Miralax dosing and response time

MaineCoonMom said:

 
My cat's skin doesn't feel dehydrated to me.  Thank you, oneandahalfcats, for the advice about checking his skin.  I called the vet about prescribing Cisapride for him but she said she needs to see him and do lab work, xrays, etc.  Plus, it is the weekend now so it would be double expensive.  Now I will hope to get through the weekend...........hopefully with a bowel movement.........or two.........for my cat.  (=^o^=)

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I inquired about cisapride just to get an idea of what your vet thinks. Cisapride induces peristalsis, or gut/bowel motility. Many cats are able to get along very well on a regimen of Miralax and cisapride. HOWEVER, cisapride also interferes with the body's natural peristalsis. Eventually you need higher doses, and sometimes it stops working. At this point cisapride doesn't work and your kitty has lost ability to produce a natural bowel movement. This means you have to consider a very invasive surgery to remove part of the colon. It takes years for this to happen, though, so since your kitty is older you could never reach that point.

You want to start cisapride when the bowel is empty because if the kitty is stopped up the artificial bowel movements could cause colon damage. So normally vets want to take an x-ray or at least give an enema.

How long has it been since the last bowel movement? My vet said to bring the cat in if it was over 3 days.

How nice of you to check with your vet.  I think it is close to 5 days since my cat has had a bowel movement.  However, after the enemas, I think my kitty got very cleaned out.  And I think he may have had a couple of small bowel movements but it could have been my other cat.  The vet is not in the office on Sat. or Sun.  I live in an isolated area and there isn't a nearby vet........except the one who is not there on weekends.  So now I am praying that my kitty will have a bowel movement.  Thank you, Raintyger.

MaineCoonMom said:

 
How nice of you to check with your vet.  I think it is close to 5 days since my cat has had a bowel movement.  However, after the enemas, I think my kitty got very cleaned out.  And I think he may have had a couple of small bowel movements but it could have been my other cat.  The vet is not in the office on Sat. or Sun.  I live in an isolated area and there isn't a nearby vet........except the one who is not there on weekends.  So now I am praying that my kitty will have a bowel movement.  Thank you, Raintyger.

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Ummm...well, it's nice of you to think that I called my vet, but I have to clarify--the 3-day recommendation is a general rule of the thumb for all kitties. I don't want you to think that you've received veterinary advice in some fashion.

If your kitty has been cleaned out it will take 2-3 days for him to resume bowel movements, as they clean out the entire colon, not just the stuff near the output end.

If the stool is soft and you're having chronic problems, then you should talk to your vet. Unfortunately there's a lot of causes for constipation, so a lot of the time it turns into trial and error as far as remedies are concerned. Any info will help, though.

Here is an article that discusses what is meant by "soft":

http://www.floppycats.com/cat-const...tment-of-constipation-with-dr-jean-hofve.html

You might try some laxatone/hairball remedy. This is not something I would recommend on a regular basis, though. Hairball remedies block nutrient absorption and have sugar in them.

MaineCoonMom said:

 
My cat's skin doesn't feel dehydrated to me.  Thank you, oneandahalfcats, for the advice about checking his skin.  I called the vet about prescribing Cisapride for him but she said she needs to see him and do lab work, xrays, etc.  Plus, it is the weekend now so it would be double expensive.  Now I will hope to get through the weekend...........hopefully with a bowel movement.........or two.........for my cat.  (=^o^=)

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You're welcome ...

MaineCoonMom said:

 
How nice of you to check with your vet.  I think it is close to 5 days since my cat has had a bowel movement.  However, after the enemas, I think my kitty got very cleaned out.  And I think he may have had a couple of small bowel movements but it could have been my other cat.  The vet is not in the office on Sat. or Sun.  I live in an isolated area and there isn't a nearby vet........except the one who is not there on weekends.  So now I am praying that my kitty will have a bowel movement.  Thank you, Raintyger.

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If the enema(s) were recently, sometimes it can take time to build up sufficient stool to produce a BM. This was the case for another member here with her cat who had an enema.

I'd like to share something with you for your consideration before you proceed in pursuing cisapride. My male, Max (avatar), had been dealing with constipation off and on during the last two years. He was diagnosed with megacolon by one vet and put on cisapride and RC Fibre Response food, against my better judgement. The only contributing factor to the diagnosis of megacolon was x-rays showing that Max was constipated? No other contributing factors like pelvic damage which is a more typical justification for such a diagnosis. Max had no pelvic irregularities at all. I felt very doubtful, and do to this day.

After almost two months on cispride, our experience was that this made little to no difference in increasing the frequency of Max's BMs. It was quite expensive and comes with very definite risks for serious side effects such as cardiac arrhythmia. My husband and I made the decision to stop the cisapride and sought another opinion which resulted in Max being put on Lactulose whereby he began having regular BMs from the get-go. We reluctantly kept Max on the RC up until last October when I decided it was time to get him off of this food, for two reasons. RC Fibre food contains corn and wheat early in the ingredients list and very little meat protein. While Max was having BMs on this food, they were huge, soft and very smelly which suggested to me that the food was going right through Max with little nutritive content being retained. I felt guilty all the time he was on this food as I felt it not good food. Long story short, what has finally made the big difference for Max is Slippery Elm Bark and Probiotics.  Max used to go sometimes 3 days without a BM. He now goes every day and sometimes every second day at the latest. This is due in large part to the SEB.

What Raintyger has mentioned with respect to long-term use of cisapride is accurate. For this reason, I believe it is important to exhaust all avenues before resorting to cisapride. Do your own research on cisapride to inform yourself of all the facts. If you do a search here of slippery elm, you will likely come upon a thread that I started at the beginning of this new year, as well as a handful of others. In my thread are details of the progress that Max has made, information about Slippery Elm and other supplements, as well as posts from other members of their personal experiences and progress.

If there is one piece of advice that I can leave with you, it is this : If  you can get to the root cause of the constipation, then this is half the battle won. Once you know what this is, then the rest is about determining the best route for preventing constipation. It's all about prevention. For Max, this was in the form of switching to wet food, incorporating the slippery elm which in part has the benefit of improving motility through nerve ending stimulation of the colon, and probiotics to improve digestion of food. B-12 has also shown the same benefit of stimulating nerve endings in the colon.

Here is a link to read more about Slippery Elm from a vet's perspective : http://www.littlebigcat.com/health/slippery-elm/.

Lots of positive vibes that your kitty will go very soon.  

Thank you for the advice about Slippery Elm and the littlebigcat.com article.  Very interesting.  When you say you give your kitty probiotics, exactly what do you mean?  

MaineCoonMom said:

 
Thank you for the advice about Slippery Elm and the littlebigcat.com article.  Very interesting.  When you say you give your kitty probiotics, exactly what do you mean?  

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Good morning .. How is your kitty doing today?

To answer your question ... I give all of my cat's a probiotic supplement which is mixed in their wet food everyday. I believe this has helped Max to better digest his food as his BMs look a lot more healthy and normal in size. My little female Maggie was producing small sharp stools which I thought were normal, for her, but on the probiotics, they are now round and look healthier. Some of this improvement however, I also attribute to the SEB in relation to Max. 

It is the live cultures in probiotics that help to introduce beneficial bacteria which in turn improves gut health and the result is better digestion of food. When digestion is optimal, this can result in greater bowel movement frequency and quality. If you have ever used probiotics then you may be familiar with the benefits this can have in promoting regularity and/or providing relief from digestive issues such as IBS. Cats can benefit from the same results.

I am currently using Natural Factors Double Strength Acidophilus & Bifidus Supplement. You can read more about this one, here : http://www.naturalfactors.com/caen/products/detail/2879/acidophilus-and38-bifidus-

If you are interested in trying a probiotic, for best results go with one that has minimum 10 billion CFUs, or active culture in plain language . Because these active cultures are live, you will want to keep probiotics refrigerated. Also, I find its best to give a small amount to start, like half a capsule to avoid possible stomach upset in the beginning. There is nothing harmful about probiotics, but some cats can react when introducing new things so its sensible to start small and increase over time when you see that the probiotic (or slippery elm if you decide to try this), is well tolerated.

Hope this helps.

I have an 18 year old cat who was having constipation issues about a month ago. I took him to the vet where they gave him an enema and suggested he take miralax. Since then I have been giving him the miralax and he has had been having a much easier time using the bathroom. His stools seem to be a pretty good consistency, not too soft and not rock hard like they used to be. However the past couple of nights when he has been sleeping in my bed I wake up in the morning to find a small piece of poop in my bed. I don't believe he is doing it intentionally. Has anyone experienced this before? I'm getting tired of washing my sheets every day!!

If it's a small hard piece he could be getting constipated.  It isn't unusual to have to increase the dosage of Miralax over time.  

My cat went through being constipated for years!  During the past year, the problem occurred often.  He was 14 and went to Kitty Heaven about 10 days ago.  When things were getting bad, a small, large, hard "chunk" would come out.  Always in his litter box.........but I think it was when he would "try" really hard to go and that is all that came out.  From then on, the situation usually got bad again.  An enema right away might help move what is behind that chunk and save him and you what usually happens next.  Maybe that chunk was right at the opening and he tried to leave it in the litter box..........but it made its way to your bed.  We can only guess.  And that's what the whole constipation/megacolon issue is about........it's all a guess.  Miralax works a little bit........as does Lactulose.  But I don't believe the problem ever ends.  Until..........it ends.  I wish I could give you more hope..........it's an awful ordeal for your kitty and you both.  Heartbreaking.  18?  Wow.........you're blessed to have your kitty for so long.  I hope you have years more to be together.  What are you feeding your kitty?

Thanks. I don't think he is constipated as he had a fairly large stool yesterday afternoon. I am feeding him purina NF because he has kidney disease. He is also diabetic. Poor guy. He still seems very happy and comfortable though. Thanks for your thoughts on the matter.

I have found that one little Dulcolax can help, although you should check with a vet first.  You can get the generic brand.  We use Miralax every day and if our girl still has trouble, we try a Dulcolax.  If that doesn't work, she gets an enema.  Fleet makes glycerin enemas for babies, these are much easier on a cat's body.

Be careful with the Dulcolax and enemas. They can both create dependencies--kitty won't be able to eliminate without them! Home enemas are also a bit risky, as you can rupture the delicate rectum lining.

Thanks for this information about Miralax. I have a Savannah kitten that is 6 months old we spent the weekend in a pet ER because she hadn't gone to the bathroom in days (I don't think).  I also have 3 rescue cats and they all use different litter boxes in the house.  Is this Miralax the same thing I can go to the grocery store and buy for people?  Do you need to add more water to their diet? My Savannah eats raw chicken so there is a lot of liquid in it, but I'm not sure if I should add more water (or course I can't make her drink it)!

Yes, it's the same Miralax that you see in drugstores.  We use the CVS brand of Miralax, and sprinkle it like salt directly into her food.  I guess it depends on how stopped up your cat is, but once she does have a movement, you can do this every day.   Raintyger is right,  dulcolax and enemas aren't the greatest thing for your cat, but if she needs it, she needs it.   A Fleet glycerin enema isn't nearly as harsh and easier on the body than the ones filled with chemicals.

You should check with the vet about putting water in their food, but it probably wouldn't hurt to add water.   Someone told me that cats prefer to have their water bowl very far from their food, and I think it's true.  I keep water in the kitchen next to the food, and I also keep another bowl in the bedroom, and the cats seemed much more interested in drinking from the bedroom bowl.  That might be a good way to get your cat to drink more.

Good luck!

CandiWilson said:

 
Thanks for this information about Miralax. I have a Savannah kitten that is 6 months old we spent the weekend in a pet ER because she hadn't gone to the bathroom in days (I don't think).  I also have 3 rescue cats and they all use different litter boxes in the house.  Is this Miralax the same thing I can go to the grocery store and buy for people?  Do you need to add more water to their diet? My Savannah eats raw chicken so there is a lot of liquid in it, but I'm not sure if I should add more water (or course I can't make her drink it)!

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Have you been feeding raw for long? It is normal for raw fed cats to have less frequent bowel movements. Every 3 days is not unusual. Raw feeding means that there is less going to waste, so less bowel movements.

You could add a little water if giving Miralax, but if her diet is 100% raw meals, then she should be getting plenty of water.

You should familiarize yourself with each cat's bathroom habits. When you hear one in the box, go take a look afterwards. Each kitty will probably have their own "style" and you will be able to tell after a while--one will prefer a certain area of the litter box, another will completely bury, etc. It will pay off in the future so you can tell who is sick. You will also be able to tell if someone's waste is not normal by seeing what exactly normal is right now. My kitty became chronically constipated, and it was hard for me to remember afterwards if certain aspects had always been that way.

Just to let you know about your concerns with Royal Canine dry food. I have a cat who absolutely will not eat wet food and about three years

ago developed chronic constipation. She went through a couple vets and many therapies until I finally found a vet in the area who saved her

life. One thing she recommended was to put her on Royal Canine. I really didn't think it would work as she is also very resistant to any dietary

changes so I started mixing the Royal Canine in with her other dry food. She actually ate it and that along with the Lactulose worked very well

until she decided she was not going to eat anything with the Royal Canine mixed in any more. I finally had to revert to letting her eat her regular

dry food and give her the Lactulose. I must say that I wish she had not rejected  the Royal Canine. It made her BM's a lot more regular with more

bulk and softness to them. I also just am facing the fact that I think I will need to take her off the Lactulose and am going to try Miralax and look

into Slippery Elm bark. The reason for taking her off Lactulose is that suddenly she has developed a very strong ammonia smell to her urine.

When I take her off the Lactulose for a day or two ( I will not go any longer than that) the order goes away. It makes me very suspicious that the smell

has something to do with the Lactulose and the vet agreed. She suggested the Miralax, which I hope will work for her. She is so sensitive to

changes and develops so many side effects from things in her environment that it becomes hard to work with her. I love her so much so I hope

it works because otherwise I don't know what I will do.

Anyway if your kitty will only eat dry food try the RC, it is a good product, in my opinion.I think this comes from the beet pulp that is in the recipe.

Beets in any form are actually quite an amazing product for constipation. I used it in liquid form when I had very bad constipation problems and it worked wonders.

My 14 year old cat Sam has colon damage and chronic constipation and I tried everything until I found a vet at VCA that put him on Royal Canine Gastro-Intestinal Fiber Responce dry food. He's been happy and healthy for 2 years now. I VERY rarely have to give him Cycapride or Lactulose. The vet also squeezed his anal glands out and said it's painful when they're full and can cause constipation.

Constipation will cause clear fluid or foamy vomiting.  As cats age they all eventually develop kidney problems which dehydrate the cat and cause constipation.

Chronic constipation and urniary tract infections are commonly associated with kidney disease.   No matter how much a cat drinks his body doesn't asborb it due to bad kidneys.  That's why they pee more because it goes right through them.  Don't be afraid to do SubQ's at home. Have you vet show you how and how often.  Very easy and painless for the cat.

I have Trupanion pet insurance to help out with the finances. They pay 90% of all pet bills minus visit fees. It has helped us out immensely and they've paid thousands towards is vet bills. The only thing I do not like is that they go by reimbursement. But they deposit the money into my account 4-5 days after the visit. I STRONGLY recommend them. They will also cover pets with prior health issues.