Hello Tripawds family!

Sorry for the looong absence, a lot has happened since the explosion and I couldn't get back in touch.

First and foremost I want to thank you all for your lovely messages, it was exactly what we needed in those tough times.

It's heartwarming to see a community for tripawd guardians support each other <3

I know my message is long, but please read it if you have time, I'm going to need every piece of advice that you'll have for me.

Here are some updates on Mango:

He has gone through another surgery a couple of months ago to re-wire his urinary ducts, I'll explain in a bit.

Unfortunately, his case was a bit more than an amputation.

Back when I made the post, I did not have the information I needed from the vet to give you (or myself) an accurate description of his case. Apparently, the vet had thought that I was an animal welfare NGO volunteer who is just bringing in Mango from the shelter to the clinic. This was never the case, and Mango was never in a shelter, it was decided that I would adopt him the moment I found him. It's just that this organization referred me to him and paid a part of the bills.

Some miscommunication (or lack thereof actually) kept me in the dark on many important details. Meanwhile the vet was communicating Mango's case with the actual NGO, and the NGO was not relaying this information to me. There were no bad intentions, just a vet with hundreds of patients passing on a message to a team of a few volunteers who also had hundreds of rescues on their minds. However, this information would have been crucial to me and Mango.

I found Mango in late April 2020, picked up and took him to the vet. He advised that we wait for a few days before the amputation and meanwhile treat him with creams that would help with skin regeneration. According to the vet, he did not have enough skin to hold together the sutures from the surgery. We did exactly that, and a few days later, Mango had his bad leg amputated.

The few-days wait was obviously not enough for much skin to grow, and the stitches were coming off. This period was a nightmare because it coincided with a complete nationwide lockdown. Sorry for the graphic description, but at some point, I could literally see Mango's insides. I wrapped him up with a cloth and took him to get re-sutured as soon as I could. We re-stitched twice within 6 weeks, and after that the wound finally sealed.

Sadly, this had been just the beginning.

I started to feel that his 'good leg' wasn't all that good. Apparently, there had been some nerve damage there too.

At first it seemed normal to me that he wasn't using it and that he preferred to drag himself rather than stand up, since this requires some time and exercise. But as time went by, it wasn't getting any better.

To add to all of that, Mango's lower parts (including: penis and testicles, excluding: anus) were also completely unrecognizable and beyond repair. However, at that point, I didn't know. I could clearly see that his whole lower part didn't look right but based on the little information that I got from the vet, this was normal because the lack of skin during the first operation meant that he needed to use 'overlap skin' (not sure I understood well what he meant). Anyway, this had big implications. It meant that whenever he urinates, he would wet his abdomen and leg, and since he's just dragging himself around the house, you can imagine the amount of filth sticking to him at any given time and the infections it engenders. For months after the initial surgery and till this day, I would shower him once or twice a day at least. And even when he was relatively clean, all the dragging around would occasionally wound his anus. Whenever I felt like he could use a break, I would put him in a large crate to restrict his movement for a few days, then free him again after treating his wounds, and so on.

Aside from the main concern (Mango's health), my mattress, my sheets, and basically everything in the house were constantly pee/poo-stained. He was dirtying himself and everything around him so much faster than we could clean. I would wake up in the middle of every night realizing that my PJs are soaked in pee, and at some point, I stopped bothering to get up, I would leave it till the morning. I'm so embarrassed to even tell you that, and this is not the main issue of course, but things were going ridiculously downhill. Even when Mango wanted to use the litter box, he wouldn't bother standing up, he would pee and poop on himself while sitting, then he would hop on my bed with everything (including litter pebbles) stuck to him.

Another lockdown was over and I wasn't having it anymore with the vet, so I went to give him a piece of my mind.

This is where I was informed that the vet wasn't actually done, and that he had told the ngo volunteers that he still needs to operate on Mango again. The second operation was to re-wire his urinary ducts to somewhere around his mid-lower belly, where he can pee without the urine wetting his whole lower body. Another thing the vet was planning to do was to wait for Mango to grow bigger so he can use the new skin to re-do the suturing from the first operation in a better way. Now that I'd been informed of all of this, I asked the vet to proceed with his plan, which he did.

After the second operation, Mango became considerably cleaner, but he is still dragging himself around, so the constant risk of infection is still there.

Around Christmas, I got him a model wheelchair , which he will be using for a while, until I 3D-print something cute and Mango-customized. However, he is still fighting some light skin burn (also on his belly, around the operation area) from his days in the crate post-2nd-operation, so he has a skin-care routine that we have to maintain until he's fully healed, again. The reason for these 'burns' is the time he spends sitting in his own pee, and not just when he's in the big crate, even when he's sleeping on my bed. The vet assures me that he still has full control over his bowel, even with the new tract-configuration, but I sometimes feel like he doesn't, or maybe he doesn't do the effort. So I have to push him aside a few inches every half an hour to make sure he didn't pee while sleeping.

At this point we're looping over the same problem, and diapers wouldn't help because they would also cause ammonia burns if not changed many times a day. It's important to mention to you guys that between my work, household chores, and taking care of 12 other rescued cats who also have different cases and require vet visits, sometimes it is impossible for me to change his diaper or clean him up within the 15-minute threshold that it takes ammonia from urine to cause these burns (like when I'm sleeping, or even if I take a two-hour nap, let alone if I ever need to go out). 

I'm at my wit's end and I don't know what else to do. We are going to test the wheelchair next week, and we'll let him start using it as soon as his skin treatment is over. I know he won't enjoy it, he really doesn't mind dragging himself around and basically mopping the whole house with his belly, but the chair is the only way to keep his body from touching the floor.

I've had dozens of rescue kitties before but so far Mango has been my absolute trickiest case.

We've been through 8 months of hell but I will do whatever is humanly possible to give this cat the life he deserves. He's still so young and has many years ahead for him, I won't accept that they be painful or even slightly unenjoyable for him, but I'm stuck in a loop that looks like this:

- If I take him out of the crate, he'll drag himself around and hurt himself + get infected real quick.

- If I keep him in the crate, he will gradually lose any chance he might still have at regaining 'good leg' mobility + he's in his most playful years now, crate-life is really not what he deserves nor what I'm planning for him. It kills me to see him there.

Please feel free to ask me anything that I might have forgotten to elaborate, and to give me any words of advice, really, anything is helpful.

If you're all the way down here, thank you so much for putting up with me. And thanks again for all of you who reached out earlier with warm messages.

Virtuals hugs to everyone, thanks for your time!

Wissam and Mango

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Feel free to reach out via email.

Hey Jerry,

Thanks for getting back right away, and thanks for your support, you really always know what to say!

The government here is leaning towards a complete lockdown next week so I'm going to visit the vet for a check-up as soon as possible and come back to you guys with more updates.

So two surgeries later, he still isn’t even close to 100% of being able to urinate normally? Have you been able to mention that to the vet? And is there any way at all you can have another vet look at Mango to see what else can be done, clinically? I’m guessing that might be tough to do? 

The work on the urinary ducts was just one surgery, by two I meant this and the original amputation, sorry for the misunderstanding.

The vet operating on Mango is known to be the best pet surgeon in Lebanon, and I was referred to him by an NGO that I fully trust. These NGOs have connections to certain vets who will take care of all their rescues for a fair price, and they offered to pay the fees of the amputation operation, that's why I had to go to this vet. Even though I was furious at him back when I was still in the dark, meaning when I'd thought that there wasn't going to be another surgery, he explained to me what he was planning to do and it made sense.

But some time was lost here because this was around the time of the explosion and subsequent events***, and the fact that I was mad at him and that for a while I thought he had done a horrible job, made me reluctant to visit him again, so more time was lost trying to get answers elsewhere (other vets, the internet, NGOs who might've had similar cases). Overall I still trust him, he seems to really know what he's doing, but this whole period of frustration was mostly due to the miscommunication that I mentioned earlier. If I'd known better, we would have been far ahead by now. 

***Note on what was happening at this point: so many people were hurt that day and the capital's main hospitals were completely destroyed, so even though it is a vet clinic, and even though is a few kilometers outside of Beirut, people were pouring into his clinic non-stop till the next morning to get their wounds treated (https://www.ins.....jnk7mpbRh/). The next few days, we also found many injured stray and home pets on the streets which the clinic team also had to tend to for weeks to come. We had to also personally tend for many found pets until their owners were found, and survivor kittens that needed bottle-feeding. I had two extra adult cats and one kitten and home. It was just a very bad time to follow-up on Mango.

When things calmed down, and before the second operation, when Mango was still wetting himself all the time, and I was getting frustrated and desperate, I took him to my main vet to take a look and help me assess the situation. I asked him lots of questions, including things like 'Are his testicles still there somewhere under the skin?', everything that I could think of. But I didn't get any helpful answers. There was this template in all his answers that sounded like "I don't know man, go ask whoever made this mess".

Now I don't know if this happens where you guys are from, but here, people in the same field of work like to flex to sound like they're the best. It happens all the time, and I got so familiar with it when it comes to vets. One vet would look at a cat who was spayed by another vet for instance, and try to look shocked at the size of the cut (even when the cut is barely visible). You get what I mean. I believe my main vet might have known what to do but did not want to get involved in someone else's "mess" in case things go wrong.

I think that sounds like a reasonable plan! And this could be part of his overall rehabilitation therapy. It’s not recommended to leave a cat or dog in a chair for long periods of time so you shouldn’t leave Mango in it all day long. But, when used incrementally and building up his time in the chair, it could help him get familiar with what it feels like not to drag himself around, which may improve his strength, endurance and mobility. Hopefully!

Exactly! That's the plan. The wheelchair will be a temporary measure, to help keep his belly off the ground and to get him used to standing up.

I'm hoping that within a few months we can ditch the chair completely.

Thing is, I believe that all is not lost when it comes to his remaining leg. I've had rescues before who recovered from nerve trauma with exercise and massages, and of course, patience. I'm optimistic in Mango's case because even though he can't stand up for more than a few seconds, he actually relies more on his leg when dragging himself to push than on his arms, and he goes suuuuper fast!

I'll come back soon with updates.

Thanks again everyone for all you do, and for all your support and help!

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Wissam and Mango