Miralax vs. Lactulose-your experiences?

I had to take my 11 yr. old David again to the ER vet this past Tuesday, as he vomited 3 times trying to pass stool. David has been diagnosed as a megacolan kitty 5 yrs. ago, he has been to the ER vet and regular vet at least 8 times in those 5 yrs. to remove impacted feces. I few years ago I switched him completely over to a wet/canned food diet with twice daily doses of lactulose. This has helped him over those years tremendously. But he had a setback last Tuesaday, I'm not sure why, neither was the attending ER vet, who was very familiar with us.
I've read that lactulose does lose it's effectiveness over time with megacolan kitties. I've also read that Miralax is much more effective with cats that have this condition. So I today bought a bottle of Miralax and will start tommorow giving him this. But my question is, how much should I give him? Dave is a big boy, he is 17-18 pounds of love and snuggles. I had been giving him 2cc's twice a day of lactulose. How much now should I give of the Miralax? I'm thinking 1/2 tsp. twice a day, does that sound right? or is this too much or too little?
p.s. I've not given him Cisapride yet, have put off giving him this because it was taken off the market for humans because of heart complications from it, and I am leery to give to Dave because of this. If I can treat his condition with more natural means, such as diet and natural remedies, I try those first..

You should really consult with your regular vet about the dosage. My Boo has CRF and was constipated for awhile, and so was my kitten Chickster, from eating the same foods as Boo. My vet recommended Miralax and said it was very gentle. You want to make sure whatever you have, it is the original strength, plain ol Miralax. (I may be getting that confused with the pepcid LOL I don't know if Miralax comes in other varieties)
I was giving Boo and Chickster 1/4 of a teaspoon mixed with 4-5 CC's of water, every other day. Then later on I used 1/4 of a teaspoon mixed with 1-2 CC's of water (So it would go faster and there wouldn't be such a large risk of him aspirating, I worry about that)
My vet told me to mix 1/2 teaspoon with 3-5 CC's of water, which I thought was a whole lot, so I cut it down to 1/4. But really, ask your vet what they recommend first, to be safe. My vet claimed it would not cause dehydration and it was very gentle, but of course with a CRF cat I didn't want to risk him getting the runs. Hope all goes well with your furbaby
By the way, I gave Boo 1/4 teaspoons mixed with 1-2 CC's of water, and he is only 7 pounds. It was very effective in the kitten, too, and she is heavier probably around 10 pounds. But ask your vet first to be safe!!!

I have not used Miralax yet, but I loathe lactulose and will not use it with any cat of mine. And yes, the dose does need increasing as time goes on as the body becomes accustomed to it.

Cisapride is not a high risk in cats. Cisapride gave me three extra years with my dear Ootay who had megacolon (along with many other things.) If she had been well enough I would have had the surgery done, but by the time it was properly diagnosed, she was not strong enough for such an invasive procedure.

My advice is to discuss the change you want to make with David's vet before doing it.

Since a cat's body does become dependent on laxatives you may have to taper the lactulose, not just take him off it abruptly.

Please do let us know how things go.

The thing is, the vets have steered me wrong in every way with this cat. The vet told me to put him on a high fiber diet. I did that, and he became worse. It was from research I had done on my own through forums such as this, to try an all wet food, LOW FIBER diet. Which helped him greatly. The vets told me to have surgery to remove his colon...NO WAY..other vets backed me up on this and said, no way to remove his colon, that would be a totally last resort..no way..!! how horrible if not needed, my whole point being, I do not trust vets "unconditionally', they have been wrong in the past with my animals, specifically where diet and nutruiton have been involved

If you don't trust your vet it is time to find a new vet.

I know a cat who had the surgery and he is doing great, but he was only 6 years old. I would have it done for a younger cat, rather than subject the kitty to a life time of ever increasing doses of medication, but Ootay was much too old and in poor health.

Many vets are still advising increased fiber for constipation and megacolon, though gradually they are starting to realize it is counter productive. Veterinarians are not perfect, and veterinary science is always changing.

You need a vet with whom you can discuss new things you have learned in your own research, someone you feel is working with you as a team to give your David the best possible care and treatment.

My Sven has had a constipation problem ever since we adopted him at the age of 7 (he's now 15). WE had to tell the Vet about Miralax, after the lactulose appeared to stop working. She checked it out and said it would be OK to start using it, and it has been a miracle worker!! We give Sven 1/4 teaspoon mixed into 1 cc water twice a day. (this is because Sven refuses all wet food) If your boy, David, eats only wet food, I think you can just mix the Miralax right into his food, as it has no flavor, but you might want to verify that. Just search "Miralax for cats" on whatever search engine you use and you'll find plenty of info on it.

Anyway, our Vet suggested we start at 1/4 teaspoon twice a day and see how it worked. If he still showed signs of straining, to adjust upwards until we had the right "mix". If you overdo it, you might be cleaning up a little diarrhea . But, honestly, I would think it'd be better to have a little diarrhea than be impacted, don't you?

Good luck wth you boy. Let us know how it works.

Does Miralax fall under the category of a laxative that leads to dependency?

don't know about the dependency thing of Miralax. We tried taking Sven off it once because he was SO regular, and when he went just a couple of days without pooping, we put him right back on it, not wanting to take any chances. Coincidence? Probably not. But, it works in a totally different way than any other type of "poop helper", so I swear by it!

My 10 year old cat was dx'd with megacolon over a year ago.

It took a longtime to get to this conclusion as our longtime vet had misdiagnosed her for over two years with enlarged anal glands instead of severe constipation. When I finally took her to another vet we started treating her for constipation (the anal glands were not even a problem). We treated her with lactulose for a few months and then the lactulose stopped working. This vet sent me to a holistic vet that immediately wanted me to discontinue the lactulose and start my cat on PEG 3350 (Miralax). She said that the difference she sees in her patients who use Miralax is amazing. And she explained the benefits of using Miralax over lactulose to me. The Miralax really has been amazing. I am at a steady dose of 1/4tsp 2x's a day. But my cat does need Cisapride and a low fibre diet as well to keep her regular.

It is tastelss and odourless so my cat does not even notice it in her canned food. I just add a little bit of water with it to her canned food. You can buy it OTC at a pharmacy and also off the shelf.

I would give the Miralax a try and maybe your kitty will not even need the Cisapride....Good luck!!!

Thanks everyone, This is the second day of Miralax. I'm giving him 1/2tsp., 2 times a day to start. I have to syringe it to him (he's used to the syringe though), but the weird thing is, I'll put the 1/2tsp. (dry Miralax) in a cup, then squirt the 2cc's of plain water in the cup. Well, the Miralax does not seem to disolve all the way in such a small bit of water it seems..Also, when I go to re-draw the now solution back in the syringe, it's like as if the amount of liquid has doubled in volume, so I'm drawing up like 4cc's instead of 2cc's...Am I doing something wrong?

Anyways, I''m praying there will be no more painful bm's for Dave, and yes mrsgreenjeans, I would much rather have some runny poops than constipated ones...

the Miralax should not be doubling the volume! It should be disolving. When I disolve 1/4 teaspoon in 1 cc water, I end up with 1 cc in my syringe. Weird. I DO, however, mix it into a tablespoon (for easy access) and let it sit for about 15 min before I try to pull it up into the the syringe. Are you mixing it up well? If I don't mix it up, I might have some granules that form around the edges of my spoon, but that's it.

Or you could just try mixing it in his food as Denali does.

By the way, is it working? Sometimes it takes a couple of days to get things started, but then he should be fairly regular. Keep us posted.

Originally Posted by mrsgreenjeens

the Miralax should not be doubling the volume! It should be disolving. When I disolve 1/4 teaspoon in 1 cc water, I end up with 1 cc in my syringe. Weird. I DO, however, mix it into a tablespoon (for easy access) and let it sit for about 15 min before I try to pull it up into the the syringe. Are you mixing it up well? If I don't mix it up, I might have some granules that form around the edges of my spoon, but that's it.

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I think I've not been letting it sit long enough to dissolve, I'll try waiting longer. Also, he KNOWS when I have something in his wet food and won't eat it, but he loves loves lunch meat, like shaved ham or turkey breast. Tonight's dose mostly ended up on me, so tommorow I will buy a small amt. of low-sodium deli meat to sneak his dose in, all torn up with a tiny bit of warm water mixed in... I think he will eat it that way..
But so far he has not gone, but I'm not too worried (yet) because he made a medium sized boom-boom both Saturday night and also Sunday night (I did the happy poop dance and praised him with treats and kisses afterward!)

Wooohooo!!! Way to go....doing the poopy dance

Have you tried baby food meat (no garlic or onions added)? I like to use the Beechnut brand because all it is is meat and broth. I'd be a bit leary on giving deli meat twice a day for the rest of your cats life as it is quite salty. I use the baby food when my cats are sick or as a bribe.

Originally Posted by Denali

Wooohooo!!! Way to go....doing the poopy dance

Have you tried baby food meat (no garlic or onions added)? I like to use the Beechnut brand because all it is is meat and broth. I'd be a bit leary on giving deli meat twice a day for the rest of your cats life as it is quite salty. I use the baby food when my cats are sick or as a bribe.

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good point, I was thinking about this as well, about the salt. I will try the baby food instead first, I've never tried it before!

I found luncheon meats to be constipating, probably from all the preservatives and chemicals. My cats love ham and stalk me until I give them a piece or three. It just means I can't eat ham as often (in home) as I like which is a good thing.

I have a cat who has odd patterns of BM. She'll go 2-3 days between a BM and then follow up with one within 24 hours. Then it's back to 2-3 days, etc. The BMs always look perfectly well form and moist. Granted the ones with 24 hours are more moist. Needless to say, for this cat, I'm conscientious of everything I feed her. My other cat is like clockwork! She's also not finicky about her food whereas almost constipated kitty is. I wonder if there is a correlation.

Originally Posted by David's Steph

good point, I was thinking about this as well, about the salt. I will try the baby food instead first, I've never tried it before!

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The problem with baby food is it can be constipating. Once in a while it might be okay, but I wouldn't use it with any regularity, unless it's a really tiny amount.

Originally Posted by otto

The problem with baby food is it can be constipating. Once in a while it might be okay, but I wouldn't use it with any regularity, unless it's a really tiny amount.

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depends on what baby food ... ie meats yes can be ... sweet potato is far less likely

You can put the miralax in food. I had to syringe my little CRF girl and once she got on the binders she became very constipated so I gave her about a half teasp of miralax twice a day and then went to latulose. When the latter did not seem to work I increased it.