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Old 06-14-2010, 10:49 AM   #31 (permalink)
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Default Re: Constipated Cat - How long does it take to regulate stool?

Quote:
Originally Posted by Kattt
Is the Kraft cool whipped brand ok for her, if it has to turn into a daily dose thing to replace the Miralax?
LOL! No, no, no, Cool Whip is NOT whipping cream. In fact, I'm not sure Cool Whip even has any dairy in it. Do NOT give Cool Whip to your girl. Buy real whipping cream (or half & half, or even just whole milk). You'll find it in the dairy section with the milk and half & half. You're not looking for cream that's already been whipped. You're looking for real cream in its natural, liquid form.

Here's the thing about dairy. Nursing kittens have an enzyme called lactase that can metabolise the lactose in milk so that it is digestible, but this lactase enzyme decreases in a mature feline if the cat stops drinking milk. If enough milk is consumed by and adult cat to exceed the capacity of the lactase present, the milk acts like an osmotic laxative, similar in action to Miralax. The only thing I'm not sure about is whether the adult cat might start manufacturing more lactase enzyme again if she starts drinking dairy regularly.

Quote:
I finally found a food that she'll eat the entire 3ozs, licks the bowl dry... meat and all - Wellness Healthy Indulgence. Down side, its the tuna flavor (of course).
Hopefully it'll help her palate eventually enjoy other canned foods, as well.

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Shes been poo'ing every 1-2 days now, and today she actually went on the first try, with no straining.
That's terrific. She must be feeling much better these days.

Quote:
So I'm hoping now that she's almost fully transitioned to wet food, along with the extra water and pumpkin that I mix in, I can possibly ween her off of the Miralax soon. I don't want to rock the boat just yet though, since she's just barely starting to get back to normal.
Sounds like a good plan to me. I hope she continues to do well and can keep things moving smoothly without Miralax once you wean her off of it. But now you'll know what to do for her if she should start to bind up again. I'm so glad she's over the hump.

Laurie
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Old 06-14-2010, 12:06 PM   #32 (permalink)
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Default Re: Constipated Cat - How long does it take to regulate stool?

Shows how much I know about whats good, and whats not for cats. Good thing she didn't eat it LOL!

Well, hopefully I won't need it. I'll go with my plan of weaning her off the Miralax in a couple of weeks, and see how that goes first. If she still needs something extra afterwards, I'll try some whipping cream.

And yes, definitely glad I know I have the Miralax on hand that works for when she does get bound up again. Saves on expensive vet bills. I'm hoping the healthy diet and additional water intake will get her back on track again.

Shes actually poo'ing in the litterbox again too. Which she hasn't done in YEARS. She's always pee'd in the litterbox, and poo'd on the floor. I got rid of all carpets and had hardwood floors installed because of her. Friends would always tell me they'd get rid of that cat. No way! She's my baby.. my cats are like my kids. No matter what her issues, I could never give my cats away. I know alot of people that get rid of pets for going on the floor though, its sad. I tell her all the time she's lucky she ended up with me, no one else would put up with her poo'ing habits and bad attitude on top of it LOL

So I'm guessing these issues have been going on for way longer than I actually realized, which was causing her to go on the floor. But the vet always gave her a clean bill of health, and said there was no medical reason for it aside from her being a high anxiety cat.
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Old 06-14-2010, 12:44 PM   #33 (permalink)
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Default Re: Constipated Cat - How long does it take to regulate stool?

Quote:
Originally Posted by Kattt
And yes, definitely glad I know I have the Miralax on hand that works for when she does get bound up again.
If she does get bound up again, remember that Miralax will not soften constipated stool already formed in her system. It will only soften newly forming stool. So if she does become badly constipated again, she still may require manual extraction or enema to get her cleaned out before the Miralax can do its job of prevention.

Quote:
Shes actually poo'ing in the litterbox again too.
Amazing how we, and sometimes even vets, make mis-assumptions about the causes of some behaviors. I think you're right; I think she's probably had constipation problems for a long time.

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I know alot of people that get rid of pets for going on the floor though, its sad.
Sad, indeed, and disgraceful how disposable animals are when they don't fit perfectly into a selfish human's lifestyle. I agree completely with you about the animals being my family. I would never dream of tossing one out of the family just because they didn't follow my human rules.

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Old 06-19-2010, 09:31 AM   #34 (permalink)
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Default Re: Constipated Cat - How long does it take to regulate stool?

So I haven't updated here in a few.

She is poo'ing every 2 days now. I know they say cats should go daily, but she has never gone daily.. its always been every 2 days. So I'm not sure if I should consider that normal or not, since its been HER norm. But she is using the litterbox now, which has not been normal for her for years. So the fact that shes using the litterbox again, I can only hope thats a sign that shes feeling better about having a bowel movement.

But my 2 main concerns are, even though she's going every 2 days, it still sometimes seems a bit on the dry side. Its not small, or round like it was when she was fully constipated... its usually normal size, but looks a bit dry. But its not always dry. Sometimes it looks normal, while other times dry. So maybe I'm just paranoid at this point after everything, and thatís not anything to worry about. But what does bother me.. is she also seems to get worrisome when she has to go. Like I can usually tell when she has to have a bowel movement by the way shes laying (on her belly with all 4 paws tucked under her) and by the look on her face. Then once she goes, shes all relaxed again. Then rinse, repeat in 2 days. Maybe its her stress causing this? I've read that stress can cause constipation issues. I have no idea. I tried a Feliway plug-in, but that did absolutley nothing to relieve her anxiety. I'm more concerned by the fact that she feels the need to worry when she has to poo, but I don't know how to change that.

I'm still giving her pumpkin - 1 tsp daily. I split the tsp up into 2 meals - half mixed in her morning meal, and half in her evening meal. I'm also still giving her 1/8 tsp of Miralax each morning. I feed her wet food 3 times a day (Because she's still only eating about 1-1.5ozs per sitting), and I mix 3 tsps of water into each feeding, to give her extra water intake.

She definitely gets the full amount of Miralax into her system, because I mix that separately into a tiny bit of gravy, and give her that first to ensure she gets it all into her system.. once she licks it up, I give her the rest of her food which has the pumpkin and water in it. She never eats all of her food, she does however lick it until its dry though. I have noticed she drinks way less out of her water bowl now, since I started putting water in her food. I have read on this forum that its normal that they drink less water when they're on wet food though.

So any suggestions on what I can change to make her stool less dry? And make her feel less stressed when she has to go? I know the pumpkin is supposed to bulk up her stool, but do you think because shes not eating all of her food, and possibly not getting all of her pumpkin, that could cause it to be dry? (I'm not sure what pumpkin does texture wise to the stool, aside from bulk it up). This morning I gave her the pumpkin in the lil bit of gravy that I mix the Miralax in, so I know she got both the full dosage of pumpkin and Miralax today. So I guess I will continue trying that as well. And maybe I should be adding more water than 3 tsps? I'm going to give the vet another call Monday too, and update her and see what she thinks as well. Given she checked out health wise, I can only think this is all somehow stress related.
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Old 06-19-2010, 07:04 PM   #35 (permalink)
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Default Re: Constipated Cat - How long does it take to regulate stool?

Quote:
Originally Posted by Kattt
She is poo'ing every 2 days now ... So the fact that shes using the litterbox again, I can only hope thats a sign that shes feeling better about having a bowel movement.
I wouldn't worry about the every 2 day thing as long as her stool size and consistency are good.

Quote:
it still sometimes seems a bit on the dry side. Its not small, or round like it was when she was fully constipated... its usually normal size, but looks a bit dry.
This is a little concerning. Dry stool means that there's not enough water in her gut to soften the stool, so it'd be a good idea to increase the amount of water that you mix into her canned food meals. If that's not enough to consistently moisten her stool, increase the Miralax to a heaping 1/8 tsp once a day.

Quote:
she also seems to get worrisome when she has to go.
Maybe that's because the dry stool is still uncomfortable for her to pass. Hopefully when her stool is consistenty moist, her worry will dissipate.

Quote:
I have noticed she drinks way less out of her water bowl now, since I started putting water in her food. I have read on this forum that its normal that they drink less water when they're on wet food though.
Water is water. It doesn't matter whether it enters her body through food or through drink.

Quote:
I know the pumpkin is supposed to bulk up her stool, but do you think because shes not eating all of her food, and possibly not getting all of her pumpkin, that could cause it to be dry?
No, I don't think that's an issue with stool dryness. You just need to get more water into her.

Given she checked out health wise, I can only think this is all somehow stress related.[/quote]

You may be right about that. I'm just not sure. Have you tried Rescue Remedy? I've also read that Feliway spray sometimes works even if the plug-in doesn't, because the spray can be applied to her coat so that it stays with her no matter how far away she is from the plug-in.

Laurie
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Old 06-28-2010, 11:08 PM   #36 (permalink)
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Default Re: Constipated Cat - How long does it take to regulate stool?

So.. back from another stressful vet visit, with yet another enema... well, 2 enemas actually. She wouldn't poo from the first one, so they gave a second one. She still refused to go, until I got her home. She really is a pro at holding her stool in.

While she was passing stool every 2 days, she was straining LOTS to get it out.. and she didn't go at all today, which was day 2. I thought her fur felt fine this morning, but as the day went on.. it started looking a bit off which made me suspect dehydration. So my gut told me it was time for another vet visit, and I took her in right away. And I'm glad I went with my gut instincts. She had quite a bit of stool backed up in her again, more so then last time.. and she was slightly dehydrated.

They said she still shows no signs of megacolon, and can't give me an answer as to why she's getting constipated. But said it was time for stronger treatment given the circumstances, to hopefully prevent this issue from happening again.

Here's the part you won't like.. they put her on Lactulose, mixed with Cisapride. YES, I do know that Cisapride was pulled from the US market for humans, and of course that raised serious concerns that I questioned. The vet claims that it has been deemed safe for cats, and used safely and effectively for years to treat constipated cats, with never any side effects. She assured me that its safe for her, and that its the best option for her right now. I have read throughout this forum that many others use it as well.

While I'm not happy to know that it was pulled from human usage, I'm also desperate to fix this problem. So do I trust my vets judgement?!

Oh, and because of the slight dehydration issue and the importance of water while on Lactulose, and me expressing that I'm finding it quite stressful to get 300 ML's of water into her daily (She was losing interest in all of the water I was giving her, no matter how creative I got), so she also gave me SubQ Fluids to administer every 2 days.

This issue is crazy. Aside from unexplanable constipation, shes healthy, and even acts happy and healthy. She's never lethargic, all tests check out healthwise.. she eats normal, plays normal... so I don't get it, and the vet can't explain it either... and claims that sometimes they never figure out why cats get constipated. But says constipation is treatable and she can live a long, happy life once we find the right balance that works for her. I hope she's right. And I hope these new meds work. It's been quite stressful and frustrating for us both to say the least.
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Old 06-29-2010, 02:23 PM   #37 (permalink)
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Default Re: Constipated Cat - How long does it take to regulate stool?

Quote:
Originally Posted by Kattt
back from another stressful vet visit, with yet another enema.
It sounds like it would be a good idea to have your vet teach you how to administer an enema at home so as to keep your girl's stress to a minimum, should another enema become necessary.

Quote:
they put her on Lactulose, mixed with Cisapride. YES, I do know that Cisapride was pulled from the US market for humans, and of course that raised serious concerns that I questioned. The vet claims that it has been deemed safe for cats, and used safely and effectively for years to treat constipated cats, with never any side effects.
I have no problem with the vet switching her from Miralax to Lactulose, because Lactulose may just work better for her, and it may have some effect on improving gut motility as well as retaining fluid in the stool. I DO, however, have a problem with any vet who uses the word "never" relative to medication side effects - esp. a med with as serious side effects as cisapride has had in human patients. It's also well documented that cisapride can cause diarrhea and stomach cramping in some cats. So do keep a close eye out for these side effects that "never" happen.

Quote:
do I trust my vets judgement?!
Listen to your vet's advice, ask your vet all necessary questions, do your own research, and then trust your own judgement.

Quote:
she also gave me SubQ Fluids to administer every 2 days.
How much fluid did she prescribe at each admin? If your girl really requires subQ fluids, it would be preferable to give them daily to maintain a more even hydration level in her body. Otherwise her body will constantly cycle between dehydration and rehydration , since fluid is not retained in the body for 48 hrs. after an admin. If your vet recommended 100 ml every other day, for instance, your cat would reap greater benefit from 50 ml daily.

If you want advice on administering subQs and on obtaining subQ supplies inexpensively, let me know.

BTW, have you started her on methylcobalamin and folic acid yet? If not, you should do so, in addition to B-Complex. The B vits are quickly washed out of the system in urine, and subQ fluids produce lots of extra urine.

Laurie
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Old 06-29-2010, 03:24 PM   #38 (permalink)
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Default Re: Constipated Cat - How long does it take to regulate stool?

Thanks Laurie.

I definitely plan on asking them to teach me how to give her enemas, and to provide me with some enemas to have on hand if this happens again. The vet visits are way too stressful on her, as with any cat. So anything I can do for her at home, I will do it.

I did spend lots of time researching Cisapride for hours last night in both humans and cats, along with some packet information my vet gave me as well. And from what I read, I felt safe attempting it with Pepper. Supposedly alot of the side effects in humans were due to it having adverse effects when mixed with other medications, and the FDA felt it was too risky due to humans often seeing multiple doctors and being on multiple medications that can interfere with Cisapride. And as my vet said, given she's only visiting one vet.. and we know she's on no other medications, those particular risks aren't there. I did read as you stated though, that it can cause cramping and diarrhea. Which my vet did advise me of that as well, and said to monitor her closely.. and contact her immediately if I notice signs, and we can scale back on her dosage, or seek alternative options. Although I'm not sure how to tell if a cat has cramping, given cats often hide their pain. But I'd imagine she'd probably hunch over, or at the very least show signs of discomfort.

She's had 2 doses so far (One last night, and one this morning). And so far she seems fine, she doesn't appear to have any cramping or anything and she appears happy and relieved. And she did again poo this morning on the first try, with no straining, about 8 hours after her first dosage. The stool was solid and normal size.. on the soft side, but not diarrhea. I'm not sure if that was the medication working, or she was still poo'ing out stool leftover from her enemas last night. So the jury is still out on if this medication works or not. Got my fingers crossed.

The vet prescribed 150 ML of SubQ fluids every 2 days. And I'm still mixing water into her wet food as well. The vet said she was only borderline dehydrated, so the fluids should give her the little boost she needs. So I should split her SubQ fluids up into 75 ML's daily then? And yes, if you have advice in this area.. please share. I haven't given her any yet, and it makes me nervous with her. I've given them to my male cat before, but Pepper.. she's a different story. She's extremely skittish, doesn't like to be held or touched, and she will bite, scratch and hiss. Aside from allowing me to pet her for a moment or 2 here and there, she gets very angry when attempting to mess with her. Plus she doesn't have alot of loose skin like he did, her skin seems tighter and hard to pull up alot of skin on her to stick the needle in. So administering tips will be greatly appreciated. I'm sure after I do it a couple of times, it'll be fine. Just need to get her (and me) into a routine. The vet said the medications/fluids may or may not be a temporary thing. She said right now, with no signs of megacolon.. she has hope that its only temporary, but no guarantees, because some cats contiuously need help staying regulated. So time will tell.

With everything going on, I forgot to ask my vet about the methylcobalamin and folic acid, I'll have to give her a call and ask her. I don't want to add in anything extra while on Cisapride, without the vets ok. The vets office did call this morning just to check up on her, which I was surprised. Vet offices rarely do that. At least none of the vets I've ever gone to anyways... never seemed to care what happened once I left. I just started going to this vet a month ago, when these constipation issues started. So hopefully this vets a keeper. Hard to find good ones that you can trust.
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Old 06-29-2010, 04:12 PM   #39 (permalink)
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Default Re: Constipated Cat - How long does it take to regulate stool?

I have only scanned the posts so far, but given your frequent reference to her being easily stressed and exhibiting anxiety, have you or your vet ever considered that as a possible cause for the constipation? Perhaps treating her high levels of stress and anxiety would resolve the constipation issue. I'm not a big fan of putting kitties (or people) on psych drugs as a matter of course, but as you said she has lived with you in the same house since she was a kitten, and still has high levels of fear, stress and anxiety, I wonder if it might not be called for in this case.

For most cats I would not recommend this, but having lived with Gabie, my Meezer who was stressed about *everything* his whole life (it took him a year to get over moving from our apartment to a house), I know that some cats just have mental issues. Some physical problems have both a physical and mental aspect.

Edited to add: Oh and I forgot to mention, it is fairly common for people to report their pets are relaxed and calmer after a change in diet to a higher quality food that has less additives, so part of the improvement after her change in diet might be related to that too.
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Old 06-29-2010, 05:06 PM   #40 (permalink)
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Default Re: Constipated Cat - How long does it take to regulate stool?

Quote:
Originally Posted by Kattt
I definitely plan on asking them to teach me how to give her enemas, and to provide me with some enemas to have on hand if this happens again.
You can buy pet enemas through many online sources, including amazon.com. They don't require a perscription.

Quote:
I did spend lots of time researching Cisapride for hours last night in both humans and cats, along with some packet information my vet gave me as well. And from what I read, I felt safe attempting it with Pepper.
In your place, I would have considered using cisapride, also, though I would have exhausted all other options first (Lactulose, methylcobalamin & folic acid, Zantac 75, etc.).

Quote:
I did read as you stated though, that it can cause cramping and diarrhea. Which my vet did advise me of,
Ah, I feel better knowing that your vet didn't really claim that there were "never" any side effects. That comment in your earlier post made me quite suspect of your vet's competency and/or honesty.

Quote:
I'm not sure how to tell if a cat has cramping, given cats often hide their pain. But I'd imagine she'd probably hunch over, or at the very least show signs of discomfort.
That depends on the cat. When Tommy was constipated and had an enema a few weeks ago, she growled and hissed in pain just before passing the hard stool. I suspect that was her response to abdominal cramping.

Quote:
She's had 2 doses so far (One last night, and one this morning). And so far she seems fine, she doesn't appear to have any cramping or anything and she appears happy and relieved. And she did again poo this morning on the first try, with no straining, about 8 hours after her first dosage. The stool was solid and normal size.. on the soft side, but not diarrhea.
That all sounds very encouraging. I'm not sure if that's a result of the cisapride working already, either, but it's all good news no matter what's causing it.

Quote:
The vet prescribed 150 ML of SubQ fluids every 2 days. ... So I should split her SubQ fluids up into 75 ML's daily then?
75 ml daily is what I'd admin if she was one of my own cats.

Quote:
if you have advice in this area.. please share. I haven't given her any yet, and it makes me nervous with her. I've given them to my male cat before, but Pepper.. she's a different story. She's extremely skittish, doesn't like to be held or touched, and she will bite, scratch and hiss.
My first CRF cat, Pea, had much the same personality. To my amazement, she accepted subQ admins with little fuss once she realized how much better they made her feel. Billy, too, had to be handled carefully because he had an extremely short fuse and violent temper when riled.

With both of those cats, I found that the less restraint I used, the smoother the procedure went for all concerned. With Pea, I sat in the bathtub with her between my legs. That worked will with her because she was too old and feeble to jump out of the tub on her own, so the tub itself was the only restraint I needed.

Billy was a different matter. He was more than capable of fighting me off if he wanted to, so I had to stage a different setting for him. I placed a couple of diningroom chairs next to each other starting in one corner and extending down one of the diningroom walls toward a large window. I would sit on the corner chair with my legs extended across both chairs toward the window. Then I'd place Billy on the chair closest to the window, between my leg and the back of the chair. So without my having to actually hold him, the chair back, wall, and my body were blocking all of his exits except the front, and I held my hand casually in front of him, when necessary, to block that exit, too.

Billy also didn't appreciate being petted, cooed to, or any of those other "annoying" comforting techniques we humans like to employ. He did best when I kept my mouth shut and my hands as quiet and passive as possible until the admin was finished. In short, Billy was a "shut up and get it over with" type.

Quote:
Plus she doesn't have alot of loose skin like he did, her skin seems tighter and hard to pull up alot of skin on her to stick the needle in.
That's probably because she's pretty well hydrated to begin with. Also, they can make it a lot harder to tent the skin if they tense up their muscles, so try to keep all of this as low key and matter-of-fact as possible. Actually, I find it a lot easier to admin fluids to a cat with greater skin elasticity. Billy's skin was so loose that it was difficult to not push the needle all the way through the skin tent and squirt fluid out the other side all over my leg or chair.

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So administering tips will be greatly appreciated.
1) warm the fluids (I'll provide more details if you need them)
2) use the right needles (Terumo 20 ga UTW are the best, IMO)
3) don't admin more than 100 ml in the same spot during the same admin or the fluid pocket can become uncomfortably large
4) don't use the same needle more than once (they dull substantially after the first insertion). If the needle slips out during admin, have fresh needles within reach to swap and continue the admin.
5) maintain an air of relaxed confidence. If you tense up and expect resistance, she'll give it to you.
6) give fluids fairly early in the morning so that your girl learns that after fluids, she gets to be pretty much left alone and relax for the rest of the day.

Quote:
I forgot to ask my vet about the methylcobalamin and folic acid, I'll have to give her a call and ask her. I don't want to add in anything extra while on Cisapride, without the vets ok.
I'm sure your vet won't have a problem with them. They are just water-soluble B vits, after all - same as she gets in her food every day.

Quote:
The vets office did call this morning just to check up on her
That's one sign of a good vet.

Laurie
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