Blood and Mucous in cats stool - lots of other problems

Hi Everyone, 

This is my first post here and I am looking for some advice on our cat who has been through a lot of stress recently. To cut a long story short she was suspected of having a fracture in her spine a few weeks ago as she was unable to walk properly. Thankfully we did an MRI which showed no fracture but a bit of inflammation in her spine which was causing her nerves to be compressed. A short course of steroid (Dexamethasone) injections relieved her symptoms and her walking is almost back to normal now.

As a side effect of the spine issue she did have intermittent constipation and the vet asked us to put her on an oral laxative to take daily to help keep her stool soft (this is lactulose based syrup). We gave her this for a couple of days and she was passing quite soft but firm stool and we were quite happy with the results, however a few days later she started passing blood (clear red) and mucus in her stool and the quantity of the stool was quite a bit less than normal. She also seemed to be in some kind of gastric pain and was passing gas quite a bit.

The vet then suspected colitis and asked us to put her on a course of Metradinazole, this did not help the issue at all and seemed to make it worse. The vet then changed her to Prednisolone orally for 3 days, this seemed to help her a lot in the first two days, but today she is back to having fresh blood in her stool and seems to be in pain. Our vet now suspects a major bacterial infection and has asked us to put her on Cefadroxil (60mg twice a day) and give her some oral sucralfate to soothe the stomach irritation.

I hope this helps her, but I was wondering if anyone else had such a chronic case of blood in your cats stool and how you were able to handle it. We have not changed her diet yet as the vet wants to wait a few days to see if the antibiotics help her.

Some background on her, she just turned 15 years old last week and has been in good health throughout her life. We had her blood work done a few weeks ago before her MRI and all results were normal, except for slightly elevated white blood count. She has been on a semi raw diet throughout her life and we don't feed her any commercial cat food (as we live in India and the cat food we get here is the worst and our vet has told us that most of the food here will cause kidney and liver issues in cats if fed for a long period of time). We give her daily vitamin supplements and she is completely indoor cat and has actually never been out on her own. 

Thank so much for taking the time to read this long story...

Constipation can cause blood in the stool.  It sounds like you are getting very good vet care and this could very well be an acute problem that can be fixed.  I don't know if you can get Miralax in India.  It's a stool softener that is actually for humans but many people have had good luck with it in their kitties.  It doesn't work like a normal laxative.  It works by drawing water into the colon.  You would have to adjust the dosage but normally people start with an 1/8 of a teaspoon.

to TCS!

Due to the different time zones our members live in, it might take a while for you to get some responses, but hopefully somebody will be able to give you some helpful advice.

Sounds like your doing the best in what sounds like a bad situation.  You have a vet involved so that's good.  One thing that might help long term is to mix a little yogurt  into the food.  I wouldn't do it without talking to your vet first, especially since your in the middle of treatment.  I've had vets suggest yogurt in cases that were less severe than yours.  I add it to all my cats and dogs meals, have been doing so for several years and not had a digestive problem yet.

Hope that helps

Joe

Sorry your wee cats having problems.if she was constipated she probably was straining and maybe caused a fissure a tear in her back passage.the blood was bright red which is a clue that it was a tear.hopefully thats all it was.wishing her good health .

My youngest cat Angel had blood and mucus for awhile when we first got her. Like kittybelle mentioned, hers was from a tear caused by her constipation. It cleared on its own after we were able to resolve her constipation problems.

I also agree with Denice. If you are able to get Mirilax I would try that. It doesn't have a taste so adding it to food shouldn't be a problem. I have not had cat experience with it but my kids have used it on and off for several years. My daughter had such severe problems recently that she was in constant pain and saw at least two doctors a week for about a month when she was sent to a specialist 3 hours away. When we saw him, he told us to give her Mirilax daily for at least a month. Her constipation stretched her intestines and that made it harder to go. The Mirilax kept things soft long enough for her insides to heal themselves.

I know this is a horribly long post about a person and not a cat. But I just wanted to give you an example of how disruptive a little constipation can be and share how much softening the stool without using a stimulant can help. I would definately check with your vet since you're in the middle of treatment, but in some cases Mirilax can be a huge help.

(Sorry so long. It's 5am & I've been sitting up keeping my cat company. Being tired makes me babble.)

Thank you everyone for your replies. We don't seem to get Miralax here but will check with our vet in the morning. This evening our vet asked us to start on the lactulose laxative again tomorrow and hopefully she will be able to pass soft stools which may relieve her stomach ache a bit. She seems to have lost her appetite as well this evening, but that may be a result of the constipation and the new antibiotics. We are hoping that a good bowel movement will make things better. Thanks again for all the support and advise...

Thank you for the detailed reply petcrazy76. Do you think a Mirilax type softener will work better than a lactulose type one we are using now? I will check with our vet tomorrow to see if we have an equivalent here in India

I am currently having the same problem with one of my cats, Sophie. It has been going on and off for about a month and a half (some few days we see blood, some days we don't). She was seen by two different vets with no official diagnosis yet.

At first we thought maybe she had worms, so we gave her a milbemax pill. The blood was gone for five days, and than it started again.

At that point we thought of constipation - so the vet gave us Bezo-Pet and although her stools are not so hard anymore, we still see a few drops of blood on her stool.

We are currently suspecting a colitis, some sort of irritant in her food/food allergy. I know you tried treating for colitis, but maybe you could try a different treatment? People here recommended me slippery elm bark but I haven't tried it yet because I have to order it, as I can not find it shops. I am currently giving Sophie sulfalazine, but it is too soon to say if it is working.

What my vets told me is that fresh blood and mucus on top of the stool, and not mixed with it, is a sign of problem with the lower colon or the rectum. Blood in the stomach or higher up the intestine would turn darker until it was passed.

Sorry I couldn't be of much help. Please keep us updated, I will do the same.

I've heard that cats become accustomed to lactulose, and that they can become dependant on it. I know tthat's not the same with Mirilax. I don't know about lactulose as far stomach pains but Mirilax is very gentle on their systems. I would definitely ask your vet.

Miralax does the same thing that lactulose does, but most people are happier with the results from Miralax. They also like that it can be easily mixed into wet food and is not the sticky mess that lactulose is.

As IrinaSaK said, red blood indicates something in the lower colon, usually a tear. Blood higher up in the digestive tract gets mixed into the stool and makes it turn black. A common cause (but not only) of black stool would be an ulcer. So while having blood present in the stool is not good, it is good that you are getting red blood, as it is usually less serious.

Thank you for everyone for your replies. IrinaSak I am sorry to hear about Sophie and I do hope she responds to the Sulfalazine. Mithu our cat seems to have a similar problem and the blood is mostly after she has been straining at the litter box quite a bit so it is not really mixed with the stool. As Raintyger says we hope that this is a good sign. We do not seem to have Mirilax equivalent here in India so we have started her on the lactulose this morning and hoping this will show some results. Meanwhile we are keeping our fingers crossed. Will keep Sophie in our thoughts and hope she shows some progress..

Can you order Miralax from an online vendor? I belong to the Yahoo! feline megacolon/chronic constipation group, and the members overwhelmingly prefer Miralax, so I think it is worth a try to get it from an online vendor. Maybe even eBay if online stores don't have it/won't ship it.

Thanks Raintyger I just found it online at Amazon so will order it now. We are also planning to start her on a few spoons of pumpkin mixed in with her regular food so hoping that settles her bowel movements. .

I feed my cat pure protein in the form of ground chicken with the bones. It's great food but will lead to constipation with blood and mucous. Now I mix in a little ground flax. Problem solved. 

Vishnu said:

Thanks Raintyger I just found it online at Amazon so will order it now. We are also planning to start her on a few spoons of pumpkin mixed in with her regular food so hoping that settles her bowel movements. .

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Good luck, Vishnu!

If your vet doesn't know about Miralax (very common), the most common dosing is 1/4 tsp. for a 10 pound adult cat. Some people start with 1/8 tsp. and then adjust. It is dose to effect, which means that you take your best guess to start with and then adjust dosing. Miralax does take 2-3 days on average to show results and works on the newly forming stool (not stool that is already formed in the bowel system). If you join the Yahoo! feline megacolon/chronic constipation group, they will tell you how to transition from lactulose to Miralax.

Regarding pumpkin and fiber, there is a big controversy over whether or not high fiber is good for constipated kitties. Some people in the Yahoo! group feed high fiber and get results; others feel feeding high fiber to their constipated kitty stretched out their color and led to megacolon. I found that feeding high fiber made absolutely no difference in frequency of bowel movements, but did make it more difficult for my kitty to keep up with the stool output, so I went low fiber. Every kitty is different, though. I would say most of the people on the Yahoo! group feed low fiber. Feed WET food, no more than 1%-1.5% fiber content if you elect low fiber. IMO low fiber is safer to try first because if high fiber doesn't work the way of finding out might be because you discover your kitty's colon got stretched.

What is being done about the inflammation? Is she still on prednisolone? There are some home remedies like coconut oil or krill oil that can be given for that, but you should only administer one remedy/drug at a time so you'll know what the results are, if any.

Raintyger said:

 
If your vet doesn't know about Miralax (very common), the most common dosing is 1/4 tsp. for a 10 pound adult cat. Some people start with 1/8 tsp. and then adjust. It is dose to effect, which means that you take your best guess to start with and then adjust dosing. Miralax does take 2-3 days on average to show results and works on the newly forming stool (not stool that is already formed in the bowel system). If you join the Yahoo! feline megacolon/chronic constipation group, they will tell you how to transition from lactulose to Miralax.

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Oops, my mistake --

Should read that most common dosing is 1/4 tsp. TWICE DAILY for a 10 pound adult cat.

Thanks for the input. I did do my due diligence. I buy my chicken whole, grind it myself with raw bones. If it's contaminated. It's also contaminated for humans too. It doesn't take much flax to keep him regular. His health has improved greatly under this raw food diet.

Thanks Raintyger for all your advise. We started her on lactulose yesterday 2ml every 8 hours. She was quite listless all day and refused food altogether. She did drink a lot of water though and sometime during the night she had two medium bowel movements where the stool was soft but not watery and luckily there seems to be no blood. She ate a full plate of food this morning but still looks listless and seems to still have some pain in her stomach area. Thank you for the advise on the pumpkin, I didn't realise it could lead to megacolon, our issue is that the vet is quite clear that because of her spinal problem he does not want her straining in the litterbox at any point as that could damage her spine further, so he wants her to be on a laxative everyday of her life, and I am quite skeptical as to how good that would be for her as lactulose is just sugar and at her age it may not be a good thing for her to be on so much sugar. Do you know if Miralax is safe for long term daily dosing? As far as I could read online it seems to be quite safe... if not I need to look at an alternative to introduce some fiber into her diet. Thanks Rollie for the flax seed advise, will check with our vet about this as well.

Raintyger, she is off prednisolone for the moment, as the vet does not want her to be on it long term as he feels it could cause other complications. So he has asked us to dose her with a 3 day diminishing course as and when required, that is when she seems to have difficulty walking, but he has cautioned us that she cannot be given more than one 3 day course a month. We have also recently started her on Cosequin with the hope that it will improve her joints, however with the blood and constipation over the last few days we just have not been giving it to her. We could not give her the anitbiotic yesterday either as she was refusing food and we could not give it her on a an empty stomach.

We are keeping our fingers crossed that clearing her bowels will relive her stomach a bit and stop the bleeding. Thank you all for your advise and support so far...

Miralax is something that can be taken long-term, however some people have reported having to increase dosing after a while.

As for fiber, if you do need to add it, be careful in your situation what type of fiber you feed her--

Insoluble fiber increases stool bulk and might add to your spinal problems by making the colon full of stool more frequently. The colon could then cause stress and pain on the spine. Your kitty could be avoiding bowel movements because of the spinal pain.

Soluble fiber does not increase stool bulk,  but also slows down digestion. Good bacteria colonizes using the fiber as a growth base. So you probably want something with more soluble fiber than insoluble fiber, and just the right amount so it does not slow down the stool transit time too much.

Foods that have fiber always have a combination of BOTH insoluble and soluble fiber, so you have to pick one where there's more soluble than insoluble. Pumpkin is a good choice, otherwise you can get Benefiber at a drug store. Insoluble fiber is found in mainly carbs (grains) and vegetables--not a good choice in general for kitties anyway.

Long-term prednisolone use can cause diabetes, so it is good that your vet is on the lookout for other ways of relieving the inflammation. Unfortunately there are not many anti-inflammatory medications that are safe for cats. If you are offered Metacam/Meloxicam, THINK CAREFULLY. Do some research, as this drug has been known to cause acute renal failure in a small percentage of cats. My previous vet gave me this without any telling me any precautions, and boy was I scared when I found out, as I had already administered one dose. I would try other remedies first before Metacam. Many have had success with the Cosequin. I believe hyaluronic acid is also frequently used in conjunction, I'm not sure exactly what the mechanism is in that.

Good luck, let us know how everything works out!