Cisapride - regular vet vs. holistic vet

[abbyntim]

If only Tim knew how well you document his BMs! LOL. I'm glad to hear he's doing well. Good thinking ahead with the fireworks. I'm worried about that, too, and the stress it'll cause my senior ones.

I think he knows! When he goes early in the morning and I'm still in bed, he stops in our bedroom after he's done to let me know!!!

Hope your guys got through the fireworks okay. Tim did really well with the calming treats. In total, he consumed between 1.5 and 1.75 treats, given at 6:00am, 12:30pm, and 6:00pm. He was almost too mellow and I couldn't interest him in playing in the evening at all.

 

[abbyntim]

Thought I'd post an update for anyone who is curious.

Tim's last dose of cisapride was Friday, June 27. So right around four weeks / one month ago. For the most part, he's doing well and we are confident he is perfectly capable of pooping on his own. But we see, and we also saw this during the weaning process when watching him so closely, when something stresses him, he holds it. He suddenly became very irregular a week ago and is slowly getting back on track; this coincides with a new large and somewhat noisy family moving into the house next door that's been quiet and empty for over a year.

Even though Tim has shown he is perfectly capable of pooping on his own, I've had to give him some help this past week by temporarily bumping the psyllium dose. It's still tiny, 1/16 tsp twice per day. The other challenge is we are reducing his food a bit because he needs to lose weight (I am reducing both his designated quantity and trying to keep him from eating Abby's). And I'm hopeful his digestion has further improved. I say this because, even with the twice-daily psyllium doses, his poops are definitely within his normal range, sometimes at the lower end of normal; they are not large at all and perhaps another part of his irregularity is his colon adapting to less volume. I know we will deal with this when we add raw to his rotation, but wasn't expecting it yet. I'm thrilled with smaller poops and I'm fine with less frequency, as long as these are not because of a functional problem. We'll be taking him in for another check-up before we start the raw transition and will make sure nothing is "stuck" in there. But given the way his stools look, I think his smaller output is due to less input, more efficient digestion, or both.

So I'm not declaring victory yet. But we're close!

Edited to add: Tim's diet remains pretty much unchanged, though I am slipping in a few bites of this and that, preparing him for more variety. He continues with a daily probiotic and the daily "hairball" blend. I've not noticed signs of nausea in a while and his energy and playfulness has increased, so Tim's really doing well. I hope this continues!

 

[goholistic]

Thanks for the update! So glad to hear Tim is doing well!

 

[cocheezie]

Well done everyone!

 

[abbyntim]

Thank you both!

Tim seems to have adapted to the new neighbors. Since my last post, he has technically skipped only one day, but it was only 29 hours between movements, so it's not really like skipping a day. He just went 37 hours from Saturday morning to last night, but that's not really unusual for him, either. So I think he is functioning just fine without cisapride.

Our job moving forward will be to keep him well-hydrated, which should be no problem as we got him off free-feed kibble a year ago and we are working towards one-half commercial raw and one-half canned. I also need to continue to work on some intestinal issues (what looks like excess stomach acid) and make sure his digestion is as efficient as possible. Finally, and this is important, we need to be really observant whenever there is any real or perceived-by-Tim change or stress, as he holds it when he's even slightly stressed. This is what got all of us into trouble with his two serious episodes- not realizing Tim had stopped going. During this most recent stressful-to-Tim episode, we tried a combination of tiny amounts of psyllium and miralax, which worked well to get things moving and out.

We are making some food changes; as I mentioned, we are working towards one-half commercial raw and one-half canned. So far, so good; he is tolerating the gradual additions well. I stopped the daily psyllium last week and he is still doing well with almost daily bowel movements. I am giving him 2 tsp slippery elm syrup twice a day in an effort to help with his tummy upset. Finally, he is getting the "hairball blend" (psyllium, marshmallow, and slippery elm) every three to four days; this seems effective, as his stools are typically loaded with hair.

All in all, I am pleased. Thanks for checking in with us and commenting!

 

[abbyntim]

It's been almost seven months since we took Tim off cisapride and he continues to do very well. He is not "regular" like he was on the medication, but I actually like his somewhat more variable schedule because that tells me he goes when he needs to and not when some medication tells him to. His intervals range from as short as 24 hours to as long as 48 hours; 36 hours is pretty typical for him. I've not had to "help" anything along in quite some time. He seems to be functioning perfectly and does not show any signs of distress or discomfort when in the box (the litter boxes are in the home office, so I'm in the room often enough to know his habits).

Tim is eating about 70% raw food at the present time. His dinner is 100% raw and his breakfast is about 50% raw. We are still dealing with a sensitive stomach, though, so I have to be very careful with changes. Some changes have been successful, some have not. I am trying to expand his variety of raw food somewhat (brands and proteins), but I have limited freezer space and need to buy a small freezer for the cats. We've decided to keep Tim on some canned food, in case we have trouble finding a cat sitter or boarding facility that will feed raw. I want him to be somewhat accustomed to canned so it won't cause all sorts of tummy troubles if he has to go on all canned for a short time.

We are continuing with the probiotic and the occasional dose of the "hairball blend". Those seem to have really helped his digestion, as he has not thrown up a hairball in months, which is a very nice bonus. Other benefits include smaller and less smelly poop. Tim has so much more energy, and is more playful and social. The cat that used to live under the bed is gone and we have our boy back, which makes me so happy.

While weaning Tim off cisapride seems to have worked for us, I would caution anyone contemplating this step to consult with a knowledgeable veterinarian. We believed Tim's two severe constipation episodes were due to dehydration from an all-dry food diet and generalized digestive problems, as he had frequent hairballs, as well as vomit and diarrhea on a regular basis. We believed that by transitioning the cats from dry food to canned, and by improving Tim's digestion with probiotics and good-quality food, he would not need cisapride. Some cats, however, might need it. My experience and example would not be appropriate for every cat.

 

[cocheezie]

Congratulations to you and Tim. It's been a long haul. Glad everything has worked out for both of you.