Constipated Adult Cat - Day 4

[lbeachstace]

Buddy is 12 years old with diabetes and has recently not been well regulated.

He has had bad constipation over the past three weeks, which has had us at to the vet three times. Once, he went on his own at the vet's office, once he had an enema and today he was given subq fluids and sent home to see if that will help. Vet determined no blockage and bowel is soft.

He's on lactulose, cisapride and miralax. He's hydrated. Eating well. Using the box normally to pee.

But he's not gone to the box to try even to poop.

We purchased both infant glycerin suppositories and cat enema (for warm water only) - not sure if it's okay to try either at home. Has anyone done either at home on an older cat?

 

[mrsgreenjeens]

Personally I would not try to give him an enema at home. The infant glycerin suppositories might be ok. I don't see why not, but why not check with your Vet just to make sure?

Have you tried giving him some Hairball gel. It's pretty oily and that has worked for my guys when Miralax alone didn't work. It sounds like your guy has mobility issues, correct? Maybe the oil would help the stool slide out .

 

[lbeachmike]

Hi - What is your reason for not trying an enema at home?

Re: glycerin suppositories - our usual vet is out of town - the less experienced vet covering for him didn't seem knowledgeable re: glycerin suppositories. I've seen numerous mentions of it being recommended by others on this forum and others, but only a couple first-hand experiences.

Re: hairball gel - we have not tried nor thought of it - nor do we have it on hand. How long does it take to pass through his system, and thus to be effective?

Re: Miralax - he's been taking this for one year. I've read mixed info on acquiring a tolerance, and thus the same dose losing effectiveness. He takes 1/2 tsp 2x/day. Lactulose and Cinapride he recently started (3 weeks) and neither seems to be effective for him.

It would appear this is a motility issue. The vet said things are soft and the waste is where it is supposed to be (not jammed up) but Buddy simply is not going to the box to try to poop. A weekly vet enema is not a sustainable solution - for his comfort, nor from a cost standpoint.

 

[mrsgreenjeens]

I'd be afraid of perforating the colon, but if your Vet has shown your how to do it so you cause no harm, then that's another story I guess. iPappy apparently has done them, so maybe can give you more info.

Seems like the hairball gel worked pretty quickly...a day or two max, but your case sounds different since his stool is already soft. I don't know about Miralax losing it's effectiveness. Our guy has been on it for several years now and gets between 1/8 and 1/4 teas, twice daily. With 1/2 teas. twice daily I would think your guy would have diarrhea! Since Buddy isn't even trying to go, I wonder if he's got some sort of nerve damage so doesn't feel it building up?

I completely understand not wanting to have to give him a weekly enema, either at home or at the Vet. When will your regular Vet be back to discuss any other options. Maybe the suppositories will work, and possibly stimulating his anus as well, as if he were a kitten ? (I went back and searched our site and found the threads you referred to. If ok for a kitten, then why not for an adult?)

 

[FeebysOwner]

I agree that this might be a motility issue more than actual 'constipation'. If that were to be the case, IMO, the only thing he is taking that might be helpful is the cisapride. Here is just a couple of articles about intestinal motility that might help at least in terms of discussing this matter with your vet.
Gastrointestinal Motility Disorders in Cats - Cat-World
Lack of Intestinal Motility in Cats | PetMD

 

[iPappy]

I have given enemas, but only to a small cooperative dog. If this is going to be an ongoing issue, I would ask the vet to show you how (it's not the most fun thing in the world, but it really wasn't as bad as I thought.)
Have they checked him for mega colon?

 

[Furballsmom]

Hi
Is he getting any exercise?

 

[lbeachmike]

Re: home enema - we'd only be going in a couple inches, and with a very flexible thin tube - so I don't think perforation would be a concern. Although he is not a kitten, below is a Kitten Lady video for a kitten enema. We bought the same items for the enema.

Re: bowel motility - I did some searches and it appears that laxatives are generally not recommended for long-term use and can cause lazy bowel (basically, the bowel stops doing its own job) - this is a pretty common side effect with most long-term drug use, so it seems to make sense here as well. we have some other variables in our situation: diabetes that was not well regulated for a few months, weight loss, change of food

Re: glycerin suppositories - my only concern is that they work by irritating the bowel (to the best of my understanding) - thus, I don't know if there are any concerns about that. I don't want to create a new problem or emergency, so would want to be certain it is safe for him. comparing with the enema approach, I have to get a finger in him with a suppository, versus a very small tube with the enema.

 

[lbeachstace]

Hi iPappy - they took an xray last week when he was in and said that everything looks soft and not causing the colon to extend, so no blockages and no megacolon.

Hi Furballsmom - unfortunately, no. He's so weak and is not interested in playing, walking, etc. We've been trying to gently walk him around the carpeted floor - he slides on wood. We do it until he has had enough....but it's not sufficient exercise.

 

[lbeachstace]

FeebysOwner - i read the link and the weird part is he has none of the symptoms of either.

It could be neuropathy from the diabetes, maybe. It's the fact that he's not even trying that is so confusing.

 

[FeebysOwner]

FeebysOwner - i read the link and the weird part is he has none of the symptoms of either. It could be neuropathy from the diabetes, maybe. It's the fact that he's not even trying that is so confusing.

Every cat is so different. I have a cat that has several diseases/issues, and yet she has none of the 'typical' symptoms.

The fact that there is no sense of needing to evacuate stool is enough of an issue to be pursuing motility issues, for whatever the cause is behind it.

 

[lbeachmike]

The strangest part is that the constipation seems to have come on suddenly - but did coincide with unregulated diabetes and weight loss. For the last two days, his diabetes regulation has been getting back on track (increased insulin dose) and we're hoping that all else will follow. Appetite has been very good, which is also inconsistent with motility issues.

 

[Furballsmom]

 

[lbeachstace]

FeebysOwner - yes, i agree with you and we feel it is motility as well. if he doesn't go tonight, we will go back to the vet in the morning for an enema.

 

[FeebysOwner]

FeebysOwner - yes, i agree with you and we feel it is motility as well. if he doesn't go tonight, we will go back to the vet in the morning for an enema.

Ask your vet about alternatives. Enemas are not the long-term solution.

 

[lbeachmike]

Enemas are not the long-term solution.

Most definitely they are not. I'm not sure how many alternative solutions are left. I am hoping we can get the diabetes well regulated and hoping that will help. We also changed his food back to what he was eating before the constipation arose.

 

[iPappy]

Most definitely they are not. I'm not sure how many alternative solutions are left. I am hoping we can get the diabetes well regulated and hoping that will help. We also changed his food back to what he was eating before the constipation arose.

If his food was changed around the same time he started having problems, that might be the best solution (along with getting his diabetes regulated.) Is he eating dry/wet?

 

[lbeachmike]

Is he eating dry/wet?

Only wet. Very wet - we add water.

 

[lbeachstace]

Wanted to update everyone - he went on his own last night!

There was one large BM and then a few small lose ones that have followed. Going to call the vet to ask about the cisapride, lactulose and miralax dosage.

He wasn't interested in eating much last night and didn't want a snack. We'll see how he is at feeding time in about an hour.

 

[mrsgreenjeens]

What a relief that he went, but how about his appetite this morning? I was honestly shocked when I read he had a great appetite since he had to have been pretty clogged up, so am wondering if that finally got up with him and now am hoping he's back on track. Poor baby.

Let us know what happens as I suspect there's more in him that just what you described.