Hi Gail
Perhaps this reply is irrelevant because I am unaware of all the details, but your vet's prognosis has me confused. If the problem is related to retention of urine the first step that would be taken (in addition to anti-biotics) is either compression to release some of the urine build up or if this is not possible (say in the case of bladder stones) then a catheter would be the alternative way to drain the bladder. Has this been attempted?
Bethanechol was originally developed for human treatment only (this is how I know about it) and was then found to be effective with dogs and cats, especially in relation to urinary problems. This medication is still currently in use for humans marketed under the name of Myotonine - a human preparation of bethanechol chloride and obtainable from a human pharmacy. This prescription only drug is available with a written veterinary prescription which would allow you to pick it up from a pharmacy in your area. The tablets are either 10mg or 25mg so these will need to be split accurately for your cat's weight - your vet should be able to advise you on this.
An alternative to Bethanechol is to use smooth muscle relaxants such as hypovase (prazosin) or dibenyline to help urine flow through a spasmed urethra, so these might be worth a try too. They are particularly good in those cats that have had a urinary catheter removed and need to maintain a good urine flow through the inflamed and sore urethra. I would suggest you have a word with your vet about these too.
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