Mega Colon

I have a friend that is looking at this diagnosis for her kitty. Her baby is 15 years old and the vet is telling her with this diagnosis nothing can be done i.e. euthanasia. Her kitty is perky but because of the messiness has to be secluded from the rest of the family. She's been battling diarrhea for the last several weeks and everything else has been ruled out. If anyone has had to deal with this issue and diagnosis any input would be appreciated. The cat has been on digestive medications for a few years now and it's just stopped working.

No!!  Euthanasia is NOT the only option!  I would have your friend take her kitty to another vet.  Someone who is familiar with how to treat this condition.  My tuxedo boy, Spyder, is 15 years old and was diagnosed with megacolon about 8 years ago.  He has been doing very well with a medication called Cisapride (for bowel motility) and Miralax to soften the stool.  You will need a prescription for the Cisapride but Miralax (or generic equivalent) can be bought over the counter. 

What "digestive medications" has the cat been given?  What do you mean when you say "everything else has been ruled out"?  If this cat indeed has been diagnosed with megacolon (x-rays taken?) then it can be managed.  A severely constipated cat will sometimes have diarrhea because there is a solid blockage (hard stool) and fecal liquid is leaking out around it.  The poor cat probably needs an enema to remove the blockage.  In some cases, the cat needs to be cleared out manually under anesthesia.  If this cat has had diarrhea for several weeks, it is most likely dehydrated and needs to be evaluated and treated by a competent vet.  Please urge your friend to take the cat to another vet ASAP.  There is a very good Yahoo group with lots of useful information.  Here is the link:  https://groups.yahoo.com/neo/groups/Feline_Megacolon/info   Please post an update about this kitty.  I would hate that this poor animal would be put down for a condition that will respond to the right treatment.

I will ask about the medications I think she has been on the motility drug for several years. I have suggested she take her kitty somewhere else but she wants to give her vet a chance. Her kitty has been followed by a vet for several weeks now. She said her kitty is being treated with an IBS protocol and anti inflammatory medications now. It looks like her vet was preparing her for the worst in mentioning the euthenasia. I personally thought it was an extreme suggestion at this point. Apparently she is now in a constipation phase again. Yes X-rays were taken, cultures were taken etc to rule out any Bactrial infection as a cause for the diarrhea. She was given 2 enemas and she did have a blockage that cleared but then the diarrhea came. I got an update yesterday and it looks like she is now constipated again. I don't think they have her on an miralax. Is there a formula for the dosage?

I found out she is on Cisapride and miralax it's just stopped working[emoji]128542[/emoji]

I agree with the idea to look for another vet. Euthanasia at this point is a ridiculous, offensive suggestion. I am wondering if the current vet has recommended a high fiber diet? This can actually make the problem worse, even though it is often thought to be a cure-all for constipation issues. Adding bulk to a system that cannot move just compounds the amount of material backed up in the colon. Wet food with a little water added is a much more appropriate diet for a constipated cat.

The Yahoo group catluuver mentioned is a great resource. Your friend will be able to find some good advice and new ideas to try on there.

Just got home and saw your post.  I'm sorry that the Cisapride and Miralax stopped working for this kitty.  What kind of food is this cat being given?  There are special foods just for this condition that can be of help.  I'm sorry but I have no experience dealing with an IBS cat.  My Spyder just has chronic constipation and does not have diarrhea issues.  When he was first diagnosed, he was put on lactulose.  It was a thick syrup and he apparently hated the taste of it.  When I tried to dose him with a syringe, it went everywhere but in his mouth!  I discovered there was a powdered version called Kristalose and I obtained a prescription for it.  It is available at any pharmacy.  I was able to dissolve the powder in water and it was a lot easier to give my cat his doses (a lot less messy too).  However, the Kristalose has gone up in price and is now very expensive.  I ended up slowly weaning him off the Kristalose and replacing it with the Miralax.  So far, no problems!  May I ask how much Miralax your friend's cat was given?  There is no "set" dose.  Most vets will start a cat out at 1/8 tsp. twice a day.  However, it is really a "dose to effect" kind of thing.  Spyder needs about 1/2 tsp.  Thankfully, it seems to be working for him.  I am sorry that this not the case for your friend's kitty.  There is a support group for owners of IBS cats on Yahoo (the other group I mentioned in my last post was just for megacolon cats).  It might be beneficial for your friend to subscribe to this group and maybe get some ideas from other people who own cats that have this problem.  I will give you the link:

https://groups.yahoo.com/neo/groups/feline_IBS/info

Today was the first day in weeks she had a normal BM. I'll forward the info about a lower fiber diet and the miralax dosage. Her food has been switch but I'm not sure to what type food. This kitty has been battling the motility issue for over 10 years now and this is the first time the remedy's are not working. the IBS regimen may be working, fingers crossed.

I am SO happy to hear this!  Wonderful news!  It may be tricky to find the right combination of meds and food but there is certainly still HOPE for this kitty.  By the way, what is her name?  Keep us posted on her progress....

Her name is Chelsea she's a grey and white with a bit of a grumpy cat face. Correction on the age she is 16. Hopefully tomorrow she will continue with the solid BMs. She's on lactulose and miralax both as well as Cisapride and now an anti inflammatory. The vet has recommended ID wet but she hates it. Any food that has helped any of your kitty's?

Hmmm.... I see that no one has made any cat food suggestions yet.  I'm sorry that I can't really help with this.  Spyder has not required a special diet and eats the "regular" stuff.  I usually make it a point to add a bit of water to his canned food.  This helps the Miralax do it's job to "move things along"!  I am guessing that the ID food is Hill's.  A lot of vets send people home with this to give to their cats.  I once had a cat that refused to touch this particular brand too.  There are plenty of other brands available to choose from.  The best choice is a good, premium no or low grain food like Wellness, Natural Balance, Royal Canin or Merrick.  Wet food is probably better than dry.  Keep trying till you find something she will eat.  How is Chelsea doing today? 

Today she is back to being constipated[emoji]128532[/emoji] They are increasing the laxatives. It is unfortunate but my friend is still hopeful.

hexiesfriend said:

Her name is Chelsea she's a grey and white with a bit of a grumpy cat face. Correction on the age she is 16. Hopefully tomorrow she will continue with the solid BMs. She's on lactulose and miralax both as well as Cisapride and now an anti inflammatory. The vet has recommended ID wet but she hates it. Any food that has helped any of your kitty's?

Click to expand...

I have a Manx Syndrome kitten.  His general story is on Beastie Momma's fairly new Manx Syndrome Advice & Support thread in this Forum section.  He does not have megacolon, but he has had recurrent constipation all his life, and about a month ago was fast approaching megacolon.  These days he eats only wet (canned) kitten food, but it is served extra extra wet, with about 1/3 can of water added to the contents of each can.  There is another,  all-stage food type that I have given him at some  (worried)  times, though, that has seemed to result in appreciably softened stools -- it is pouched Whiskas Choice Cuts Poultry Selections and pouched Whiskas Choice Cuts Seafood Selections.  They are packed in a good deal of apparently palatable gravy (or sauce).

I hope Chelsea and her caregivers can find a good a good solution for her.  Prayers for her from here.

Tough situation.....

Hello....  Just checking in to ask how things are going with Chelsea.  Has increasing the laxatives helped?  Have you found another brand of food that she will eat instead of the vet recommended one that she hates?  Sending my best wishes that things are improving for this kitty!

Unfortunately she is not improving this is now going on 2 months now and nothing is working. It was for the last 10 years but now no more. Tomorrow surgery is going to be discussed with the vet but she's 16 years old. It's not looking too good. She was found very very malnourished as a kitten and has had a lot of issues throughout. It's just tough all around.

Sorry to hear that Chelsea does not seem to be improving.  You mentioned that surgery will be discussed with her vet tomorrow.  By surgery, you must be referring to total or subtotal colectomy.  Am I correct?  There was a time when I was considering this option for my Spyder.  This was before I was able to get his constipation under control and he required repeated enemas to unblock him.  I contacted a board certified veterinary surgeon in my area that specialized in this particular procedure.  He explained that in some cases, a cat will no longer respond to medication and the only hope for these animals would be surgery to remove part or all of the colon.  He told me that he had done this surgery hundreds of times and the majority of his patients did very well and recovered nicely (even the senior cats!).  Talking to this surgeon really put my mind at ease!  Fortunately, Spyder got through his rough patch but if his meds stop working in the future, I would not think twice about getting him the surgery.  Let me know how the discussion goes tomorrow.  Perhaps the vet can suggest an internal medicine specialist to take Chelsea to and have her evaluated.  A second opinion is always a good idea especially in a serious situation such as this one. 

I will let my friend know about the surgery info. Thanks.

It might be a little late in the game, especially since you are discussing surgery at this point; however, high fiber diets are not recommended for cats with constipation or megacolon. 

You mentioned she is refusing the suggested food because she doesn't like it. Have you tried to gradually incorporate it with her  current food by mixing in just a little at a time and gradually working up to just the ID wet (some is better than none)? Ask your vet if you could try Iams vet formula low-residue canned cat food. Also, ask about giving a daily probiotic.

Unfortunately, megacolon can't be reversed, but it can be treated. The soft muscle has lost it's elasticity and a stretched pocket develops in the colon in the rectal vault, which allows the feces to build up. The water is absorbed from the collected stool and becomes hard and when a large amount builds up, the muscle stretches. (kind of like a balloon after it has been blown up to capacity. After the air is left out it looks like the flappy skin hanging off my upper arms. Poor analogy, I know, but it hopefully draws a picture?). 

I know that, when I was a geriatric nurse, I would gently massage my patients abdomen in the direction the stool normally moved through the colon to assist in moving it down and out. Of course, this was done on humans, but I don't see why it wouldn't work the same on a cat. Ask your vet if light abdominal massage would help (maybe incorporating a gentle, full-body massage would help with relaxing and comforting her as well?) It never hurts to ask! 

There is also another thread on here (started back in 2011 - most recent post 4 days ago) that discusses Megacolon. Not sure it really offers much info, but there is a case about a very successful surgery you might want to read. 

http://www.thecatsite.com/t/236396/my-cat-had-colectomy-surgery-for-megacolon-looking-for-others

At any rate, ask, ask , and ask questions! The more you ask, the more you learn and even the most 'trival' of answers could be the one you need most! 

I will keep you, your friend and Chelsea in my thoughts and prayers that you get the right answers and all turns out for the best.

Thanks Fyillis

So...  How did the discussion with Chelsea's vet go?  I've been thinking of Chelsea today and hoping for the best!