Q's constipation problem

Hi,  I'm new on this thread.  My 12 year old neutered male Q has been having some issues with his bowels. He started straining and there was blood when he was trying to go.  Brought him to the vet and his doctor put him on Lactoluse 2X a day plus a chewable antibiotic table 2X for 7 days to help with the blood. He seemed okay for a couple of weeks, but then it started up again this past Friday and this time the blood was really bad.  Brought him again.  Did xrays, more blood work and sent his stool to the lab.  Miralax has now been added to what he has to take and his lactoluse dosage was increased to 3 times a day, as well as a probiotic that is sprinked on his food in the morning.  This was about 3 days ago.  I got his results back and they said everything looked good.

He seemed to be doing okay, but last night he went (stool was soft - but not super soft), then about 45 minutes later started to seem to be straining again.  There was some blood then he went again (stool was again soft).

It's just very frustrating. I  have paid over $600 to his vet for this problem and I hate seeing him like this.

I was wondering if anyone else has encountered this kind of problem?  I just don't understand why there is sometimes blood. When he went last night, both stools were soft.

He's also diabetic, but I am not sure if this would have anything to do with it as his blood sugar/fructsomine levels have been the best yet.

Miralax would be what I would have chosen. How much are you giving? Increase the dose. Miralax is pretty benign.

Constipation can definitely be complicated to figure out, I've been there.

The thing about miralax and any oral constipation remedy is that it can only help with the stool that is being formed, not the hard stool already sitting in the colon. Sometimes soft stool can be pushed out around the hard blocked stool, which might be what you're seeing. The only surefire way to clear a blockage that has been around for several days is an enema. I would take him to a different vet and see what they think. I had to go to 4 vets when my cat was chronically constipated before I found one that was actually helpful.

It's weird that they didn't recommend an enema to begin with, since he sounds so blocked up. The x-ray should have shown that. Perhaps it has gotten worse since they took the x-ray. To keep costs down, if the next vet recommends an x-ray (which are expensive!) maybe ask if they can just go ahead with an enema without it.

My cat had some mucousy blood a couple times during the worst of it, but they still couldn't find anything "wrong." After several enemas and trying remedies that didn't work we finally worked out adding 1/4 tsp Miralax twice a day to her food as well as some acacia powder fiber. This fiber is soluble, which is very important because it retains water making the stool softer. Unsoluble fibers make the stool bigger, and while they sometimes seem to help push things through, they can also make it more difficult and uncomfortable if the stool is too big, and this can stretch out the colon and lead to megacolon. Canned pumpkin is another good soluble fiber, but my cat wouldn't eat it.

That worked for a few months, and then it started to lose efficacy and I had to keep tweaking the dosages. Finally I started adding probiotics to her food, which miraculously solved everything. She doesn't need any fiber of miralax or anything, just those probiotics. Not all probiotics are the same, though. Acidophilus and a high CFU count seem to be very important. I use PB8 Nutrition Now, but there are lots of options out there.

Some other tips to keep constipation at bay: hydration is so important. Feeding exclusively wet food is best, but if that doesn't work for you feed as much wet as possible. Exercise helps keep the bowels moving and active, so if you can engage your cat in more playtime that would be good. Also fur can get caught up in the colon and aggravate things, so frequent brushing can help.

Constipation in cats can become serious very quickly. It's important to take your cat to a vet immediately if he becomes lethargic, loses his appetite, vomits, or has gone more than a couple of days without a bowel movement.

Since you say your cat is diabetic, you may also want to ask for advice on the FelineDIabetes.com message board if you're not a member there.

Diabetes wouldn't cause constipation. Diet sometimes can, particularly dry food. What are you feeding your diabetic cat?

he's on the Hill Sciene KD food - kibble, as he also has kidney issues. He absolutely refuses to eat the canned food.  His moist food is Fancy Feast grilled.  

I have been going to this vet for over 20 years, but lately I feel they arren't as committed to Q as I think they should be - maybe it's just me.

When he went to the vet the first time, they gave him an enema.  He is a dificult cat so they had to sedate him.  But not a lot of poop came out when he received it.  I felt since they had him there the whole day, they should have waited a few hours and tried another one, but I understand I am not his vet.

He's had bowel movements. He had 2 last night - both soft. but I just dont' understand why he goes days with being okay and pooping then suddenly straining and having some blood.

Since he's now on Lactoluse 3 times a day, and I am now adding 1/2 tablespoon of Miralax twice a day and the probiotic, he's not on dry food right now.  The probotic was recommended by the vet.  The name is FortiFlora Feline Nutritional Supplement.

The crazy thing is his kidneys are doing okay and his blood sugar/fructsomine levels are all good and I think great he's okay and then this happens.

Goodness I really feel for you. My girl had constipation problems 4 weeks ago and even though she started having regular(ish) stools, she has lost her appetite the last 2 weeks. Blood work  last week came out normal but the only xray was done 4 wks ago and it was "yup she's backed up but everything else looks fine. No evidence of blockage or megacolon." The vet said I could try probiotics but she wanted to wait until Meph got back to pre-constipation normal. She's on Miralax right now too but if she doesn't eat then she's not taking it. In fact I'm taking her to the vet in 30min because the appetite stimulant (mirtazapine) doesn't seem to be working anymore.

Good luck with your kitty   I'm sending good vibes your way. 

FortiFlora isn't the best probiotic. It has very few strains of good bacteria and the CFU count isn't very much. Many people don't like it because it contains animal digest. You can buy other pet specific probiotic supplements. You can even use Human probiotics. Here is info:

http://www.foodfurlife.com/use-probiotics-in-cats.html

http://www.rawfeedingforibdcats.org/probiotics-for-cats---why-and-which-ones.html

Thank you.  I will try those.  It concerns me that the vet would recommend something that may not be the best thing for him.  Looking on their website, I notice the probiotic they recommended (and I purchased from them) is the only probiotic they have in their pharmacy!

Vets are only familiar with veterinary products. Many don't know much about general pet supplementation and nutritional products. Don't forget that just because the vet recommends / advises / suggestions / etc a partcular product or treatment, you don't have to go along with it.  It's fine to decline to use a product or start a treatment because you don't feel comfortable with it. Or maybe you need some time to look up info online and see what other cat owners are using / doing for their cat in a similar situation so you can go back to the vet and discuss options that would be better for your cat. Pet owners should be proactive in their pet's veterinary care and should not feel bad or guilty for asking the vet questions.