Help! I don't know if my cat is constipated or has diarrhea

Hey everyone,

My cat Noah has been having bathroom issues for over a week now (after having giardia) and I was wondering if anyone could offer any advice (might be a little graphic).  I don't know if he has diarrhea, constipation, or a bit of both. He is also a five year old cat that has never had any health issues before (except for being a tubby boy).
 

So today Noah is still going to litter box but cannot push anything significant out.  A little bit of liquid poop will come out and stick to his butt which I keep wiping up.  However, when I go to clean him up, I can see his anus is wide open and I can see a formed poop just sitting in there.  It doesn't look hard because the outside looks wet but I can't tell without actually seeing it in person.  Luckily, when I clean up his bottom there doesn't appear to be blood in the stool but that can always change. 

I am guessing that he cannot push out the poop because it is not large enough.  So I have been mixing pumpkin in with his wet food in an effort to bulk it up.  Any thoughts on this?  Is this how you would treat him?  Should I be worried I can see inside his anus?  It's so hard seeing him go through this.

Thanks in advance for any info! 

PS: Here is his background information if it helps

1) This all began last week when Noah started having bloody diarrhea.  

2) He was diagnosed with giardia and the vet prescribed him Flagyl. 

3) After a few days on the medication, he appeared to be feeling better but then became constipated. We did find a couple of hard poops around the house (with fresh blood in them) which we assume came from him. 

4) The vet prescribed him Lactulose, which is a stool softener, to administer twice a day.  He has had three doses so far over two days which we have stopped due to his most recent symptoms.

It sounds like he's seriously constipated and blocked up. I would call your vet and describe what you're seeing and asking if an enema may be needed. It is not normal for the anus to be wide open and have a formed poop be visible inside.

I know in people with severe constipation the diarrhea you see is what is forced out around the constipation. Your poor cat sounds severly constipated, please call your vet to see what he recommends.

Di and Bob said:

I know in people with severe constipation the diarrhea you see is what is forced out around the constipation. Your poor cat sounds severly constipated, please call your vet to see what he recommends.

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Absolutely this! In bowel obstruction of humans, the bowel tries to eliminate the obstruction by becoming hypermotile. That's why you see diarrhea "slipping" past the obstruction. This is a veterinary emergency.

Good luck!

Thanks so much for all your input!  I really appreciate it.

Noah did have this same problem last week while we were waiting for the Flagyl to start working and eventually he passed the stool (and I thought this would be all over with!).  He doesn't appear to be in pain.  I just hope giving him pumpkin won't make him worse.  I called the vet and he wasn't there.  I may try calling the emergency vet and asking for his or her advice.