Cat strains so hard she pukes

[Rudie999]

Hello. Bare with me this is long.

My calico is 14 years old. Since I can remember she has had small pellet like dry poops. She used to pass them with no issues. In the last few years she has strained to go poop. She would strain so hard she would make herself puke a few times before heading back to the litter box to try pooping again.
She did this for years and the vet gave me laxatives to help.
Last year or so it got worse. She was so backed up with poop they had to do an enema and keep her over night to flush out old dry poops. She's been given laxatone, lactulose and benefibre as well she's on the royal canin gastrointestinal dry food (her wet food is urinary care for her cystitis.)

Even using these laxatives and stuff she is still straining and puking. I noticed after she had gone the other night a bit of a prolapse. The inside was outside (red ring looked very raw) until she finished pooping and then it had relaxed and gone inside again.

I do not know what to do at this point. The vet just keeps giving me lactulose and suggesting things we've already tried

It's worth noting she's had 3 lumpectomy procedures and a lot of her stomach is scarred from cutting open and stitches. I'm curious if her abdomen muscles may be too weak. But then again she has been doing this yearsss before that.

She still is energetic, eating, hungry, thirsty and drinking. She just keeps straining to poop and will only go outside the box now (still pees in the box.)

Any advice? I'm lost!
Thank you

I also want to add: she's had imaging done and there is no blockages seen

 

[Docs Mom]

A second opinion from a different vet ? Pursue getting radiographs done of her abdomen, that includes her back end. (its not always included in abdominal radiographs) Maybe she has a stricture or scar tissue binding some of her colon. Making it difficult for her to eliminate.

I wish you luck in finding an answer. My ckd kitty Maggie used to have the same problem, its difficult to see let alone what she feels ....


Just saw your next post.... you have already done that.....
Try Miralax 1/8 of a teaspoon dissolved in water, poured over her wet food, every day.

 

[WMM201]

It sounds like your kitty is chronically dehydrated and that not enough water is getting into her colon to move the stools out. When she's been to the vet for these issues, did they give her subcutaneous fluids? That usually helps the kitties a lot. Does your cat have any conditions that kidney disease? A blood test for kidney values is a good idea. If your kitty is eating wet food, try to add some water to that. If she isn't eating wet food, try to introduce her to it. As a daily supplement, Miralax (start with 1/8 to 1/4 tsp once a day) is really useful for drawing water into the colon. It's even more effective if the kitty isn't dehydrated. But don't use more than one laxative at a time with your cat and really try to get more water (or tuna juice or whatever liquids she likes to eat) into her. Good luck.

 

[Alldara]

What it sounds like is that she is too dehydrated so the laxitives and fibre is making the constipation worse, or at least not helping it.

Fibre helps constipation if the problem causing constipation is lack of fibre. Otherwise, it can increase constipation.

What can help with chronic constipation is a switch to wet food. You can add a bit of extra water to it (as much as she will tolerate). If not affordable, you can see if she will eat the dry food rehydrated. (Basically, any dry food uses the water the cat already had in them to rehydrate itself before digestion, which can increase dehydration).

There are some "over the counter" wet foods for urinary issues now. Those might be suitable alongside her other wet food.

As they get older, it's hard to stay hydrated.

Our vet has Nobel on Restorilax for the same issue. It's going very well. Our friends' vet has their cat on 1/4 tsp of pumpkin every other day for the same purpose. These are "wet" contsitpation options: things that come with their own water when given properly so they don't dehydrate your cat further, or lower the risk of such.
in any case a second opinion might be good as it sounds like the current laxative regime is not solving the problem. The VCA says the laxatives should begin working within 2 days.

 

[Furballsmom]

Hi, I second speaking to another vet from a different clinic.

Try Miralax 1/8 of a teaspoon dissolved in water, poured over her wet food, every day.

A possible problem with miralax is that if there are kidney issues it can be detrimental, as A Alldara refers to, so daily might be too much.

As you know, we're not vets and every cat is different, so this is just a word of caution to be sure to talk with your vet, current or new, about all the options, benefits and other effects of meds etc. Being a team for your kitty and communicating everything is the very best approach

Take a look at this article, and additionally you could also provide a couple of clean daily tall water glasses or mason jars with fresh daily filtered water, in unusual locations for her;

Tips To Increase Your Cat’s Water Intake – TheCatSite Articles

 

[fionasmom]

All imaging and medical records are yours and have to be given to you to sent to another vet on your request.

 

[louisstools]

My girl had constipation issues a few months ago and at one point was on laxatone, lactulose, and benefiber. This was when she was on a 50-50 diet (by calories) of wet food (normal) and RX dry food (for UR). She wasn't on the benefiber for long b/c that made things worse for us...her stools became even harder.

What solved the constipation issues for my girl was changing her diet from 50-50 to "preferring" the dry food at 70-30 which ended up with the cat wanting just the dry food only (which was what my vet and I wanted). As the proportions changed to favor the dry food her drinking shot up. She has historically had a very low thirst drive and that's caused UTIs in the past. The RX UR dry food she is on is one that works by triggering them to drink more. The vet's theory was when we were at a 50-50 diet that the moisture she was getting from the wet food was "just enough" to sate the additional thirst the dry food was triggering. I only add the bulk of this b/c your situation sounds like what I just lived through a few months ago.

 

[nurseangel]

Oh, no! A vet visit (with a different vet if possible) is a must! Please keep us updated.

 

[mrsgreenjeens]

A possible problem with miralax is that if there are kidney issues it can be detrimental, as A Alldara refers to, so daily might be too much.

Two of my kidney cats were on Miralax twice daily for two years AFTER being diagnosed with kidney disease. Our Vet didn't see any reason not to use it. Besides, we don't even know if this particular cat has CKD, only cystitis (not that that isn't a big deal!)

To the original poster, I would highly recommend Miralax (or a generic form, which is what A Alldara uses). No matter the size of your cat, it seems all Vets recommend starting with 1/8th teaspoon dissolved in a little bit of water, and upping that up to 1/4 teaspoon depending on results. WE have been advised to do that twice per day, every single day, and it works extremely well for our chronically constipated furry guy. Worked very well in the past for our kidney cats too. And as everyone has stated, hydrate, hydrate, hydrate. Plus exercise also helps get the bowels moving. I actually massage my cats tummy daily too. As he's standing I almost lift him off the ground as I run my hands under him to try to stimulate his intestines. He seems to enjoy it.

Since you already said your cat eats both dry and wet food, perhaps you could add extra water to that wet food. I try to mix in at least 1 tablespoon of filtered water to each meal of already wet food. And I avoid feeding dry food to my boy who has this issue.

 

[Furballsmom]

Two of my kidney cats were on Miralax twice daily for two years AFTER being diagnosed with kidney disease. Our Vet didn't see any reason not to use it

That's good to hear

 

[maggie101]

Second opinion for sure! If there is ever a time what you have tried doesn't work take her to a vet,even a specialist. I am taking my female cat to the vet because she is also doing small pieces of diarrhea. Optagest is not working. Last time he did a radiograph that showed slightly more stool than normal in her colon and gave her a steroid shot. Also had imaging done that showed no blockages but possible pancreatitis or ibd.

.

 

[Rudie999]

What it sounds like is that she is too dehydrated so the laxitives and fibre is making the constipation worse, or at least not helping it.

Fibre helps constipation if the problem causing constipation is lack of fibre. Otherwise, it can increase constipation.

What can help with chronic constipation is a switch to wet food. You can add a bit of extra water to it (as much as she will tolerate). If not affordable, you can see if she will eat the dry food rehydrated. (Basically, any dry food uses the water the cat already had in them to rehydrate itself before digestion, which can increase dehydration).

There are some "over the counter" wet foods for urinary issues now. Those might be suitable alongside her other wet food.

As they get older, it's hard to stay hydrated.

Our vet has Nobel on Restorilax for the same issue. It's going very well. Our friends' vet has their cat on 1/4 tsp of pumpkin every other day for the same purpose. These are "wet" contsitpation options: things that come with their own water when given properly so they don't dehydrate your cat further, or lower the risk of such.
in any case a second opinion might be good as it sounds like the current laxative regime is not solving the problem. The VCA says the laxatives should begin working within 2 days.

Thank you so much this is very helpful

 

[Rudie999]

It sounds like your kitty is chronically dehydrated and that not enough water is getting into her colon to move the stools out. When she's been to the vet for these issues, did they give her subcutaneous fluids? That usually helps the kitties a lot. Does your cat have any conditions that kidney disease? A blood test for kidney values is a good idea. If your kitty is eating wet food, try to add some water to that. If she isn't eating wet food, try to introduce her to it. As a daily supplement, Miralax (start with 1/8 to 1/4 tsp once a day) is really useful for drawing water into the colon. It's even more effective if the kitty isn't dehydrated. But don't use more than one laxative at a time with your cat and really try to get more water (or tuna juice or whatever liquids she likes to eat) into her. Good luck.

Thank you. the vet never mentioned subcutaneous fluids! They just keep giving me lactulose and laxatone and having me add powder fibre to her water. I'll talk to them about miralax! All of these are great ideas. When we did her bloodwork a few months ago she had slightly high creatine levels but they weren't overly concerned just keeping an eye on it. Thank you

 

[Alldara]

Thank you. the vet never mentioned subcutaneous fluids! They just keep giving me lactulose and laxatone and having me add powder fibre to her water. I'll talk to them about miralax! All of these are great ideas. When we did her bloodwork a few months ago she had slightly high creatine levels but they weren't overly concerned just keeping an eye on it. Thank you

High Creatine can be a side effect of the lactulose. You may want to consider ceasing using it. Lactulose

I recommend always checking medication and diagnosis on the VCA website to see potential side effects and things to watch out for

 

[Furballsmom]

In the incredible amount of information that is on felinecrf .org, I didn't initially think to check to see if there's anything about feline constipation.

Well, of course there is info on felinecrf, and it completely supports mrsgreenjeens comments above (here is a snippet); --Peg3350 is what Miralax is.

"Both PEG3350 and lactulose (see below) are osmotic laxatives, but unlike lactulose, PEG3350 retains water in the colon rather than pulling it into the colon from the rest of the body. The US National Library of Medicine explains more about how it works."

And here's the page.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Constipation

Here's the TCS article as well
Everything You Need To Know About Constipation In Cats – TheCatSite Articles

 

[Chrissy66]

When my boy had constipation really bad, little did we know that feeding him dry food was the worst that you can do. I would recommend 1 of 3 things. Raw of course is the best for them, Gently Cooking their food, and Canned Food Diet Only. When we put Peanut on a Canned Food Only Diet, and Mirralax it cleared up his constipation. Constipation is always a sign of them not getting enough water.

 

[Alldara]

In the incredible amount of information that is on felinecrf .org, I didn't initially think to check to see if there's anything about feline constipation.

Well, of course there is info on felinecrf, and it completely supports mrsgreenjeens comments above (here is a snippet); --Peg3350 is what Miralax is.

"Both PEG3350 and lactulose (see below) are osmotic laxatives, but unlike lactulose, PEG3350 retains water in the colon rather than pulling it into the colon from the rest of the body. The US National Library of Medicine explains more about how it works."

And here's the page.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Constipation

Here's the TCS article as well
Everything You Need To Know About Constipation In Cats – TheCatSite Articles

Wow! That's some awesome research. Thanks for sharing.