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Slippery Elm Bark, Wet food, Managing Constipation
- Thread starter oneandahalfcats
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Oh. Well this might explain why you are not seeing more results. I would talk with your vet about increasing the frequency of the dosage. One dosage per day is not enough. I would also try and give her the dose sooner if you can.
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Yes, I think he wanted to see if it would work on the lowest dose possible. So was I. I'm to report Dory's progress this Saturday. If the situation continues, I'm pretty sure he'll increase the dosing. This will add up...I paid $18 for 20 tabs. I'm definitely going to ask the vet to okay an online prescription.
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That was the right approach, for sure. You want to know that she tolerates it well which is very sensible. At the same time, there needs to be enough concentration of cisapride built up in the system to be effective I think. The 5mg is about 1cc amount and a typical dosage.
I recall that the cisparide was not cheap. According to my records I paid close to $100 for 60 tabs here in Canada
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I would give the Cisapride to her at approximately the same time each day. A single dose stays in the system for several days, with subsequent doses creating a cumulative effect, and I would think consistency in dosing is important. I gave Tim's dose every morning at approximately 5:25 (even on weekends, ugh, often going back to bed afterwards). Now that we're skipping three days, I am still continuing the same dosing time.
5 mg once per day is a small dose. Tim did well on this, other cats need more. But Tim was able to resist Cisapride for 6.5 days when we went on vacation and boarded the cats. He did not poop the entire time he was being boarded, Saturday through Thursday. This was with daily Cisapride, daily laxatone, and super doses of laxatone on days 4, 5, and 6. Our vet strongly suggested an enema, but my husband wanted to take Tim home. I'm glad we did, because he went about 30 minutes after arriving home, then got back on his regular schedule the next morning. I tell you this because Cisapride, especially at low doses, isn't irresistible and Dory may need more.
I can only guess how frustrated you are with this constipation. But I agree with @oneandahalfcats that your vet is sensible to start with a low dose of Cisapride. I wish mine had suggested other things before starting with Cisapride, even though it was a low dose, as now I find myself worrying at times that Tim may be dependent on this expensive drug.
Cisapride needs to be compounded because it is banned for human use. I believe you can get it at Wedgewood or Diamondback (Diamond something, can't remember clearly), but do research availability first.
Cisapride is listed on Wedgewood and PetMeds.
Does Cisapride have a flavor or odor? I see that capsules are an option. Dory is used to ingesting capsules. If the capsules are too big and the contents too much to fit into the empty capsules I have, mixing it into food would be an option. But obviously, a strong or distasteful flavor would be a deal breaker.
The chicken flavored tabs aren't enticing Dory at all.
Does Cisapride have a flavor or odor? I see that capsules are an option. Dory is used to ingesting capsules. If the capsules are too big and the contents too much to fit into the empty capsules I have, mixing it into food would be an option. But obviously, a strong or distasteful flavor would be a deal breaker.
The chicken flavored tabs aren't enticing Dory at all.
I don't know about the medication itself, but my vet gave it to me liver flavored, and it did make it easier to administer. I think it was Wedgewood that had different forms you could order like rapid melting tabs. I believe cisapride can also be administered via the ear--you rub it in.
If all else fails you can take your prescription to a compounding pharmacy and they can flavor it with the flavor of your choice. I've heard of tuna or beef flavoring. For dogs they do peanut butter.
We get our Cisapride in a capsule format, which I mix in with Tim's very first bowl of food in the morning and he gobbles right up.
When we first started with the medication, I tried opening the capsule and sprinkling the contents on his food and mixing in. Tim wouldn't have anything to do with that food. For Tim, that is saying a lot. I can only guess it has some odor or taste he didn't like.
How big are the capsules? I use sizes 4 and 5 capsules.
Dory went this morning just as I was about to call the vet and give the 7 day progress report. So Saturday to Wednesday (4 days) to Saturday (3 days). Hopefully, she'll continue to improve on only one 5mg dose daily. Oddly, her BM wasn't as soft as usual. I don't know if I shortchanged her water in the wet food or gave her one too many kibble. Josie goes just about every other day and her BMs are usually dryer than Dory's. So maybe it's just one of those things....
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Thanks for the update. Great progress I'd say, given that she is getting just the one dose. You must be feeling pretty good about this.
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Just thought to track back on this part of your update .. Have you decreased or eliminated the miralax dosage while Dory is on the cisapride? If yes, this could be what is making the difference with the stool being drier.
No, I've actually thought to myself that I should increase Miralax by a bit. Basically, they get 1/6 -1/8 of teaspoon once daily. When they were on 1/4 teaspoon, it was too soft. Maybe their bodies are acclimating to the drug and they need a slight increase?
Dory's last dose of Cisapride was 11 days ago. While on Cisapride, Dory's BM schedule increased from every 5 days to 3 days. Since stopping medication, she has maintained the 3 days schedule. Though I wish she'd go more frequently, I'm heartened by the fact she has maintained her BM schedule off-medication.
Should I go back to the vet and request another round of Cisapride at a higher dosage to see if Dory's schedule can improve from the 3 days frequency? Her first round was 20 days at one dosage of 5mg daily. I'm extrapolating/hoping Dory may be able to maintain the the more frequent schedule once another round of Cisapride ends. Though who knows if this type of improvement works linearly.
I am stepping down my cats' Prozac dosage--very, very gradually. I wonder if that is positively affecting Dory's BM schedule. Should I put off another round of Cisapride to see if Dory's BM schedule will improve as Prozac leaves her system? I'm aiming to stop Prozac by late July.
Should I go back to the vet and request another round of Cisapride at a higher dosage to see if Dory's schedule can improve from the 3 days frequency? Her first round was 20 days at one dosage of 5mg daily. I'm extrapolating/hoping Dory may be able to maintain the the more frequent schedule once another round of Cisapride ends. Though who knows if this type of improvement works linearly.
I am stepping down my cats' Prozac dosage--very, very gradually. I wonder if that is positively affecting Dory's BM schedule. Should I put off another round of Cisapride to see if Dory's BM schedule will improve as Prozac leaves her system? I'm aiming to stop Prozac by late July.
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Hi tdonline ... Great to hear that Dory has maintained the 3 day schedule. This is definitely an improvement
Its really hard to say what would be best going forward as you are closer to this situation and know Dory best. I haven't used Prozac on any cats I have had, so can't comment much on how much it takes to cause constipation, I only know that it can be a cause for.
On the one hand the increase in cisapride 'might' improve on an increased dosage, on the other hand, I am thinking the same as you, that the decrease in prozac may be contributing to the increased frequency in BMs. You could do a one to two week trial at the two doses per day and see how this goes. If no change, then I would pull back on the cisapride, and see where you are at with the prozac in terms of the dosage. Or, continue decreasing the dosage of prozac and hopefully she continues to improve.
Since my last post here, Dory's going every other day...squeee! I feel like I'm jinxing it by posting. Last Saturday, she went on schedule--3 days. Then she went Sunday, which blew my mind and since then, she's been going every other day. That's pretty close to her pre-prozac days.
I'm not sure how Cisapride worked and how much it's affected her schedule post-dosing. I'm quite pleased and pleasantly surprised Cisapride seems to have worked in jumpstarting her BM schedule without long term dosing. Dory was on it for only 20 days. I've also decreased Dory's prozac dosing from 5mg every other day to 2.5mg every third day since early April. Next week, I'll step her down to 1.6mg and hope to stop it altogether in July.
I'm not sure how Cisapride worked and how much it's affected her schedule post-dosing. I'm quite pleased and pleasantly surprised Cisapride seems to have worked in jumpstarting her BM schedule without long term dosing. Dory was on it for only 20 days. I've also decreased Dory's prozac dosing from 5mg every other day to 2.5mg every third day since early April. Next week, I'll step her down to 1.6mg and hope to stop it altogether in July.
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Great progress tdonline!
Have you increased the cisapride, maintained the same dose or not giving this at the moment?
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