Possible Megacolon? Something else?

Hi! I have a male cat of 1 year and 4 months. About 7 months ago, he had constipation- the vet thought it was liver shunt. Every 6 or so weeks, I'd take him back to the vet because he was backed up. We got him lactulose, miralax and even some wet/fibre foods. They didn't even seem effective.

I don't have enough money to keep doing this. I can't afford 200$ every 6 weeks for the rest of his life to take him to the vet. All of the symptoms of liver shunt seem to have faded, except for the constipation. It now looks like it could be megacolon. Feces seems to build up right under his tail, into a hard ball. Is there something other than this that it could be?

So I was wondering- is there a safe way to effectively remove the built-up stool from his rear? I tried doing this, but it was painful for him. It worked, though, as he wasn't constipated for several weeks after it- I just want to know if this can be done without anesthesia, or is this really painful for him?

I was also wondering how I could go about in treating this. I see lots of things about low-fiber foods, using many laxatives to decrease the stool size and frequency.. but I've also heard about using a lot of fiber to make the stools soft, feeding him canned pumpkin, raw fish and lots of articles on "cisapride."

I have a huge bottle of lactulose in which I squirt 2½ ml into his mouth twice a day. It doesn't seem to do anything. Can I safely increase this amount? Will this be effective at all? And miralax? I give him 1/4th teaspoon daily. This is hard to do, as he doesn't like any soft foods I give him. Mixing it into milk and dumping hard food onto it seems to work.

There is also the surgery- but I don't think I can come up with 2000-3000$ anytime soon. Should I put him down? He's so young, and I don't know what I should do.

I know that the best choice would be to ask my vet, yes, but that would be another 200$; 200$ which could be saved to treat him via food/etc for several months.

Please help me, and thank you.

*as a side note, he has an undescended testicle. Could this be interfering with his colon/bowel movement/etc?
*I have enough to take him to the vet, but I'm unsure as to if I can afford x-rays, blood tests, etc

Hi MrJay and welcome to the forum!

I can almost bet my life that the cause of all this is....the dry food diet (and, probably the composition - ingredients - of that dry food) AND, the consequential lack of water in his overall intake.

Three suggestions:

1. Some reading - and, pay particular attention to the part on "Tips for Transitioning - Getting dry food addicts to eat canned food" - Here you are http://catinfo.org/  That info may seem long, but - unless you "get" the messages in there, you're doomed. I'd suggest biting off a little at a time, until you get through all of it. BTW, it's rock-solid info provided by a well-respected Veterinarian (who spends a lot of time volunteering in real time online helping people in special groups - people who are dealing with the effects of dry food diets on their cats!)

2. Start immediately - but gradually!!! - moistening his dry food...even if you begin by spraying a little mist over it, then very slowly, perhaps over a number of weeks, increase the moisture content...to what extent? to as watery a composition as you can make it! (one thing: You'll need to exchange the food dish and whatever's still in it every 12 hours or so...too much bacteria can grow if moistened dry food is left "out" for too long)

3. Once there's enough moisture on the food, ditch the lactulose and sprinkle Miralax (powder) on the wet kibble. A starting dose is likely to be 1/4 teaspoonful a day. If the stool becomes too soft, reduce that amount.

This part is not intended to offend you, but to inform you. Most people, the average person, knows diddlysquat about what cats require by way of nutrition, and simply buy's "whatever" from the grocery store.To be blunt, most of that fare is absolute crap - not fit for cats...and, worse than that, downright deadly. Now, learning what's what in catfood can be a challenge...but it isn't rocket science, either.

Perhaps you could start by posting the name/s of the food you're using - we could spot the garbage ingredients for you and make alternate suggestions.

BTW...some kitties might appear not to like wet foods - but, what's really happened is that eating dry food was the only option as a kitten, it was all they "learned", it's all they know.....so, in cases like this, we need to expect the re-learning can require time and lots of patience.

There's another piece of reading I would recommend to you. It's another well-respected website dedicated to feline constipation - there are two versions inside the site, a full-length and a short version - the short one is just fine. The point here is: if you don't know what's going on inside his gut, how could you ever expect to fix what's wrong? Here it is http://felineconstipation.org/

OK, back to the only question in here: what are you feeding?

Thank you.

I am feeding all 3 of my cats iams proactive health

http://www.iams.com/cat-food/iams-proactive-health-multi-cat-with-chicken-salmon

The sick cat, Felix, licks the juice out of the soft food, but I don't think he understands that he has to eat it. It's the same way with little bits of lunch meat/cheese/etc. He'll lick the meat, but he won't ever chew it. However, the other 2 cats [his sister and father] have no problem whatsoever.

MrJay said:

The sick cat, Felix, licks the juice out of the soft food,,,

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OK - take your cue from that....what IF all of the soft food was juice?

'Have a blender? Put some of that soft food in there, start blending and add enough water to make a very thin slurry/juice - and try some of that. Warming it to "mouse temperature" - a little more than room temp will enhance the flavor.

If he'll take that, you've made it to first base....very, very gradually you can cut back on some of the water....but your goal will be to get to the point where he'll take canned food plus a little water.

Now, for the Iams....

If by now you had gotten through that first reference I gave you above, you'd be able to tell me what's wrong with it (aside from the fact that it is dry).

But, for now, click on the "Nutritional Information" button:

Ingredients

Chicken By-Product Meal: Cats have evolved to NEED protein and fat derived from muscle meats. "By-products" do not fulfill that requirement, although a small amount could be acceptable if the greatest portion of the overall food was the former.

Chicken: Great......except, that there's so little of it. Take a look below at how many other "filler"ingredients there are

Corn Grits: Sorry, that's not meat!

Dried Beet Pulp: That's a fiber, and cats do require a little fiber....problem is, there's waaaaay too much in there - they're using it as a filler!

Powdered Cellulose: Hello? What? -about as distant from meat as is possible.....isn't that stuff inert? Actually, worse than a filler...but, that's why they use it....and, oh, so cheap!

Corn Meal: Maybe a good protein source for omnivores like us, a lousy choice for cats....remember: MEAT protein!

Brewers Rice: More inappropriate filler

Salmon: probably included for flavor only and, while fish isn't good for cats, there's probably not enough in there to worry about

Ground Whole Grain Sorghum: Well, you take a look and see how much meat is to be found here http://en.wikipedia.org/wiki/Commercial_sorghum#Growing_grain_sorghum

Animal Fat: Well, it is from some animal(s)...so, it's not all that bad...but, could be better if we knew, for example that it wasn't a low quality blend

All dry foods will need to contain some binding material to make the kibble hold together...the trick is to find one with the least of it and, the least offensive. Best of all, feed as much wet food as you can.

There's also the huge issue of carbohydrate content in dry foods - an enormous problem for cats, because their systems can't deal with it - website #1 above will explain that.

You remember the Atkins diet? Well, for cats, it's similar. Think MOUSE and it's the CATkins diet: http://web.archive.org/web/20101222024231/http://www.catnutrition.org/catkins.php (give it a few secs to load)

Meantime....to the blender!

OK, you've got a start with Felix licking the juice off the soft food!  I complete agree that you need to transition him to canned food (all of them would be best to transition, really, but if that's not realistic, Felix really  needs moist food if he's chronically constipated.  BUT, if he's at least licking juice off of wet food, then it's way to get the Miralax in him.

What I did for years for my guy Sven was to mix 1/4 teas. Miralax with about 1/4 teas. water, than I would mix that mixture into a little gravy from canned food.  That's all I would give him at first, just to make sure he got his Miralax.  That way I didn't have to stress him out by forcing it into his mouth.  Sometimes I would add even more water to the gravy, to make sure he got even more liquid in him.  And he got Miralax twice a day, every day for the last few years of his life.  It kept him regular.  It truly was a God send.  And if I ever noticed that his stools appeared to be getting a little too soft, then I would decrease his dosage to maybe 1/8 teas. (twice a day still) for just a day or day, then go back to 1/4 teas.  This worked so much better than Lactulose.  

BTW, I'm not an expert on Megacolon (Sven was never diagnosed with that, only with chronic constipation), but I didn't think that the stool could make it all the way to the anus if they had it.  I thought it got stuck way back in the colon.  Has he been officially diagnosed with Megacolon?  If so, I know there is another medication that helps the colon actually constrict, I think it is, which helps it push the feces out? 

Thanks, I'll get right on.. blending his soft food. Gross, but I guess I can give it a shot.  I'll just have to boil it before making a smoothie!

His supper time is in about and hour and a half, so I'll try it then. If that doesn't work, I could go out and get some cat milk [lactose free, right?] and get some miralax in him.

He hasn't been diagnosed with megacolon- it was pretty much a self-diagnosis. It just builds up and I guess it creates a pocket of feces. The first time they removed it, it was the size of a golf ball. Here's to hoping it's nothing more than constipation.

Is it safe to give him slightly more miralax than 1/4th of a teaspoon for the first serving? I'd prefer to clear out his system for a fresh start, but I don't want to give him cramps [like laxatives would to anyone else]

Thanks again, all. This guy appreciates it, too, I'm sure. 

I misunderstood: you did write, "he licks the juice out of the soft food".....so I presumed "soft" meant canned and, that he simply sucked up the juice/gravy and left the more solid wet food.

Well, you should at least try liquifying the dry - might be easier if you crumbled it first and let that soak in boiling water, then blend. If he's already used to the dry's juice, it might just work as a starting point.

You'll have to begin adding just a pinch of a good wet food - again blended - into this in gradually increasing amounts to get to the goal mentioned above. I said "good quality" because, to me, he really looks like he needs to build up his muscle mass. I'm sure all this has taken a toll on him.

More Miralax to effect a quick resolution? NO. The process of regulating his stool IMO needs to be done carefully. IF HE IS IMPACTED NOW, that MUST be cleared BEFORE starting on the Miralax THAT IS CRITICAL. You will know when he last had a BM and you know from experience when he has had impacted stool, so, only you/the Vet can make the judgement on that. Personally, I would not attempt to remove an impact. But again, there could well be major problems if you start a flow going with Miralax - and that flow plows into a dam.

Both Lactulose and Miralax are dose-to-effect drugs with a normal stool as the goal. The intent is not to flush out the cat. If the cat has impacted stool, osmotic laxatives are not suitable until that situation is relieved. We do not want to create pressure behind a dam! In any event, osmotic laxatives do not 'catch up with' the stool already formed to act as stool softeners. They are better used to prevent trouble than to deal with a serious bout of constipation and are not suitable for impacted stool. http://felineconstipation.org/acutetreatment.html#OsmoticLaxatives

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BTW, Miralax won't cause cramps...Miralax acts only by keeping water in the stool and colon.

What a picture - so engaging, those eyes!

He does lick the juice from the soft/canned food, yes. But he doesn't even bother trying to bite into it.

He isn't impacted at the moment. I was just wondering if I could get his system completely cleaned out using that method because enema are messy. Glad to know it won't cramp him up.

As for his eyes, they've darkened to a deep copper color. [one of the reasons the vet thought it was a liver shunt- but this is genetic throughout his entire family]


All of the cats are hiding from the weather, so they didn't eat. I guess only time can tell with using these methods. 

MrJay said:

He does lick the juice from the soft/canned food, yes. But he doesn't even bother trying to bite into it. OK, then, use that food for the blending job - don't even bother with the kibble

He isn't impacted at the moment. I was just wondering if I could get his system completely cleaned out using that method because enema are messy.      Don't worry about 'cleaning out his whole system - just start with daily Miralax mixed in with the blended food (use only a little of the slurry, so you will know that he got the whole dose). With three cats, you'll probably have to isolate him to monitor his stool. Now, the stool will harden in the litterbox, so you'll need to check its firmness when it's fresh. You should be seeing at least one BM daily when things are moving regularly and his food intake is the amount his system needs.

All of the cats are hiding from the weather, so they didn't eat.  What kind of weather is that?

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And, this wet food you're using - which is it?

I'm just a little confused as to what is gross and why you need to boil anything if all you need to do is mix a little bit of Miralax with a little bit of water,then mix that into just a little bit of the gravy from canned food.  I'm talking about less than one Tablespoon of total "smoothie" here....probably 1/2 Tablespoon, if that, since you want to make sure he slurps it all up.  You should be able to do that with a spoon.  (use a 1/4 measuring spoon for the Miralax, though, because you don't want to over "medicate" on that or you might have a big mess on your hands that would be gross

mrsgreenjeens said:

I'm just a little confused as to what is gross and why you need to boil anything if all you need to do is mix a little bit of Miralax with a little bit of water,then mix that into just a little bit of the gravy from canned food.,,,

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Well, I can see where some of the back-and-forths might be confusing you now.........but. we understood each other

There were actually two goals here:

- one, to get a regular, ongoing dosing of Miralax onboard in whatever vehicle was acceptable (that's where he & I had to sort out just which "gravy/juice" was being consumed)

- two, to begin the difficult process of transitioning this little cat from dry food addict status to accepting wet food (and, that's partly where the blender came in - if he accepts only the juice from wet food, then blend all the wet food into a slurry starting "thinly" and gradually increasing the "thickness" until, eventually he's consuming the entire food presentation)

MrJay, once you post the identity of the "acceptable" wet food you're using, we can look at its fibre content...we might want to add a little...sloooooowly!

So, MrJay............how 'bout an update?