Looking for advice/experience with obstipation

spookymom

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I took my cat to the clinic a week ago after he stopped eating. They took x rays which showed he was super backed up. They trued an enema and manual extraction, got a little but he still wasn’t doing well. Sent him home with lactulose.

The next day I took him to the ER. They said one enema would not be enough, he would need multiple enemas and colonoscopy prep through an ng tube. I was expecting 2 days or so from the invoice. It ended up being 4 days of enemas before they agreed to manual deobstipation under anesthesia.

They removed two pieces of hard stool but were not able to clear the blockage that was further back in the colon. We figured it was best to send him home becausehe was quite stressed after all this and not eating. Still giving him lactulose, and miralax and cisapride to try to get the remaining stool moving.

He has been home for two days now, purring and eating, but still straining and no stool passage. I’m so worried. It’s not that money is an issue, but we are now $4000 in and it feels like it was all for nothing. I’ve read about subtotal colectomy and I’m trying to understand why this wasn’t tried in the first place. I was told the enemas would be less invasive and cheaper but here we are after 7 days of them. I’m also a bit skeptical of how effective this could’ve been given the severity of his condition, and that both vets I have been to had less than a year of experience..

Has anyone had a cat with this procedure? Is there anything we can try before it gets to that point? Is it risky? How much would this cost? I can’t keep throwing money at a problem I can’t solve, but it’s also killing me to think about losing him so young. Please help.
 
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spookymom

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I'm not a vet, but thinking out loud maybe not for nothing if it avoids megacolon?
I’m not sure if it did, given he was backed up and colon was dilated 4-5x normal size for 6 days (that we know of). And I believe it would still be dilated further back where the blockage remains :/
 

FeebysOwner

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HI. If it were me, I would probably consider looking into megacolon, even if it is not quite yet at that point according to the vet(s).
Megacolon | American College of Veterinary Surgeons - ACVS
I searched this site for related issues, but most are old threads, and sadly most posters don't often follow through with what their resolutions were. But, there was this one -
Megacolon in cats - Need information | TheCatSite

Still hoping some members who have some experience with this will come along soon.
 
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spookymom

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Thanks for your support ❤ I have looked into megacolon which almost leaves me more confused. It seems colon removal is not a matter of “if” but “when,” since kitties eventually stop responding to the meds. I’m trying to figure out why the surgery isn’t done right away, it seems like it’s just kicking the can down the road. But I’m not a vet, so I could totally be wrong.
 

Furballsmom

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I’ve read about subtotal colectomy
This is the formal name for that, I see now. ooof. I guess I'm wondering, surely they did xrays to see what was happening and still thought they could get him squared away without surgery? You mentioned neither one has been practicing for all that long, did they know it eventually comes to this?
 
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spookymom

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This is the formal name for that, I see now. ooof. I guess I'm wondering, surely they did xrays to see what was happening and still thought they could get him squared away without surgery? You mentioned neither one has been practicing for all that long, did they know it eventually comes to this?
They did do x-rays, and I guess the hope was that surgery would not be needed. The first clinic was short staffed so they didn’t have the capacity to do much more, which is why I ended up at the ER vet. The second vet seemed nervous to do anything that involved anesthesia, even the manual deobstipation. I’m not a vet so I don’t know much about anesthesia for pets, but I feel like she made the risk out to be much higher than it really was, possibly because she is new and a bit nervous to perform more invasive procedures like that? The medications they prescribed were “for life,” so I imagine they have some level of understanding of the prognosis. I guess the idea is to put high risk procedures off for as long as possible?
 
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