Lactulose not working on senior cat 4 days after enemas/impaction removal

[impacted]

About a week ago my cat started vomiting after using the bathroom and stopped eating. Several years ago she had the same symptoms which ended up being an obstruction high in the digestive tract that was surgically removed. I rushed her to the vet Wednesday morning where they ran a CBC and an x-ray. The blood panel was great, but the x-ray showed stuck poop that is basically on the verge of coming out. The vet was confident it was just poop and not a foreign body because it wasn't up in the digestive tract. They ran 2 enemas that didn't clean her out, so they put her under and the vet manually removed what he could. He told me that he only removed what he could reach, that he was confident everything was lubed up good, and prescribed about 3.5ml of lactulose 2x per day.

The next morning, she was able to pass a small but fat piece of poop. Since then, it's been nothing. In the last 24 hours, she's frequently going to the box and straining but nothing is coming out. She's still eating small amounts and not vomiting. Is it possible there's more poop stuck or is the gas from the lactulose making her feel like she needs to go? I added pumpkin puree and Miralax yesterday hoping that would help something.

I'm guessing she needs to go back to the vet tomorrow? I'm beyond frustrated because my $500 quote ended up costing $900 and didn't fix anything.

 

[FeebysOwner]

I personally feel that pumpkin puree is debatable in terms of what to use it for. It supposedly helps with both constipation and diarrhea, so I always wonder if it can help with both, maybe it only works for each condition depending on what is causing either. Maybe stop giving her the pumpkin. And increase the amount of Miralax for the next couple of days or so, if you are not giving her that much. I don't think Miralax is known to cause flatulence like lactulose can. Additional water intake is encouraged with both.

Any chance that there has been some scar tissue that has formed at the old surgery sight that might be slowing things down and causing her stool to become hard as it slowly moves further down the digestive tract? Not sure if that would be seen on an x-ray, might require an ultrasound.

 

[stephanietx]

If she's not been eating, there won't be much to eliminate. How much is she eating and how long has it been since she's pooped? Are you feeding her only wet food?

 

[impacted]

I personally feel that pumpkin puree is debatable in terms of what to use it for. It supposedly helps with both constipation and diarrhea, so I always wonder if it can help with both, maybe it only works for each condition depending on what is causing either. Maybe stop giving her the pumpkin. And increase the amount of Miralax for the next couple of days or so, if you are not giving her that much. I don't think Miralax is known to cause flatulence like lactulose can. Additional water intake is encouraged with both.

Any chance that there has been some scar tissue that has formed at the old surgery sight that might be slowing things down and causing her stool to become hard as it slowly moves further down the digestive tract? Not sure if that would be seen on an x-ray, might require an ultrasound.

I did 1/4 tsp on the Miralax yesterday (bought in afternoon) and 2x today. Hope it works in a day or so. Not sure if the sugery sight is problematic. That was 2 years ago and the constipation is new!

If she's not been eating, there won't be much to eliminate. How much is she eating and how long has it been since she's pooped? Are you feeding her only wet food?

Evacuation procedure was Wednesday and she pooped a little bit extra Thursday morning. For the last 24 hours she's going to the box with nothing. Not sure if it's gas or more poop. She's been eating about half her normal diet. I should have mentioned she is a regulated diabetic and on low carb canned food only. One of the varieties has carrots and the other has sweet potatoes. I'm wondering if the fiber from those is problematic.