Gah! Why does the constipation journey never seem to end?

[orangie]

Howdy everyone - quick back story - Orange was put on a 7 day round of Metacam and restricted mobility on Sat due to pain in his mid-back. Xrays also showed that he was again experiencing some constipation but not enough that she felt the need to intervene. (no dehydration noted btw) The recommendation was to hit him hard with lactulose and get things moving, then slow to a daily dose until he was once again going without assistance.

Saturday: three rounds of lactulose (2 ml each)
Sunday: morning he had a fourth dose before everything finally started moving. first trip to the box produced hard stool and the second produced hard stool followed by diarrhea, he also obviously had strained for that trip as he didn't even cover things up (he's a fastidious coverer) before he jumped out of the box and vomited. But I felt pretty good as the boxes looked to me to probably have enough in them to show that we'd gotten things moving again.
This afternoon:
He's eating his normal amounts: wet food only, breakfast includes some pre-gelled chia seeds and the lactulose and then a small wet food snack at lunch to get the metacam into him, four oclock snack has the lactulose again and then so does bedtime feeding. BUT we haven't seen solids in the box since the Sunday morning erruption. (he did use the litterbox to pee twice overnight/this morning)

Should I be worried? I thought we'd see production with the fact that he's eating and drinking as per normal....

 

[mrsgreenjeens]

This is only a guess, but I'm thinking that the Metacam could be part of the problem, since it can cause constipation (yes, I know, most Vets will tell you it does NOT cause constipation, but it is an NSAID, and even OTC nsaids can cause constipation) So, are you to have him on the increased Lactulose for the entire time he's on the Metacam, or just until he got himself "cleaned out", which already happened? If the latter, then perhaps contact your Vet when you can and discuss keeping him on the higher dose for the entire 7 days, or perhaps an in-between dose for the remaining days.

 

[orangie]

I was wondering about the Metacam.... she didn't actually specify a timeline for the increase in Lactulose usage so I may have wrongly assumed it was just until he cleaned out. I'll give her a call and see if we should stay on the increased dose until we're done with the Meta.
The restricted movement was also a 7-day instruction so it makes sense that he's going to be less likely to "go" when he's not moving the way he normally would.
I'm probably just jumping on the panic button a little too soon too because the last time he had a serious constipation episode it left him on the edge of not making it.

Thanks for taking your time to respond - hearing a rational third party opinion helps

 

[FeebysOwner]

Hi. You mentioned restricted mobility because of his back pain. That triggered me to think of restricted motility - of the bowels. Once this treatment session is over and he still has problems, you might ask the vet about a med that would help if he should have an intestinal motility issue, which can attribute to constipation.

 

[orangie]

Will def mention it at the follow up - we're expecting a call any day now to let us know when the joint supplements will be in and I should get an opportunity to chat with the vet at that time.

For now I'm sticking with the lactulose at the increased dose while he's on the meta - yesterday afternoon the litterbox production was still unformed.
Overnight he had gone a little again. There were about 3 little clumps - litter was stuck to them, but still seemed a little dry to me so I'm guessing leftovers from the back up.

the good news is he's eating his full meals, the meta obviously has him feeling better 'cause he's pretty whiney about not being able to run up and down the stairs and we caught the constipation issue much earlier then we did the first time around...

 

[stephanietx]

Pain meds and lack of mobility both contribute to constipation (in humans and in cats). I would definitely mention this to the vet.

 

[orangie]

I’ve put a call into the vet since we’ve had no production since overnight on Monday into Tuesday (which was only a few little solid pieces) and at lunch today he didn’t want his snack so no noon dose of lactulose. I’m sure he’s not feeling well since he’s also not wanting to move around a whole lot today.
I’m slipping the meta dose until I hear from the vet - just waiting for the call