Megacolon and Cisapride

[MalikandMilanosMum]

Hello! I have just had my eldest boy l, Malik (14) diagnosed with Megacolon Malik went into the vets when I saw poo running out his bum and they took him in for an enema which didn’t do much and then said he need a manual removal of all faeces under sedation so we proceeded with this and he was apparently so backed up!! Malik came home with a clean slate, is my understanding . The vet prescribed Cisapride 0.5ml and Lactulose 2-3 times a day. Since then he did a poo 4 days later. I’ve only just started the cisapride yesterday but had been doing the Lactulose for 4 days and am waiting for something to take effect. It’s been two days and no poo. How long does the cisapride usually take to kick in
Also am curious where you got your compounded tablets as I am also in AU and am thinking this may be a better option that the liquid?
Malik also seems to always just want food, I’m hesitant to feed him more than his twice a day without a BM as I’m scared he will just back up again like before. He currently is eating Hills ID which I water down. I give him Actilax with a syringe twice a day but am considering swapping to Osmolax instead.
Would love any suggestions please!

 

[catloverfromwayback]

Hi there! Sorry your Malik is going through this.

I just looked at Daisy’s poo diary and she did a poo the same day she started Cisapride. BUT, and this is the thing, she had been pooing on and off before that. It hadn’t come to a 48 hour gap since the previous time I’d had her to the vet for an enema. I’d also put her on Osmolax, which I find much easier to get her to take than the Lactulose. She hated that, and no wonder, horrible sticky stuff. She drinks Osmolax (5/16 teaspoon) straight from the spoon I dissolve it in these days. The vets did say it can take a couple of days for it to kick in - it’s damned difficult to find any useful information online about the initial doses, isn’t it?

I’m currently buying it from National Custom Compounding. Not cheap, but a few dollars less (including express post) than the second cheapest I’d found. They’re in Queensland but managed to get it to me in Victoria in two days the first time, which amazed them as much as it did me!

 

[MalikandMilanosMum]

Thank you for your quick response! It is really hard to find additional information. Malik has no issues taking the Lactulose via syringe (it is horrible though!) I feel like 0.5ml of Cisapride is a very low dose?

I found a place called Pet Care Pharmacy and paid $89 for 100ml liquid Cisapride, I picked it up as it was close by but delivery via Aus Post is $7.95 or $11.95 express. I didn’t ask if they do capsule form.

its just so very frustrating not knowing if he is getting the right amounts or what I should or shouldn’t adjust and why is he ALWAYS hungry?

 

[MalikandMilanosMum]

Just checked for you and they do the capsules! Cisapride 2.5mg capsules (100) for $89 + delivery above. Petcarepharmacy.com.au

 

[catloverfromwayback]

Thank you for your quick response! It is really hard to find additional information. Malik has no issues taking the Lactulose via syringe (it is horrible though!) I feel like 0.5ml of Cisapride is a very low dose?

I found a place called Pet Care Pharmacy and paid $89 for 100ml liquid Cisapride, I picked it up as it was close by but delivery via Aus Post is $7.95 or $11.95 express. I didn’t ask if they do capsule form.

its just so very frustrating not knowing if he is getting the right amounts or what I should or shouldn’t adjust and why is he ALWAYS hungry?

Ah, I missed that you were asking about liquid Cisapride, sorry! I give Daisy capsules, they’re easy to poke down her throat. She sleeps on my bed, so I keep the bottle on my bedside table and can give it to her first thing in the morning without having to get up. She has to wait 90 minutes minimum before she has her Osmolax, and the doses for both are at 12 hour intervals, so she needs to have the Cisapride early.

She has 100 capsules per bottle, btw, fifty days’ worth. That’s a good price for 100ml, especially if you can collect it. We’re unfortunately short of pharmacies that do veterinary compounding in Geelong.

Has your vet said what dose Malik should have?

 

[MalikandMilanosMum]

Oh that’s very convenient for you and Daisy! Is there a reason why you wait btwn the Cisapride and the Osmolax? My vet didn’t say anything to me about this.
My vet has said 0.5ml of Cisapride with 2-3 ml of Lactulose 3 x per day.

 

[catloverfromwayback]

Oh that’s very convenient for you and Daisy! Is there a reason why you wait btwn the Cisapride and the Osmolax? My vet didn’t say anything to me about this.
My vet has said 0.5ml of Cisapride with 2-3 ml of Lactulose 3 x per day.

I think it’s just that you need to wait a couple of hours after medication before taking laxative. Don’t remember where I read it, probably on the Osmolax bottle.

 

[catloverfromwayback]

Oh that’s very convenient for you and Daisy! Is there a reason why you wait btwn the Cisapride and the Osmolax? My vet didn’t say anything to me about this.
My vet has said 0.5ml of Cisapride with 2-3 ml of Lactulose 3 x per day.

Just checked the Osmolax bottle, and yes, it says to take it two hours before or after other medications.

 

[MalikandMilanosMum]

Thank you for following this up for me, I will follow this direction moving forward.
We are now on day two and a half of Cisapride. Malik had two doses on Tuesday (as I didn’t receive the liquid till 2pm), 3 doses yesterday as directed, and his first dose this morning. Still no BM. Should I be concerned?

 

[Furballsmom]

Should I be concerned?

Hi - you might double check with your vet. Since he was empty, it would take a little bit for his digestive system to work up material for output, but I would also ask about the med dosage with no results, and his hunger.

 

[MalikandMilanosMum]

Hi - you might double check with your vet. Since he was empty, it would take a little bit for his digestive system to work up material for output, but I would also ask about the med dosage with no results, and his hunger.

Hi! I just got off the phone with the vet. She wants me to pick up a script for another medication to also give alongside…how many medications can he take she said to keep the cisapride at 0.5ml and that his hunger is normal. I know my boy, he was a grazer all his life, now he just paces back and forth looking for food. I don’t think my vet is listening

 

[Furballsmom]

Can you find a different vet? All of his medical documentation can be requested by you to be sent over, or sent to you.

 

[MalikandMilanosMum]

I spoke to her again and re explained his behavior, she now thinks he ALSO has diabetes She said if he doesn’t poop after the additional medication she prescribed that the next step is surgery…has anyone had Megacolon surgery and had success?

 

[fionasmom]

Megacolon Diagnosis
My cat needs your help.
Ask Elizabeth: What is There to Treat Idiopathic Megacolon?

 

[MalikandMilanosMum]

How many BMs are your babies having and how many days apart on the Cisapride and Miralax? Malik has pooped this morning after 3 days which I thought was ok…the vet disagrees and prescribed me ANOTHER medication and said to get back to her on Monday as if it continues this way we will need to look at surgery or the other alternative!? Is that a normal response from a vet? I don’t imagine Malik is meant to be pooping every single day in this situation or am I wrong?

 

[catloverfromwayback]

Daisy’s has varied. She’s usually a few hours either side of 24. Today she’s gone about 33 without anything, which is a bit worrying (of course she does this on a Friday afternoon). 48 hours is usually given as the upper limit to let cats go without a poo, but I don’t know if diabetes might change that.

 

[catloverfromwayback]

Well, Daisy’s just back from getting a mini-enema. She hadn’t pooped since before 7am Thursday, and when I rang the vet this morning (Saturday) they booked her straight in. Bit strange, she didn’t have hard poos in her, the nurse found soft feces in her anus, and she hadn’t behaved at all differently from usual at any time. Anyway they gave her the microlax and about fifteen minutes later she did a nice soft, formed poo. I rang the vet back, as they’d asked, and they were very pleased and said she’d probably have more to do later.

Moral of which is, get it checked when a cat goes over 48 hours.