Chronic constipation

abbessheloise

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I've posted here about introducing my two cats (who are now the best of friends, so thank you all for the advice!).

My older cat Pippin had surgery in April to remove a blockage, and recovered well, becoming a happy, healthy cat. However, since the operation he's had a few bouts of constipation that have led us to the emergency room for a full removal. The last one was on Saturday night.

He's on an all wet food diet and I add water to the food to make it a bit soupy before feeding him. He's also on Lactulose, but after reading some of your opinions, it looks like this may not work as well as I'd hoped. All other health signs are fine (blood, thyroid, urine etc) and his coat is shiny, his appetite good and his bowel movements regular (every 24 hours). However, he's still producing hard, dry stools.

Has anyone else had issues with chronic constipation, and if so, what have you done to remedy this? I'm in Australia, so I can't get Miralax here (I think the equivalent is Osmolax but if anyone knows for sure, please let me know!) and I don't want to switch meds before talking to a vet.
 

Kieka

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I've never had that problem but I have heard that canned pumpkin or cooking some squash or pumpkin can help with that in cats. Have you tried maybe switching to a different food with more fiber (just thinking of what they recommend for humans)?

Hopefully someone on here has some more first hand experience that can help. Good luck!
 
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mrsgreenjeens

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If you can't get Miralax, look for something where the active ingredient is polyethylene glycol 3350.  It's very possible the Osmolax is the same product with a different name. I know in Canada it's called something different too.

I second trying some canned pumpkin, or real pumpkin if you want ( or have) to go to the trouble.   Use about 1 teaspoon per meal.  It's an unsoluable fiber which should not bulk up the stool, yet helps it to pass thru the colon. 

But, really, if you can find the Miralax equivalent, that's your best option, IMHO.  I've had two chronically constipated cats, and it worked miracles for them.  Somehow it helps the intestines retain water, which helps sotten the stool.  We used between 1/8 and 1/4 teaspoon morning and night, diluted in some of the extra water we added to their canned food.   If you use too much, you'll know as their stool will get VERY soft.  Then just back off a little in the amount used.  If you don't get the right results, increase a little. 
 

bellel

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How much Lactolose are you giving him? I have a cat with chronic constipation and I've found that with the right dosage it works great. And if the dosage is too high, it makes her have diarrhea. She's 15 pounds. We started her out on 1.7 ml every 8 hours. That caused the diarrhea. We scaled back to 1.7 ml every 12 hours and she's finally producing good stool. And because it is a chronic conditions, she will be on it for life. Has your doctor done any tests to see if he's possibly developing megacolon?
 
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molly92

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I second trying some canned pumpkin, or real pumpkin if you want ( or have) to go to the trouble.   Use about 1 teaspoon per meal.  It's an unsoluable fiber which should not bulk up the stool, yet helps it to pass thru the colon. 
Just to clarify, pumpkin is mostly soluble fiber, which does not bulk up the stool nearly as much as unsoluble fiber, so if you're looking for alternative fiber sources, make sure you stick to mostly soluble ones! Acacia fiber, sold at places that sell supplements, is also a good soluble fiber. Soluble fiber absorbs water in the stool and makes it softer, and unsoluble fiber can push everything along but it can bulk up the stool too much, and make constipation worse and/or damage the colon. 

My Delilah struggled with constipation for months. I eventually got her kind of consistent on a bit a of Miralax and acacia fiber added to her wet food, but both of these seemed to work less and less well over time, and I didn't want to keep increasing the dosage.

I tried a few other remedies, including slippery elm, but the one that finally worked was probiotics! I just add a bit of human acidophilus probiotics to her wet food at each meal and she's been doing wonderfully for about 9 months now. It's really been amazing. I don't have to add miralax or fiber to her food or anything. I'm guessing something upset her microfloral balance that created the constipation in the first place, and probiotics helped to put everything back in order.

Another slightly more minor tip for constipated kitties is to brush them often, because ingesting large amounts of fur is difficult on the colon and can contribute to constipation. When I brush my cat daily I notice much less hair in her stool.
 

bellel

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Thanks for the info on acacia! How much do you give your cat?

My kid's constipation started because of a flare up of arthritis in her left rear leg, making it hard for her to squat. It also kept her from eating and drinking because she didn't want to get up. Now she's on gabapentin, lactolose, and a pain med. The lactolose is working great, but I'd like to find something that helps where I don't have to syringe it into her mouth.
 

molly92

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Thanks for the info on acacia! How much do you give your cat?

My kid's constipation started because of a flare up of arthritis in her left rear leg, making it hard for her to squat. It also kept her from eating and drinking because she didn't want to get up. Now she's on gabapentin, lactolose, and a pain med. The lactolose is working great, but I'd like to find something that helps where I don't have to syringe it into her mouth.
I think I started with 1/8 tsp mixed into her wet food twice a day and went up from there.

Can you ask your vet if you can get the lactulose in a powdered form? That might be easier to disguise in her food so she doesn't need to take it with a syringe.
 

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PEG= Polyethyl glycol.  In Canad it's known as Restoralax or Mirilax. I prefer Restoralax as it doesn't cause as much bloating and gas. I've had a cat with chronic constipation since he was 2 and he will be 17 this December.  After checking with your vet, start with a 1/4 tsp daily in wet food. It will take awhile to work if there is hard stool blocking the new. Is your kitty on ciscipride? That is a propulsate that allows the stool to move through the bowel faster.

Also, have your vet teach you how to massage your kitty's bowel. With all of these in place, your kitty will be fine. It's just second nature for me now and my boy is doing great....and he's had his share of issues.

Hugs to you and your kitty!
 

mrsgreenjeens

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I second trying some canned pumpkin, or real pumpkin if you want ( or have) to go to the trouble.   Use about 1 teaspoon per meal.  It's an unsoluable fiber which should not bulk up the stool, yet helps it to pass thru the colon. 
Just to clarify, pumpkin is mostly soluble fibe
OOOPS!  Mea culpa 
    Thanks for catching that. 
 
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abbessheloise

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Hi everyone! We had a huge storm on Sunday and no power till Tuesday night, so sorry about the late responses!

I've tried pumpkin in food, but since the March incident, Pippin has been (rightfully) suspicious of all non-cat food and avoids it. He's quite picky and gives me filthy looks if I try and change from his traditional plain boiled chicken breast wet cat food diet. He's been prescribed Hills R/D diet so we'll make the switch slowly! This is the complete opposite to the kitten, who will eat anything she can get her little face into. I sometimes wish she was the cat with digestion problems - it's so much easier to feed her remedies!

I've spoken to his vet about lactulose and Osmolax and we've worked out a routine for him going forth combining the two. I also have a different form of lactulose to add to his food. We talked about ciscipride but this is going to be the next phase of intervention if the first one doesn't work! I'll give them a call today to talk about slippery elm as well. He hasn't been checked for megacolon yet, but this will be part of the 'next phase', should it get to it.

Thanks also for the tip on brushing him - he's an overgroomer and we've started a routine of brushing him while he lies in the sun. I'm trying to do it for both cats, but the kitten won't sit still long enough


He'll go back for a check up in the next month or so and I'll talk about a future plan for him.
 

darkhorse321

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I found PEG (restoralax/mirilax) much better than lactulose. But every cat is different. Also, learn how to massage the bowel. Your vet can teach you how to break the stool up inside your kitty while it's still soft and maliable. This makes it much easier for kitty to pass (at least in my boys case).
 

bellel

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Massaging, however, won't work if it gets too backed up and dry. Then it's just painful, so keep up the massaginG if you do it while kitty's stool is still soft.
 

bellel

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molly92

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Totally agree! My Pepper had to have 2 before we finally got her on the proper dosage of lactolose. And don't worry....enemas are not stressful for the cat. They are very gentle and help a lot when the stool is dry in their bodies.
I'm glad your cat did well with the enemas, and they definitely are necessary when the stool has been backed up for too long and can't come out any other way. My cat had to have 3 before her medications were adjusted correctly, but they were definitely incredibly stressful for her. Then again, she acts like she's dying when she's just being brushed, so she might be extra sensitive.
 

bellel

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I'm glad your cat did well with the enemas, and they definitely are necessary when the stool has been backed up for too long and can't come out any other way. My cat had to have 3 before her medications were adjusted correctly, but they were definitely incredibly stressful for her. Then again, she acts like she's dying when she's just being brushed, so she might be extra sensitive.
Makes me wonder if your cat should get a light sedative (maybe a Xanax) if she ever has to do that again? Because my Pepper freaks out about everything and I had several techs and vets tell me how amazing she was during the procedures. And they told me that wasn't uncommon. Hmm... something to think about.
 

molly92

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Makes me wonder if your cat should get a light sedative (maybe a Xanax) if she ever has to do that again? Because my Pepper freaks out about everything and I had several techs and vets tell me how amazing she was during the procedures. And they told me that wasn't uncommon. Hmm... something to think about.
Yeah, knowing what I know now I think I would make sure the vet knew how stressed out she got and explored every option to make her more comfortable if she ever had to have one again. I'd just gotten her when she started having problems and it took me a few trips to different and vets to find one that I felt really knew how to help her and handled her gently, and by then she'd already had the enemas.
 
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