My 16yr old cat hasn’t pooped for 13 days

Daisy’sMom

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I just joined The Cat Site & this is my first post.
When I first noticed that Daisy (it’s a him) hadn’t pooped it had probably been about 3 days. He’s had issues with constipation in the past a couple of times, beginning in 2018. Anyway on 8-18-22 I couldn’t get into my my regular vet so I took him to another nearby to see about giving him an enema. She expressed his anal glands, but said she didn’t think he was in trouble. I went home with a tube of Laxaire (sp). He puked that up. I made an appointment with my vet for Monday 8-22-22. In the meantime (8-20-22) I gave him 1/2 tsp MiraLax In the morning. About 24hrs later he pooped a small hard log, probably about 2-3”. I was ELATED.
We had our appointment on Monday, our vet did a physical, a blood work up, X-rays, and a urinalysis. From the X-ray she said she did think he was constipated. Told me to continue with the MiraLax. But discovered other concerns which were all kidney values were elevated, phosphorus was elevated, liver values normal, normal white blood cell count & no signs of anemia. He has a heart murmur & slightly elevated enzyme. His urine had some bacteria. Depressing news. I went home with a couple of cans of food for kidneys & for renal.
I continued with the MiraLax and on Monday 8-23-22 Daisy pooped, not much but at least he pooped. From that point on no pooping. I called the vet again Wednesday 8-31-22 to see about him having an enema. Different vet but in the same practice. She checked him over did another blood panel on him, came back and told me he was in kidney failure & that the pooping was the least of my worries. I went home with the prescription Lactose starting with a 2ml dose. No pooping, I upped it to 3ml according to the script....nothing. Yesterday morning I quit with the Lactose and gave him MiraLax again & again this morning. Today is day 13.I wanted to try to give him an enema today, but I’m scared to do it at this point because he could very well be obstipate and I don’t want anything to happen to him. I can’t afford to keep going back to the vet for this very same issue and it never being dealt with. They seem reluctant to do anything. Please Help...any ideas on what I should do?
 

LTS3

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13 days is too long to go without popping. Are you sure there isn't poop hidden under a sofa or other place in the home? My rule of thumb (may be different for everyone) is that if a vet throws out band aid treatments that are clearly not working and the vet is basically :dunno: and won't dig further into the cause of the health issue, find a new vet at a different practice. Bring copies of your cat's medical records for the new to review.

1/2 tsp of Miralax is a pretty high dose. A general cat sized dose is 1/8 to 1/4 tsp up to twice a day. Can you try 1/4 tsp twice a day for a few days to see if that helps? Are you dissolving the Miralax in water before mixing it into food?

I would not attempt an enema at home even with any instructions you may find posted online.
 

Alldara

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Nobel is 17 lbs and he gets 1/4 tsp twice per day.

Sometimes I find that Nobel poos the next day when he takes it.

You may need to find a vet who will do an ultrasound and/or slight sedation to remove what they can. This was my vet's first course of action, along with bloodwork. We got to a cat only hospital.

Did they comment on your cat's hydration levels? Or provide fluids? For kidney issues, fluids are usually part of the treatment.

Has any vet noted a heart murmur before? A cats heart can go into murmur during stress. Our old vet used to note one in Nobel whenever he was in pain or sick, but whenever we went back for follow up it was gone. He explained that sometimes cats sound like the have one when they don't. Heart blood work is needed to confirm. This is usually not part of a normal panel.

What level of kidney food did they give you? That might provide others on here an idea of how progressed the kidney disease is. Or if you have his kideny values that may help provide some insight.

As mentioned above, please go to a different vet if possible. The vet clearly doesn't care about resolving any issues for your cat. I think another poster on the website mentioned sticking with Miralax for kidney issues might be best as it's least likely to cause further dehydration as long as it's fully dissolved before mixing it into the food.
 
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Daisy’sMom

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Thank you for replying.
I’m sure there isn’t poop hidden anywhere.
I just got off the phone with Emergency Animal Hospital and there‘s no guarantee that Daisy will get an enema with them either. I’m calling my vet tomorrow & asking for an enema. This amount of time to not poop is SO ALARMING to me that I just don’t understand why ANY veterinarian wouldn’t give him one. I‘m continuing to give him MiraLAX until I take him into the veterinary office.
Yes, I mix it with chicken broth to dissolve it, then put it in his food.
I’m not going to attempt an enema. I’m just overwhelmed & broken-hearted over not reacting sooner.
Again thank you for responding
 
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Daisy’sMom

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Nobel is 17 lbs and he gets 1/4 tsp twice per day.

Sometimes I find that Nobel poos the next day when he takes it.

You may need to find a vet who will do an ultrasound and/or slight sedation to remove what they can. This was my vet's first course of action, along with bloodwork. We got to a cat only hospital.

Did they comment on your cat's hydration levels? Or provide fluids? For kidney issues, fluids are usually part of the treatment.

Has any vet noted a heart murmur before? A cats heart can go into murmur during stress. Our old vet used to note one in Nobel whenever he was in pain or sick, but whenever we went back for follow up it was gone. He explained that sometimes cats sound like the have one when they don't. Heart blood work is needed to confirm. This is usually not part of a normal panel.

What level of kidney food did they give you? That might provide others on here an idea of how progressed the kidney disease is. Or if you have his kideny values that may help provide some insight.

As mentioned above, please go to a different vet if possible. The vet clearly doesn't care about resolving any issues for your cat. I think another poster on the website mentioned sticking with Miralax for kidney issues might be best as it's least likely to cause further dehydration as long as it's fully dissolved before mixing it into the food.
The first time (8-22) she did 2 Radiographs, bloodwork up, and urinalysis. The second time (8-31) Additional radiograph, Chem17/Cbc/Electrolytes. I asked for copies of the blood work, and looked up the ones she highlighted.
creatinine 3.2
phosphorus 5.2
From the Creatinine it looks as though Daisy is in stage 3 of kidney failure.
I don‘t know why they didn’t do some removal either. Nothing was mentioned regarding hydration level, nor did they provide it. Heart murmur is a new thing. As far as food, they gave me Hills Kidney Care & Royal Canin Renal support.
I appreciate this informatio, thank you.
 
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Daisy’sMom

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I’m happy to report that my Daisy pooped!!🎉🎈 I even weighed it 💩 3.32oz, but there was clay litter attached to it, so maybe a couple oz less.
I lowered the MiraLax to 1/4 twice a day.
This is the FIRST time I’ve ever done posting on ANYTHING before (trying to learn🤦🏻‍♀️how to navigate this site) & it’s a bit challenging for me.
Thank you very much for replying to my post, it‘s strangely comforting to hear what others who have been in similar situations have done for their pets.
Now I can focus on his kidneys👍🏽
😻🧶
 

FeebysOwner

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I’m happy to report that my Daisy pooped!!
Good news! Hopefully, he will continue without issue.
creatinine 3.2, phosphorus 5.2, From the Creatinine it looks as though Daisy is in stage 3 of kidney failure. Nothing was mentioned regarding hydration level, nor did they provide it. Heart murmur is a new thing. As far as food, they gave me Hills Kidney Care & Royal Canin Renal support.
Based on those numbers, Stage 3, according to IRIS (International Renal Interest Society) is about right. However, the phosphorus level is not all that bad, and if he likes the renal foods, that should be enough to lower it to below 5.0.

Re: the hydration. Do you check his hydration level by performing the scruff test? (Gently pull up on skin on the back of his neck and then let go. If the skin falls back into place quickly, he is likely not dehydrated. The slower it takes to go back into the place the higher the level of dehydration.) I have a cat with a creatinine of 2.9 and phosphorus of 5.9, and so far, she has not required sub-Q fluids. I check her hydration level pretty routinely. So, not all cats automatically require sub-Q fluids when diagnosed with CKD. The other thing that could influence hydration with Daisy would be the heart murmur and if excess fluids would not be good for his kind of murmur. You can ask the vet about that, if you find he is dehydrated. Hopefully, the heart murmur is related solely to stress.

Another great place to learn all about CKD is Tanya's web site: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org). It is loaded with data and takes a lot of time to go through and digest all of the information, but well worth it! It can be overwhelming so read what most interests you first and go back later to read more.
 

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it’s a bit challenging for me.
You're doing a terrific job :)

It can be overwhelming so read what most interests you first and go back later to read more.
Agreed, it can be a lot to take in, but on the home page, if you look for the hot pink text Just Diagnosed Click Here, that can help cut things down for your intitial read.
It's this;
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - What You Need to Know First

Also, this link might have something for you and your kitty regarding other ways to get water into him - my Poppycat really likes the baby food soup :heartshape:
Tips To Increase Your Cat’s Water Intake – TheCatSite Articles
 
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Box of Rain

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Do you know how to do the easy home diagnostic test for dehydration that is often called "skin tenting?"

If not, gently grab the loose skin at the scruff of the cat's neck and stretch it out. Then release. If it rapidly "snaps" back into place, your cat is likely well-hydrated. But if it slowly falls back into place (no "snap") your cat is likely dehydrated.

Dehydration is at the heart of so many health issues with cats, including constipation (and kidney disease).

Consider trying this simple test.

Glad for the good news update.

Bill
 

mrsgreenjeens

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So happy he pooped! Now if I were you, I would continue giving the Miralax as you are twice per day on a regular basis. I've had three kidney cats and they all required the use of Miralax. But if I ever skipped a dose it would cause them to back up again, so I gave it to them every day, morning and night, like clockwork.
 
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Daisy’sMom

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So happy he pooped! Now if I were you, I would continue giving the Miralax as you are twice per day on a regular basis. I've had three kidney cats and they all required the use of Miralax. But if I ever skipped a dose it would cause them to back up again, so I gave it to them every day, morning and night, like clockwork.
Thank you! That’s exactly what I’m doing now👍🏽
 
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Daisy’sMom

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You're doing a terrific job :)


Agreed, it can be a lot to take in, but on the home page, if you look for the hot pink text Just Diagnosed Click Here, that can help cut things down for your intitial read.
It's this;
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - What You Need to Know First

Also, this link might have something for you and your kitty regarding other ways to get water into him - my Poppycat really likes the baby food soup :heartshape:
Tips To Increase Your Cat’s Water Intake – TheCatSite Articles
Thank you I appreciate the encouragement, and I also got on Tanya’s site👍🏽
 
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Daisy’sMom

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Do you know how to do the easy home diagnostic test for dehydration that is often called "skin tenting?"

If not, gently grab the loose skin at the scruff of the cat's neck and stretch it out. Then release. If it rapidly "snaps" back into place, your cat is likely well-hydrated. But if it slowly falls back into place (no "snap") your cat is likely dehydrated.

Dehydration is at the heart of so many health issues with cats, including constipation (and kidney disease).

Consider trying this simple test.

Glad for the good news update.

Bill
I’ve never heard of skin tenting before, I’ll definitely be trying with my Daisy. Thank You😊
 

Box of Rain

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I’ve never heard of skin tenting before, I’ll definitely be trying with my Daisy. Thank You😊
So many issues with feline health seem to be associated with chronic dehydration that simple diagnostics like this one can provide us with strong clues about our cat's condition.

I hope it proves useful to you.

Bill
 
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