extreme constipation, might need surgery :(

Hi everyone,

I posted earlier about my almost 10 year old boy cat Nub and how he was given an overly large amount (1 teaspoon) of psyllium husk (metamucil). Well I'm pretty sure that is what has caused the current situation. 

After he refused to eat and was having watery diarrhea he ultimately had an ultrasound and they discovered a very hard piece of poop stuck in his colon yesterday. They gave him something to stimulate the movement of the intestines, as well as a stool softener, in hopes that he would poop, but I took him home overnight and he still hasn't besides some more watery diarrhea. (He has been force-fed for the last couple of days because he won't eat).

The vet is going to take an x-ray today to see if the poop moved and then make a decision on what to do, but she told me that if it hasn't moved then the next step would be to put him under light anesthesia and give him an enema, and if that doesn't work he will need to be operated on.

i'm obviously completely freaking out about this (I live alone in Amsterdam now as an expat, so Nub and his sister, Squish, are pretty much all I have). I'm frustrated because I really believe that the psyllium error is what caused this in the first place. 

If anyone has had any experience with very constipated cats, too much psyllium, cats that required surgery for constipation, or anything related, I'd appreciate advice and/or calming "this happened to my kitty and he/she was fine" kinds of stories.

Thanks very much for all the help and support thus far, it has been tremendously helpful. 

I don't believe the psyllium caused the impaction.  It did give him diarrhea which is moving around the impaction which is actually good so he isn't really backed up which could cause real problems.  I can't give any advice on his current situation that is something the vet will have to take care of.  I am sorry you are going through this with your kitty.

Any update on Nub and what's next for him? Lots of wishes that he has pooped and feeling better. 

Thanks Denice and Susank521. Still no poop! They took an x-ray yesterday and it did seem that the poop had moved, so they decided to wait for it to come out on its own for the time being. They also saw a lot of gas, which was thought to be the cause of his nausea and the reason for him not wanting to eat. 

He was given Emeprid for nausea (Metoclopramide) and I am to administer 1/4 of a tablet twice a day, and I was told that this is also supposed to increase gastrointestinal motility. We went home in hopes of poop, but here we are 1 full day later and he hasn't pooped at all, not even diarrhea.

The medicine has seemed to help him feel a little better, he finally slept some (he basically had not slept at all in close to 3 days) and even showed some interest in food from his bowl, but only a few bites at a time. I am still force-feeding and praying for poop. 

Just spoke with the vet tech and she said she will call me back if the vet thinks he needs to come back into the office today or whether we should wait until tomorrow morning to see whether he poops. My vet's office has 2 vets in alternating shifts and today is the one I don't trust so much though, so if anyone has feedback on how long cats can safely go without pooping, that would also be helpful. 

I think the reason the diarrhea has stopped is that he is cleaned out so to speak except for the impaction.  It isn't unusual after an enema that gets everything for a kitty to go up to 3 days without poop because it takes that long for enough to form again.  It would be good to get what is in there out before more forms.

Oh no he didn't get an enema in the end. That's the thing. They waited a while and then took an xray and then decided that the impaction had moved so they would just wait for it to come out, but it still hasn't. That's why I'm wondering how long it's okay for him to go without pooping. 

Hopefully it will move SOON. I would insist on an enema at this point. It's been blocked too long. That way you'll know if it you will have to operate. It's having an impact on his health.

Surgery is very invasive if they have to go into the intestine. Your cat is going to be sore, on heavy pain medication, and I suggest oral antibiotics instead of the antibiotic shot (convenia controversy). He's not going to eat on his own a few days so you'll have to assist again. You may even have to take him in a couple days for IV hydro therapy. You'll have to deal with the stitches and cone for 14 days as well.
AND it is expensive.

I just spoke with the vet and he seems to feel it is safe for him to wait until tomorrow. I hope very much that he's right, and even moreso that Nub poops already! 

If he doesn't poop by morning I will bring him into the office again and then maybe we'll go with the enema option. The vet said that maybe they'd take another x-ray first to re-assess, I'm not sure whether it's better to spend the money on that or go straight to the enema... 

This has been going on for a while! I wonder if your vet would be so "patient" if it was his cat?

I would insist tomorrow is enema day....and not wait again.

X-rays are expensive and it can be milked for quite a while to "see if it moves."

Have you given Nub a large dose(s) of hairball gel?  It may not be something you want to use daily but in these circumstances something to help it 'slide' out may be useful.  I brought my two cats to the vet last week and he talked me out of enemas for them ($1,400 total for bloodwork, x-rays, enemas, etc).   One cat hadn't defecated in 7 days, the other in 4.  The vet tech dosed my cats with Laxatone and sent us home.  One cat went within a couple of hours of returning.  The other went the next morning.  Granted my vet examined my cats and assured me that while they had feces in the colon, it was not impacted.  My cats's feces were soft as I was giving them Miralax.  

$1400 for enemas!!!? That is crazy.

Your vet should be on very familiar ground with your cat's colon by now. I'd suggest having the vet feel around first and ask him/her to make a judgment based on that. If the vet feels there has been no dramatic change, I'd forego more xrays and go the enema route.

Poor Nub! I know it's hard deciding what to do, especially since you don't have a lot of confidence in the vet that's there today. With them suggesting waiting, perhaps the feces is close to being eliminated? Did the vet give any explanation regarding their reluctance to administering an enema? I think I'd have to agree with those above, tomorrow should be an enema day unless there is some really good reason they are avoiding that course. Lots of wishes that Nub poops! 

Thanks Susank521, I had hoped that it was close to being eliminated but I just keep waiting and it's not coming and it's agonizing. I am trying to trust that the vets know what they're doing but it is difficult to know for sure whether I can. 

Are enemas fairly common, or is it a risky procedure? Should I be worried if he needs one? 

My kitty is prone to constipation and has had a few.  I am sure he didn't enjoy the experience but he was fine.

I guess I will push for the enema tomorrow if he hasn't pooped yet, but that scares me... Mosimom, tdonline, and cocheeezie, thanks as well. 

Also Denice regarding the psyllium, I still believe that is what caused the impaction. I had given him Laxatract (lactulose) for 2 days prior to the psyllium and he was pooping great, he pooped every day and the poop was soft. As soon as I gave the "overdose" of psyllium, this happened. Also when I administered that dose I called my vet back in Baltimore to ask them whether it was an emergency (since the Amsterdam vet was already closed), and they said that while not an emergency, it could cause him to be more constipated.

I can only give you my experience, so here goes!
My then 11 year old cat Poppy had problems with her bowels in August and became severely impacted. Took her to the vet who tried an enema under light sedation. This didn't work and a few hours later, she had to have manual evacuation under general anaesthetic. She was absolutely fine afterwards and to stop it happening again, she is on Miralax and Lactulose. An enema isn't that big a deal but the manual evacuation was a bit more difficult as the faeces were impacted high up in her colon!

my cat had chronic constipation...has anyone tried massaging her anal area?

worked for us sometimes

My 16-year-old duchess had an enema a few weeks back. She was not sedated (that I know of) during the process. It worked, albeit in tiny bits & pieces, over 12+ hours. She did not get much sleep, and was quite exhausted about the entire experience - car trip, vet visit, the indignity of it all, litter box trips - but once we (vet, forum, me) figured out the right meds for her, she rebounded quickly.

If your cat is a long hair, you might request a bit of shaving beforehand. It can get messy back there.

Also frequently check your cat for dehydration during and afterward.

As poppysmummy said, the enema, with the light sedation, is really less of a concern than impaction. In the end you've got to do what you feel is best for Nub, based on the information you've got. You'll be able to see your preferred vet tomorrow, so hopefully that will make your decision easier. Enemas are not typically a major deal, that's why I can't help but think there is some reason that the vet is reluctant to do the enema. It's something you may want to ask them tomorrow. Hopefully his nausea is still settled. Is he drinking lots of water? That's helpful, of course. Water with a little tuna juice in it might entice him. Come on Nub, poop, guy!

About the metamucil, the instructions you received, 1 teaspoon sprinkled on food, are exactly the same as I received from my vet last week for my constipated kitty.