Cat with chronic constipation - at wits end!

I have read through pretty much every thread on constipation, lactulose, cisapride, miralax and megacolon on this site. It has made me feel like i'm not all that alone in dealing with a kitty with  chronic constipation issues, but I'm not sure what to do anymore. My Noah is about to turn 8 and he has had issues with constipation for the last 3 years, but nothing that ever required the vet, or so I thought. Last year it started happening more often and for longer bouts, but I figured it was dietary and made adjustments. I feel like such a bad cat mom knowing now what i know. Had I dealt with this a year ago it may not be as bad as it is.

Never the less, at the beginning of January of this year, he got really bad to the point where I said enough was enough and I took him to the vet. He was so backed up she had to give him an enema to clean him out.  She told me he didn't seem to have megacolon as that was my major concern, and she suggested a high fibre diet and manual massage if he got another build up in his rectum. She also said we could do surgery, but we didn't want to do that if it wasn't our only option. Fast forward to 3 weeks later and he was backed up even worse from the high fibre food and my husband was ready to have him put down. The surgery my vet suggested was a colopexy, which from my own research is not common in cats. It is a specialty surgery and we were looking at approx. $4000 (cdn) if she referred us out, but our vet said she could help us out financially and do it herself, but we had to understand she hadn't ever done this specific surgery before. I managed to get my husband to agree to the surgery which ended up costing $1500 + meds - still a lot of money for us considering we are expecting our first child in 2 months, our only car just kicked the bucket, and we are trying to save up for our first home.....things has been really tough lately. 

Through reading on here I heard of lactulose and cisapride and mentioned those to my vet to help keep the stool soft and moving along post surgery and she said they both would be a good idea, along with a low fibre canned food diet. She said during the surgery she felt a pocket in his rectum where poop has been sitting and building up causing a blockage thus not allowing him to follow through in the cat box. She didn't do anything to fix this at the time as she didn't feel it was necessary.

Post surgery our vet had us giving him 2ccs of Lactulose 3x a day, and .5ccs of cisapride 3x a day for the first 5 days, but he got really bad diarrhea 24 hours after the surgery so she said to drop the lactulose down to 1cc 3x a day. We did this and he was still pooping pudding-like poop, which was still too soft. I decided to drop one of the doses of lactulose and cisapride and he pooped one more time, but that was it.. that was sunday night (he had the surgery last Wednesday). fast forward to last night (wednesday) and I was starting to freak out that he was getting all backed up again and putting strain on his colon he had sutured to his abdominal wall. He has been trying to go the last couple nights but with no success. He  hasn't been straining to go, but when he tried nothing came out. I went out and picked up some Restoralax (canadian version of Miralax) and started him on a 1/4 tsp dose this morning with his food and then again at lunch time along with his .5 ccs of Cisapride (which I have started giving to him 3x a day again),  and this afternoon he tried going and only pooped a soft little nugget the size of a dime...I know there is more poop in his colon though. He has been eating daily, and there is a soft build up in his rectum just above his tail. I have tried manually massaging his rectum as instructed by my vet, but so far he just struggles to complete a poop. We go in to the vet tomorrow to have his stitches out and we have to let her know that things are not working out as hoped. We are financially strapped and I am feeling really overwhelmed by this whole ordeal. I haven't cried and felt so depressed since my sister passed away 5 years ago. I love my kitty, but my husband doesn't want to spend anymore money on him as the cost has accumulated to over $2000 in the last 2 months, and I know that once our little girl arrives in April its going to be too much for me to handle; its hard enough right now. I'm afraid we will have to have him put down and it just breaks my heart, but I feel like we have no other options. Just saying such words causes such feelings of guilt.

What are you feeding him? I'm a big, big believer in bio appropriate food for cats which means high quality canned food with little fillers or homemade raw or cooked. Have you looked through this website about megacolon/constipation? Honestly, it does sound like he could have megacolon, despite whatever your vet is telling you. It seems like your vet is really giving you the run around rather than a proper diagnosis and a plan to control it. Megacolon/constipation can be well controlled with both diet and the right fiber. Water and fat content also plays a big role in their ability to move foods through the body. 

I think you can get this under control, but you need to do your research so you have the right approach to both diet and fiber. 

http://www.felineconstipation.org/

http://www.felineconstipation.org/prevention.html#Diet

I have a kitten who I just got figured out for his severe severe constipation. He eats canned food mixed with olive oil, miralax, and warm water. I feed him that three times a day, sometimes I will just give him the canned with everything but the miralax, and he hasn't been backed up since. I can tell I the amount I mix with the entire can is well over 1/4th teaspoon. It does last him quite awhile, but he's only u weeks old tomorrow. Plz don't put him down, find a shelter or someone to take him if u absolutely can't keep him. I would also say load him down with an enema (my vet just gave me one to take home and do myself). The key for little Bob was to get it all out, and keep it coming. He never got really runny (except for after the enema). I don't think he eats much hard food anymore although he has access throughout the day, and we haven't had a problem since. Maybe this will help u some I hope.

Pure unsweetened, canned pumpkin puree works as well for constipation as it does for diarrhoea.  Try adding a teaspoon per day to his food to start with, then see how well he responds.

Slippery elm is another plant remedy that is very successful for treating constipation in cats.  It comes as a powder then turns slippery when wet.

Epsom salts are a very strong laxative.  I don't know the dose for cats but for humans just 2 to 3 teaspoons moves mountains.  It must be safe for cats as I have read a number of people on this site have had it veterinary prescribed for drawing out infections from wounds.  However, I'd advise you talk to your vet, or do your own research, about the exact dose, as perhaps an 1/8 teaspoon might do the trick, whilst 1/4 teaspoon may release Niagara Falls.

Olive oil and vaseline are useful for hairball type of constipation. 

Don't give up on him just yet.  The above suggestions are all very inexpensive and effective.

 

He has been doing much better over the weekend, and finally started pooping! Lucky for us his wasn't actually constipated, the stool in his colon was soft, he just wasn't pooping yet. The vet explained more to us about his condition and she suggested we up his Cisapride over the weekend to 3x a day at a higher dose to get things going as his colon motility seems to be an issue, but as everyone else has said, we'll have to adjust to effect as it really does differ for each pet. I have been giving him just under 1/4 tsp of Restoralax (canadian version of Miralax) 2x a day with his morning and night meal, and 1cc of lactulose with a smaller meal at lunch time. He has been pooping often throughout the day (not always in the box though due to the softness of his stool, which irritates my husband), but now we are going to play with the doses of Cisapride, Restoralax and lactulose a bit to get him to a good level where he is pooping well more regularly in the box 1 or 2 times a day. I have him eating Wellness canned food with added water as I want to keep his fibre intake low (1.5% or less), since I know fibre led to his last really bad bout of constipation. Hopefully we can find a happy medium with everything

Brian007 said:

 
Pure unsweetened, canned pumpkin puree works as well for constipation as it does for diarrhoea.  Try adding a teaspoon per day to his food to start with, then see how well he responds.

Slippery elm is another plant remedy that is very successful for treating constipation in cats.  It comes as a powder then turns slippery when wet.

Epsom salts are a very strong laxative.  I don't know the dose for cats but for humans just 2 to 3 teaspoons moves mountains.  It must be safe for cats as I have read a number of people on this site have had it veterinary prescribed for drawing out infections from wounds.  However, I'd advise you talk to your vet, or do your own research, about the exact dose, as perhaps an 1/8 teaspoon might do the trick, whilst 1/4 teaspoon may release Niagara Falls.

Olive oil and vaseline are useful for hairball type of constipation. 

Don't give up on him just yet.  The above suggestions are all very inexpensive and effective.

 

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Please do not use Epsom salts for cats... dangerous!!!

Artiemom said:

 
Please do not use Epsom salts for cats... dangerous!!!

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In general, before trying any suggested home remedy you find on the Internet, ask the vet first to make sure if the remedy is safe to give or not.

Are you giving the Restoralax correctly? Mix the powder into some water to dissolve and then mix into canned food. Some vets don't know the correct way to give Restoralax / Miralax / etc.