Please help- My 13 year old Manx was diagnosed with Megacolon

[Baellchen]

Good morning, everyone.
I am new to this site and I feel totally helpless. Maybe someone here can give me some answers. I have two cats: Annabelle 13 years, Manx and Dominick 11 year, Russian Blue. Annabelle had her entire life never any health issues. She sees the Vet one time per year for her vaccinations and her regular check up.

Last week Monday was when it all started. The week before I observed that her poop was a little dry and one time I had to help her getting rid of it. I didn't think much of it at that point, but now I am beating myself up for it, not reacting right away. On Monday last week I found her lying in the grass in front of the house, not able to walk. I live on a farm and she loves to run and watch the birds. She is normally very upbeat and wants to go out once in a while.

While she was lying in the grass I first thought she's just enjoying herself, until I called her name. She normally comes straight up to me, not this time. She got up and couldn't walk. I lifted her up and she was screaming in pain. I put her inside to see, if I might hurt her while lifting her up but she still was not able to walk and was sitting in the corner. I've rushed right away to my Vet, who took her in and told me that they need to do an X-Ray cause the Vet assumed constipation after the physical exam. Two hours later I was told I can pick her up. The doc told me that she had "some" constipation and that she for an enema and some manual feces removal was done. I was given Lactulose and was told, to give it twice a day. The doc said, she should be fine. She also said that Annabelle has a little Arthritis in her lower back, which could make it painful for her to go to the bathroom. The doc didn't want to give pain meds cause she said, that pain meds can cause constipation as well. I first should do the Lactulose and then in a week we would address the arthritis. I've felt relieved and thought, after a day or two she will use the bathroom. Tuesday and Wednesday it got so bad, that I called the doc again, asking why the meds are not working and my cat is doing so bad. The answer was: " I don't know". That was the moment I knew I need another doctor.

On Thursday I finally found an excellent Vet clinic. They took her in overnight and in the evening the doc called me in. He showed me the X-rays and the blood results (which the first doctor didn't see any need for). Here is what he found:
-severe constipation in all three areas of the colon / megacolon
-arthritis in the lower back / tail area
-blood work overall very good, only Sodium is slightly elevated. Liver slightly elevated but not concerning, says the doc.

Here is what was done so far:
-three enemas
-manual removal of feces
-she got liquids injected cause she was slightly dehydrated
-was put on Cisapride cause the Lactulose didn't work in the first place.
- was given a high fiber food

I could pick Annabelle up Friday evening and the doc had taken another X-Ray to see how far the colon was emptied out. The lower and middle section was pretty empty whereas the back end still showed constipated feces. He said he could remove 80% but he stopped at one point cause he could not reach the rest, without taking chances to hurt the colon. He decided to give her the weekend on Cisapride and see if she will poop by herself moving the stuck part in the back a little further. In case she doesn't poop he wants to see us on Monday and try to get the rest

I took her home and she was through the ringer but was upbeat when she entered the house. Walked around and ate something. Doc told me to make her eat cause she didn't eat much in the clinic. Yesterday she was pretty alert. She eats well, even her new fiber diet she likes, drinks well, urinates well but no poop. She was upbeat yesterday and even went on the porch, lying in the sunshine. She can't jump on anything right now, but I guess she is very sore in her back.

Today she ate well in the morning, drank well and urinated. But her overall demeanor is moody. Not walking much and she looks so sad. Its Sunday 11.00am and no poop so far.

Guys, I am so sorry for this long story but I am so worried. I have no one I can talk to and the Vet is closed today.
-Has anyone here ever dealt with a situation like this?
-Is it normal that she is so lethargic today? (someone said she is very sore and tired from all the working on her)
-Is there more that I can do to get her poop? (I feel so helpless)
-Should I ask for pain meds? (doc says not now because they cause constipation)
-Do you think its "normal" that she isn't pooping after 3 enemas (doc said I should move her as much as possible, but she is not up for it at all)
-I'm worried that there is more to it, but the doc ran so many tests. Would an ultrasound give more deatils?

Thank you so so very much for reading.
Annabelle & her Mommy

 

[reba]

Hi Annabelle’s Mom, I have no experience with mega-colon, but I am someone who knows what it’s like to drive yourself nuts if they aren’t eating/defalcating/whatever.

Also: when vet’s say “I don’t know” it’s often the truth, not incompetence. My question after they say “I don’t know” is “well, what are my options”. For example, is it life threatening if we wait? The most likely explanation is that she’s constipated, but because she’s an outdoor cat, it’s impossible to rule out that she ate something she shouldn’t have.

When you say “it got so bad” a few days after the first vet, do you just mean she wasn’t pooping or more than that? If the first vet gave her some enemas and cleaned out some feces manually, it wouldn’t be surprising that she doesn’t poop right away. My vet actually just told me they could go 5-7 days if they aren’t eating much and if they aren’t throwing up then their intestines are unlikely to be blocked.

Also, just some food for thought: I just looked it up and it says that mega-colon is diagnosed by injecting a dye and then watching food move through the intestines. It doesn’t sound like that second vet did that so unsure how they could tell you that your cat had chronic mega-colon in all three sections. Also I can see keeping the cat overnight for observation in an eclinic, but what’s the advantage of doing so in a regular vets office when there’s nobody there?

I’ve really gotten away from doing tests just to “see if they show anything”, because more often then not they don’t show any definitive answer. For example, what does blood work clarify for you if the cat is constipated? How would it change the treatment?

And yes pain meds cause constipation.

What you said here looks pretty promising to me: “

“She eats well, even her new fiber diet she likes, drinks well, urinates well but no poop. She was upbeat yesterday and even went on the porch, lying in the sunshine. She can't jump on anything right now, but I guess she is very sore in her back. Today she ate well in the morning, drank well and urinated. But her overall demeanor is moody. Not walking much and she looks so sad. Its Sunday 11.00am and no poop so far.”

Finally anybody who had three enemas and someone manually digging poop out of them would be in a bad mood. My experience is that they are so relieved when they first come home from the vet that they get an adrenaline rush and then when that wears off they go back to being more lethargic.

 

[fionasmom]

Search Results for Query: megacolon
These are TCS threads related to megacolon.

The idea that she is tired, possibly not able to poop because she has had the enemas, and sore make sense. Given that this was on Thursday, if I am understanding your time frame, and this is Sunday you may be in the window where there are still some side effects from last week.

I would ask the vet if imaging would help to clarify anything.
Megacolon in Cats | VCA Animal Hospitals
This article mentions possibilities for expanded testing and surgical treatment which I am not suggesting that your cat will need nor that you should jump to that conclusion.

 

[Baellchen]

Hi Annabelle’s Mom, I have no experience with mega-colon, but I am someone who knows what it’s like to drive yourself nuts if they aren’t eating/defalcating/whatever.

Also: when vet’s say “I don’t know” it’s often the truth, not incompetence. My question after they say “I don’t know” is “well, what are my options”. For example, is it life threatening if we wait? The most likely explanation is that she’s constipated, but because she’s an outdoor cat, it’s impossible to rule out that she ate something she shouldn’t have.

When you say “it got so bad” a few days after the first vet, do you just mean she wasn’t pooping or more than that? If the first vet gave her some enemas and cleaned out some feces manually, it wouldn’t be surprising that she doesn’t poop right away. My vet actually just told me they could go 5-7 days if they aren’t eating much and if they aren’t throwing up then their intestines are unlikely to be blocked.

Also, just some food for thought: I just looked it up and it says that mega-colon is diagnosed by injecting a dye and then watching food move through the intestines. It doesn’t sound like that second vet did that so unsure how they could tell you that your cat had chronic mega-colon in all three sections. Also I can see keeping the cat overnight for observation in an eclinic, but what’s the advantage of doing so in a regular vets office when there’s nobody there?

I’ve really gotten away from doing tests just to “see if they show anything”, because more often then not they don’t show any definitive answer. For example, what does blood work clarify for you if the cat is constipated? How would it change the treatment?

And yes pain meds cause constipation.

What you said here looks pretty promising to me: “

“She eats well, even her new fiber diet she likes, drinks well, urinates well but no poop. She was upbeat yesterday and even went on the porch, lying in the sunshine. She can't jump on anything right now, but I guess she is very sore in her back. Today she ate well in the morning, drank well and urinated. But her overall demeanor is moody. Not walking much and she looks so sad. Its Sunday 11.00am and no poop so far.”

Finally anybody who had three enemas and someone manually digging poop out of them would be in a bad mood. My experience is that they are so relieved when they first come home from the vet that they get an adrenaline rush and then when that wears off they go back to being more lethargic.

Hi Annabelle’s Mom, I have no experience with mega-colon, but I am someone who knows what it’s like to drive yourself nuts if they aren’t eating/defalcating/whatever.

Also: when vet’s say “I don’t know” it’s often the truth, not incompetence. My question after they say “I don’t know” is “well, what are my options”. For example, is it life threatening if we wait? The most likely explanation is that she’s constipated, but because she’s an outdoor cat, it’s impossible to rule out that she ate something she shouldn’t have.

When you say “it got so bad” a few days after the first vet, do you just mean she wasn’t pooping or more than that? If the first vet gave her some enemas and cleaned out some feces manually, it wouldn’t be surprising that she doesn’t poop right away. My vet actually just told me they could go 5-7 days if they aren’t eating much and if they aren’t throwing up then their intestines are unlikely to be blocked.

Also, just some food for thought: I just looked it up and it says that mega-colon is diagnosed by injecting a dye and then watching food move through the intestines. It doesn’t sound like that second vet did that so unsure how they could tell you that your cat had chronic mega-colon in all three sections. Also I can see keeping the cat overnight for observation in an eclinic, but what’s the advantage of doing so in a regular vets office when there’s nobody there?

I’ve really gotten away from doing tests just to “see if they show anything”, because more often then not they don’t show any definitive answer. For example, what does blood work clarify for you if the cat is constipated? How would it change the treatment?

And yes pain meds cause constipation.

What you said here looks pretty promising to me: “

“She eats well, even her new fiber diet she likes, drinks well, urinates well but no poop. She was upbeat yesterday and even went on the porch, lying in the sunshine. She can't jump on anything right now, but I guess she is very sore in her back. Today she ate well in the morning, drank well and urinated. But her overall demeanor is moody. Not walking much and she looks so sad. Its Sunday 11.00am and no poop so far.”

Finally anybody who had three enemas and someone manually digging poop out of them would be in a bad mood. My experience is that they are so relieved when they first come home from the vet that they get an adrenaline rush and then when that wears off they go back to being more lethargic.

Hi Reba,

thank you so much for your reply. The first doctor who said " I don't know" was very stressed out that day and said that she was a "liitle" constipated. The second doctor showed me the X-Rays and she was not "just" a little constipated, her entire colon was extremely full. The first doc didn't show me any pictures and I told her the Lactulose doesn't work. She wasn't really interested so I've opted for the second Doc. He did an amazing job with blood work and showing me the brutal truth of her colon before and after all the enemas. Her poop was hard as a rock, no way this would have come out by itself.

I went today and grain free canned food with a little lower fiber but more water content, keeping her hydrated. She ate everything. Drank and went after to the bathroom. Just urine no poop so far. To be honest I am not so worried about the pooping after all the enemas, but the doctor said she should have a bowel movement in max 48 hours. That stressed me a bit. Her little behind is red and swollen and I think she is really sore. The doc told me to play with her. She loves all kind of ribbons. Today we played a little and she was participating. A good sign?

They have charged me $60 for the overnight stay and you're right, no one was there. But I was so worried and wanted to do the right thing.

The doc sover the weekend she has to come back for more. I'm not sure if I want to do that. She looks so beat up. What do you think? She can jump down but not up? Ideas why?
Thank you so so very much.

 

[Baellchen]

Search Results for Query: megacolon
These are TCS threads related to megacolon.

The idea that she is tired, possibly not able to poop because she has had the enemas, and sore make sense. Given that this was on Thursday, if I am understanding your time frame, and this is Sunday you may be in the window where there are still some side effects from last week.

I would ask the vet if imaging would help to clarify anything.
Megacolon in Cats | VCA Animal Hospitals
This article mentions possibilities for expanded testing and surgical treatment which I am not suggesting that your cat will need nor that you should jump to that conclusion.

Thank you so much for your reply. I will check it out. She had X-Rays done three times. The first doc sedated her and that was pretty bad afterwards. The second doc told me not to sedate during imaging, too much stress on the system. My girl has had a rough week. But I wanted to do the right thing. When you talk about side effects, do you mean from the sedation, hospital stay and enemas?

 

[fionasmom]

I do. Basically what you were thinking that she has been through a lot and that is the cause of what you are seeing now.

 

[Baellchen]

I do. Basically what you were thinking that she has been through a lot and that is the cause of what you are seeing now.

She truly has. She is eating very well, I’ve switched to canned food instead dry. The doc gave me high fiber dry food and she takes it, but I’ve read here, that that is often not the way to go. I’ve purchased today grain free canned food with lower fiber. She loves it. She also drinks well. I freshen her water bowl every 2 hours. She even played a little today. She uses the litter box and urinates without problems. I’m so worried cause the doc said when she hasn’t pooped until tomorrow morning, she has to come back for more enemas. He could get 80% but there’s still some stuck at the end of the colon. I’m not feeling good with the idea having her to go through this again. Her entire back hurts her so badly. Lactulose didn’t work, Cisapride is not doing anything. Do you think she’s so emptied out that it’s normal that nothing is coming? She eats since Friday night, small portions. I the doctor said I should give her food so that this pushes the rest of the constipation up to her rectum. I’m so worried.

 

[fionasmom]

One of my cats, Graycie, has constipation problems. Not megacolon but she does need Miralax 4 times a day at 1/8 tsp each time. During one episode, the vet found some hard stool in the back of the colon and told me that she (Graycie) could get it out. Nothing happened and she had no appetite, so the vet gave her one shot of dexamethasone which increased her appetite and did help her to evacuate her bowels. I am not saying that your cat needs Miralax, and certainly not at the same time as other products unless you discuss it with the vet, or dexamethasone, but that it is possible that there is not enough in her right now to come out.

You could discuss this with your vet tomorrow; you don't have to agree to any procedures that you feel are not right or not immediately necessary.

 

[reba]

Hi Reba,

thank you so much for your reply. The first doctor who said " I don't know" was very stressed out that day and said that she was a "liitle" constipated. The second doctor showed me the X-Rays and she was not "just" a little constipated, her entire colon was extremely full. The first doc didn't show me any pictures and I told her the Lactulose doesn't work. She wasn't really interested so I've opted for the second Doc. He did an amazing job with blood work and showing me the brutal truth of her colon before and after all the enemas. Her poop was hard as a rock, no way this would have come out by itself.

It’s so hard with vets. I still haven’t figured out what’s realistic. I think I went through 3-4 of them and they were probably all fine, but I was always thinking the grass was greener. I had a vet at the eclinic tell me I could take the cat home after one vet botched his neuter surgery (well I felt ok about dumping THAT vet) and I insisted he stay another night because I was terrified I’d get him home and something would go wrong. So believe me I understand wanting to do what feels like the least risky option. I go straight to catastrophe, but I’m trying to step back and not do that so much.


I went today and grain free canned food with a little lower fiber but more water content, keeping her hydrated. She ate everything. Drank and went after to the bathroom. Just urine no poop so far. To be honest I am not so worried about the pooping after all the enemas, but the doctor said she should have a bowel movement in max 48 hours. That stressed me a bit. Her little behind is red and swollen and I think she is really sore. The doc told me to play with her. She loves all kind of ribbons. Today we played a little and she was participating. A good sign?

It’s fantastic that she’s eating. My biggest fear is ribbons, well any string. I have PTSD from the time my kitten ate dental floss. She also swallowed the best-selling (at the time) cat toy on Amazon when the pins came out of the top of the synthetic mouse. She eventually passed it, but she was so sick and there was nothing to do but wait.

I think fionasmom gave you some great opinions/advice on why she’s behaving as she is. I bet she does feel crappy from everything.[/QUOTE]

 

[Baellchen]

One of my cats, Graycie, has constipation problems. Not megacolon but she does need Miralax 4 times a day at 1/8 tsp each time. During one episode, the vet found some hard stool in the back of the colon and told me that she (Graycie) could get it out. Nothing happened and she had no appetite, so the vet gave her one shot of dexamethasone which increased her appetite and did help her to evacuate her bowels. I am not saying that your cat needs Miralax, and certainly not at the same time as other products unless you discuss it with the vet, or dexamethasone, but that it is possible that there is not enough in her right now to come out.

You could discuss this with your vet tomorrow; you don't have to agree to any procedures that you feel are not right or not immediately necessary.

So sorry to hear that your

Hi Reba,

thank you so much for your reply. The first doctor who said " I don't know" was very stressed out that day and said that she was a "liitle" constipated. The second doctor showed me the X-Rays and she was not "just" a little constipated, her entire colon was extremely full. The first doc didn't show me any pictures and I told her the Lactulose doesn't work. She wasn't really interested so I've opted for the second Doc. He did an amazing job with blood work and showing me the brutal truth of her colon before and after all the enemas. Her poop was hard as a rock, no way this would have come out by itself.

It’s so hard with vets. I still haven’t figured out what’s realistic. I think I went through 3-4 of them and they were probably all fine, but I was always thinking the grass was greener. I had a vet at the eclinic tell me I could take the cat home after one vet botched his neuter surgery (well I felt ok about dumping THAT vet) and I insisted he stay another night because I was terrified I’d get him home and something would go wrong. So believe me I understand wanting to do what feels like the least risky option. I go straight to catastrophe, but I’m trying to step back and not do that so much.


I went today and grain free canned food with a little lower fiber but more water content, keeping her hydrated. She ate everything. Drank and went after to the bathroom. Just urine no poop so far. To be honest I am not so worried about the pooping after all the enemas, but the doctor said she should have a bowel movement in max 48 hours. That stressed me a bit. Her little behind is red and swollen and I think she is really sore. The doc told me to play with her. She loves all kind of ribbons. Today we played a little and she was participating. A good sign?

It’s fantastic that she’s eating. My biggest fear is ribbons, well any string. I have PTSD from the time my kitten ate dental floss. She also swallowed the best-selling (at the time) cat toy on Amazon when the pins came out of the top of the synthetic mouse. She eventually passed it, but she was so sick and there was nothing to do but wait.

I think fionasmom gave you some great opinions/advice on why she’s behaving as she is. I bet she does feel crappy from everything.

[/QUOTE]
So sorry to hear that Graycie has constipation problems. Poor girl. I have asked the doc about Miralax because I hear a lot of good things. He didn’t respond but I will ask again. The Vet gave me so many mixed messages that I’m totally confused. She’s eating, drinking, urinating, walking a little but mostly lying around.

I would just like to know how long it can take after all these enemas and manual removal for her to poop again. The Vet said that she should be able to poop the next day. I can’t believe it. She hasn’t pooped in two days.

 

[reba]

My parents had to start giving their cat Miralax. She would literally cry out in pain every time she had to poop.

The vet may have meant she should be able to poop (if she wants to) versus ‘she will poop in 24 hours.’ You would think the logical thing would be to say “but if she doesn’t don’t worry”, but they often don’t seem to see around that corner.

Since it’s a lot more stressful for me to call the next day, I now try and make sure the vet there’s not a gap between my expectations and what the immediate future may hold. Or, more specifically, what is/isn’t cause for concern.

 

[Baellchen]

Thank you so much for all your comments. I’m so glad I’ve posted here. I haven’t slept in a week and now I’m totally constipated due to stress.

Could you please specify your last sentence? Should I not call the Vet?

 

[reba]

No, no, that’s not what I was saying. I was saying it’s just easier to go through the what-ifs with them sitting in front of you. When we pick them up the thinking goes “I’m so glad that’s over, now we can get onto getting better.”. Then you get them home and they don’t seem better, which makes you enter the hellish stage of SOMETHING IS REALLY WRONG OR MAYBE I’M JUST OVERREACTING. Then next thing you know you’re standing over the cat with a stopwatch and a magnifying glass counting respirations, because you just read on the internet that that’s a sure-fire way to tell if your cat is in distress. Then you finally do call the vet and you don’t hear back for 3 hours which angers you because the vet clearly doesn’t understand that we’re dealing with life and death here. Because we’re probably not - but we don’t know that and the vet hasn’t made that clear.

Well at least this is how it has been for me. LOL.

Anyway, if I do call I say “my expectation was X based on my conversation with the vet, but Y is what’s happening. I need to know if that’s cause for concern and what my plan should be going forward if this doesn’t change. You can ask at what point things change from ”wait and see” to “I need to make sure she’s seen immediately.”

 

[Baellchen]

No, no, that’s not what I was saying. I was saying it’s just easier to go through the what-ifs with them sitting in front of you. When we pick them up the thinking goes “I’m so glad that’s over, now we can get onto getting better.”. Then you get them home and they don’t seem better, which makes you enter the hellish stage of SOMETHING IS REALLY WRONG OR MAYBE I’M JUST OVERREACTING. Then next thing you know you’re standing over the cat with a stopwatch and a magnifying glass counting respirations, because you just read on the internet that that’s a sure-fire way to tell if your cat is in distress. Then you finally do call the vet and you don’t hear back for 3 hours which angers you because the vet clearly doesn’t understand that we’re dealing with life and death here. Because we’re probably not - but we don’t know that and the vet hasn’t made that clear.

Well at least this is how it has been for me. LOL.

Anyway, if I do call I say “my expectation was X based on my conversation with the vet, but Y is what’s happening. I need to know if that’s cause for concern and what my plan should be going forward if this doesn’t change. You can ask at what point things change from ”wait and see” to “I need to make sure she’s seen immediately.”

Thank you so much. You describe it so perfectly. And I love your approach. This is what I do tomorrow. Thanks sooooo much.