
A radiograph (x-ray) of your cat's spine and chest. The spinal radiograph is to assess for presence and severity of the vertebral fracture as well as associated trauma. The chest radiograph is required to assess for pulmonary bruises or contusions, pneumothorax and diaphragmatic hernia that can occur concurrently to the trauma that caused the tail trauma.
If your cat cannot feel his/her tail and has absent anal tone, your treatment options will be limited. If there is urinary/fecal incontinence, there is a small chance that he will be able to regain some urinary-fecal function. The urinary and fecal incontinence is caused by trauma to the pudendal nerve that supplies function to the urethra and anus. The injury is called a cauda equina avulsion and the nerve trauma is classified according to the degree of nerve damage. Bethanachol functions to increase the strength of the bladder contraction and is given 2-3 times per day.
If your cat has decreased sensation to the tail, you will need to observe him closely and allow frequent neurologic examinations by your veterinarian.
In cases of a traumatic-paralyzed tail, most veterinarians recommend that cat's tail be amputated to prevent further injury to the pudendal nerve that supplies the urethra and anus. Amputation also prevents the tail from becoming soiled with feces and urine, which is a major health concern for these cats.
If your cat frequently has cystitis (urinary bladder infections), a specific therapy of antibiotics may be recommended and may include low-dose antibiotics or weekly alternating therapy. Another option is to treat with a urinary antiseptic such as methenamine.
Following amputation, your cat should rest in a crate. This will allow him to heal adequately and will assure the best chance to regain nerve function. A cat with an amputated tail is not handicapped in the least.
Treatment also involves helping your cat urinate and defecate. Your veterinarian may recommend stool softeners if your cat becomes constipated. Some stool softeners are mineral oil based such as hairball remedies or fiber based such as metamucil. Other stool softeners are DSS and lactulose.
Your cat may need his bladder expressed if there is no sensation to the urethra. There are some medications that may help your cat urinate more normally. Some of these drugs are bethanachol, phenylpropanolamine, diethylstilbesterol, phenoxybenzamine, diazepam and flavoxate.
Phenylpropanolamine and diethylstilbesterol are drugs that can increase the urethral sphincter strength. The dosing intervals for these drugs vary with the response and the severity of weakness.
Phenoxybenzamine, diazepam and flavoxate can decrease spasticity of the urethral sphincter. These drugs are given two to three times daily.
The drugs are prescription drugs and require close monitoring by you and your veterinarian. Your cat will need rechecks to assess response to therapy. Depending on your cat's injury, you may need to adjust the medications.
Your cat will need strict bed rest in a crate or cage following tail trauma. You may need to bathe and medicate your cat frequently if he has difficulty urinating.
Your veterinarian will need to re-evaluate your cat with a neurologic examination. The injury may need to be re-examined by x-ray as well. If your cat has difficulty urinating, your veterinarian may need to monitor his urine for infection by performing urinalysis and cultures.
Finding the right balance of medications for your cat will take time and patience. Your cat's need for medication may change over time.