Cat with megacolon and some behavioral issues. Advice?

[otto]

Originally Posted by Denali

Your cats megacolon may not have been as progressed as some cats as well. The reason I say that is many megacolon cats stools seem to get harder then regular cats stools. This is where the extra water can really help soften the stool. But megacolon cats tend to lose the use of the muscles in the colon which push the stool out. My personal experience is I don't think water alone can remedy this. In many cases a motility drug is required to help contract the colon muscles to push the stools out. I know when I was giving my cat Miralax only (no motility drug yet) the stools would become soft but she could not get them out and she would block. The vet would say the stool is really soft when he would give her an enema. But once she was put on a regimen of Cisapride (motility drug) and Miralax she was able to push the soft stool out.

.......

 

[denali]

Oh my gosh, I didn't know it could come in flavored pills. Do you get it from an online pharmacy? If so, do you have the name? That would be so wonderful. Even more so if it's less expensive

.


I live in Canada so I am not familiar with the online pharmacies in the US. My vet gets the flavoured chews from a compounding pharmacy in a different province because they are cheaper and tastier then the local compounding pharmacies chews where I live.

Online compounding pharmacies are always a topic on the Feline Megacolon group I gave a link to you. Some of the online pharmacies they use are:

Diamonback http://www.diamondbackdrugs.com/

Wedgewood Pharmacy http://www.wedgewoodpharmacy.com/

Roadrunner http://www.roadrunnerpharmacy.com/

http://www.bcpvetpharm.com/

 

[denali]

Sorry for the fourth post in a row, but I just wanted to thank all three of you again for your replies. I'm very glad I posted here, and hopefully Thomas will be, too.

I'm going to feed him three times a day and I have a list of things to talk to my vet about.

Your welcome

At first this condition can be very scary. That is why I was so thankful to have found the Feline Megacolon group on Yahoo. Everyone on there is experiencing the same condition with their cat. They helped me through the first few scary months with my cat when she was diagnosed with megacolon.

My personal opinion is discontinue the Ducosate and just give the Cisapride and Miralax. Miralax is relatively safe without many side effects. As Otto said the "Ducosate sodium can decrease levels of magnesium and potassium in the blood. It can also cause cramping and gas pain, so he may be in some discomfort". You can increase the Miralax to 2 x's a day instead. This way you don't have to give another pill.

Also, if he is still hungry after 3x's a day ~ then try 4x's a day....try to stick to a schedule if you can or atleast as close as you can (example: when you wake up, just before you leave for work, when you get home from work, before you go to bed). If you work long shifts (like 12 hours) could you freeze portions of canned food and put it down as you are running out the door? This will unthaw at some point throughout the day for the cat to eat as well.

 

[begemot]

Thanks for the responses, everyone. Sorry I've been AWOL for a while, but I did make some changes.

1. He's eating three meals a day instead of two. He is meowing less, but I'm a little worried about weight gain. I know I should just give him less food, but with smaller portions he harasses me for ages after eating, begging for more. Does anyone know whether weight gain could make his megacolon worse? If that's not an issue I won't worry about it.

2. He got bloodwork on Tuesday and I got the results on Thursday. Everything was normal! No other health issues at this point.

3.I brought up nutrient absorption problems, but the vet said that, unless the bloodwork revealed a problem, he thinks Thomas is getting what he needs.

4. The vet prescribed amitriptyline for anxiety and pain. I haven't started giving it yet because I need to buy a pill cutter. He said it could make him lethargic, so I'm not totally sure what to expect. He also suggested a half of a low-dose aspirin every other day, but I'm going to hold off on that and try just the amitriptyline first. (Actually, I'm still a little bit undecided about this; I keep wondering whether maybe I should try the aspirin first, and hold off on the amitriptyline.)

5.I brought up pepcid AC, but the vet said that it could actually work against the other medicines and make his constipation worse. He said that anything that would help with gastrointestinal discomfort would also worsen the constipation.

6. I've decided to do a trial period of increasing the miralax and eliminating the ducosate sodium. I'll let you guys know how it goes! It's too soon to tell yet. (Thanks for the advice, Denali.) I'm hoping that this will decrease his discomfort without causing his stools to get too hard.

7. I joined the yahoo megacolon group, so now I can read up on different approaches and learn more about it. Thanks for the link!

8. I'm giving the cisapride 15 minutes before food, instead of immediately before.

9. I'm marking his poops on the calendar with little stars so that I can make adjustments when he goes longer than three days without pooping.

Thanks also for the pharmacies and all the other suggestions. I can't leave frozen food out because I have three who all roam free, but it's a very clever idea.

 

[denali]

1. He's eating three meals a day instead of two. He is meowing less, but I'm a little worried about weight gain. I know I should just give him less food, but with smaller portions he harasses me for ages after eating, begging for more.

What food are you feeding? And how much? Rule of thumb is a cat should be getting 20-30 calories per lb of ideal body weight ~ ie. If your cats ideal body weight is 10lbs then he should be getting 200-300 calories a day. (closer to 200 calories for a non-active cat and closer to 300 for a very active cat). So, what you have to do is find out the calorie count in the food you are feeding your kitty and figure it out from there. I can help you figure this out if you want

Who knows? You may be under feeding and this is why your cat is always so hungry.....

2. He got bloodwork on Tuesday and I got the results on Thursday. Everything was normal! No other health issues at this point.
4. The vet prescribed amitriptyline for anxiety and pain. I haven't started giving it yet because I need to buy a pill cutter. He said it could make him lethargic, so I'm not totally sure what to expect. He also suggested a half of a low-dose aspirin every other day, but I'm going to hold off on that and try just the amitriptyline first. (Actually, I'm still a little bit undecided about this; I keep wondering whether maybe I should try the aspirin first, and hold off on the amitriptyline.)

I am happy to hear the blood work is normal

But I have to ask ~ why with the Amitriptyline? Is the vet 100% sure that your cat is experiencing pain and anxiety...or is it just a hungry cat? My personal opinion is do not give this right now. You don't even know if he is feeling pain or anxiety. Plus there are way more natural remedies for pain and anxiety then this type of harsh drug. Try the other suggestions first and see if this makes a difference. Why give something as harsh as Amitriptyline if it isn't even required, right? Side effects of Amitriptyline http://www.marvistavet.com/html/body_amitriptyline.html

http://www.ehow.com/list_6653680_sid...line-cats.html

5.I brought up pepcid AC, but the vet said that it could actually work against the other medicines and make his constipation worse. He said that anything that would help with gastrointestinal discomfort would also worsen the constipation.

Amitriptyline can also cause constipation

6. I've decided to do a trial period of increasing the miralax and eliminating the ducosate sodium. I'll let you guys know how it goes! It's too soon to tell yet. (Thanks for the advice, Denali.) I'm hoping that this will decrease his discomfort without causing his stools to get too hard.

Please keep us updated on his progress with this.

7. I joined the yahoo megacolon group, so now I can read up on different approaches and learn more about it. Thanks for the link!

Yay!

You'll get alot of useful tips there

9. I'm marking his poops on the calendar with little stars so that I can make adjustments when he goes longer than three days without pooping.

Also keep track of the consistancy, shape and size (length, diameter) of the poops. This will help out alot!

I would also suggest you join the "WHOLECATHEALTH" group I suggested earlier. They will definately be able to help you with more natural options for your kitty then the Amitryptiline.

 

[begemot]

Otto also sent me a pm about the amitriptyline causing constipation. That's out, then. My vet wasn't sure about him being anxious at all, or in pain. I kept just trying to describe how he acted, and how I thought discomfort might be the cause. And how he's so disinterested in everything except sleep and food. I think he may have suggested it because there weren't any other options that he could think of, and he wanted to give me something. I can't believe he would make this mistake! Constipation is a common side-effect of a lot of drugs, so if he was at all unsure he should have looked it up first.

I hope that stopping the ducosate sodium helps. I'll have to consider the aspirin. Because there's no way for him to tell me that he's in pain, I think it might be worth a shot. If he starts to seem a lot happier then I will know that pain was an issue. If not, I'll stop giving it to him. Does anyone think aspirin is a bad idea?

I don't think I'm underfeeding. He is very inactive, and not thin. I think he's a healthy weight right now, though he has been a little heavier in the past.

Also, I have tried feliway in the past, without seeing any changes in my cats. (I tried using it before and after a stressful move, and then I kept using it for a while because I thought it might help Thomas.)

 

[denali]

Otto also sent me a pm about the amitriptyline causing constipation. That's out, then.

Thanks for letting her know this as well Otto. I am glad to hear this is not an option now!

My vet wasn't sure about him being anxious at all, or in pain. I kept just trying to describe how he acted, and how I thought discomfort might be the cause. And how he's so disinterested in everything except sleep and food. I think he may have suggested it because there weren't any other options that he could think of

,

No other options from a conventional perspective maybe ~ which is very limited. But there are more natural options forsure.

I don't think I'm underfeeding. He is very inactive, and not thin. I think he's a healthy weight right now, though he has been a little heavier in the past.

How much of what are you feeding?

Also, I have tried feliway in the past, without seeing any changes in my cats. (I tried using it before and after a stressful move, and then I kept using it for a while because I thought it might help Thomas.)

How many of them did you have plugged in? Sometimes the more the better. Did you combine the feliway with something like the Pet Bach Rescue Remedy or Australian Flower Emergency Essences? My experience with Feliway is not as positive a one as my sisters was with her cat that sprayed. But she combined the feliway plugins with the Rescue Remedy and a flower essence combo for feline spraying. It helped tremndously for her cat.

 

[mrsgreenjeens]

I've just been reading this with great interest. Can't wait to see the results with the changes you are making! My Sven doesn't have megacolon, but he does have chronic constipation, and Miralax is a Godsend! It works differently than anything else, and I suspect that putting Thomas on it twice a day will be very helpful in keeping his stools soft, even without the Ducosate.

What I'm surprised about is the recommendation for low-dose Aspirin. I always though Aspirin was toxic to cats (and dogs). Guess I'll have to google that now

 

[begemot]

Originally Posted by Denali

How much of what are you feeding?

I feed the large cans of wellness (all the flavors), chicken soup for the cat lover's soul kitten formula, felidae grain free, and occasionally EVO (he doesn't like it but the price and ingredients are good, so I still buy it sometimes). There are a lot of foods that I would like to buy for him but can't because of cost or because he's rejected them in the past. Buying canned can get alarmingly expensive very quickly. With the large cans (12.5oz - 13.2oz) he eats about one can in a day and a half. With the small cans (just the chicken soup) he eats about one and half cans per day. Despite his frequent begging, often he doesn't eat a lot in one sitting. I can't leave it out for him because of the other cats. Also keep in mind that this is an very inactive cat.

How many of them did you have plugged in? Sometimes the more the better. Did you combine the feliway with something like the Pet Bach Rescue Remedy or Australian Flower Emergency Essences? My experience with Feliway is not as positive a one as my sisters was with her cat that sprayed. But she combined the feliway plugins with the Rescue Remedy and a flower essence combo for feline spraying. It helped tremndously for her cat.

Just one, but my apartment is quite small. I have considered Bach's Rescue Remedy, and may buy it in the future. The truth is, I'm on the fence between "traditional medicine" and natural approaches. I think that it pays to be skeptical with both. I don't think either is regulated enough, particularly in products aimed at pets. For this reason, I only give the cats fish oil that's for people, not the pet brands, which I think could easily get away with having dangerously high levels of mercury and other contaminants. I've also read about human supplements having hugely varied amounts of the substances they say they contain. If St. John's Wort for people is subject to these problems, how can I possibly trust something marketed for pets, where the regulations are so much laxer?

There's also so much misinformation about natural remedies, and so few sources that I feel I can trust. I majored in psychology in college, where we studied experiment design, and I know how powerful (and effective!) placebos can be. I have yet to read of a well-designed study demonstrating the efficacy of Rescue Remedy or Feliway, which makes me suspicious. Why haven't they funded studies?

Anyway, I don't mean to be too cynical, and I hope the above paragraphs don't offend anyone who really likes these remedies.

Originally Posted by mrsgreenjeens

I've just been reading this with great interest. Can't wait to see the results with the changes you are making! My Sven doesn't have megacolon, but he does have chronic constipation, and Miralax is a Godsend! It works differently than anything else, and I suspect that putting Thomas on it twice a day will be very helpful in keeping his stools soft, even without the Ducosate.

What I'm surprised about is the recommendation for low-dose Aspirin. I always though Aspirin was toxic to cats (and dogs). Guess I'll have to google that now

I am really hopeful that the additional miralax can pick up the slack as I remove the ducosate sodium, and hopefully leave him more comfortable. Chronic constipation is such a balancing act! If you find out anything really important about aspirin, please do post. He said to give him half of a low-dose (81mg, I think?) aspirin every other day.

 

[mrsgreenjeens]

OK, Aspirin CAN be toxic to cats, if overdone. But as long as you follow your Vet's instructions, you should be alright.

 

[joyceann69]

how much cisipride and miralax do you give your megacolon cat each day?  my cat is 12 and is very constipated right now.  she has been on lactulose, and cisipride.  it is not helping much anymore.  any other ideas would be appreciated.

 

[otto]

how much cisipride and miralax do you give your megacolon cat each day?  my cat is 12 and is very constipated right now.  she has been on lactulose, and cisipride.  it is not helping much anymore.  any other ideas would be appreciated.

My Ootay by the time she left me, was on the maximum dose of cisapride for her weight, 7.5 mg a day. When she first started on it, she was taking 2.5 mg a day. The dose had to continually be increased over the years. She was also taking 2 ml of mineral oil, twice a day. That also had been gradually increased over the years. Even then, she was still having trouble and my vet had taught me how to give her enemas at home. Awful thing to have to do.

If she had been younger and healthy when it was first diagnosed I would have had the surgery for her, but by the time she was properly diagnosed, she had kidney disease and her little body was not strong enough to withstand such an invasive surgery. (the first vet messed around for so long, by the time she was diagnosed by a better vet, it was too late)

I didn't know about miralax in those days (nor did my vet), and lactulose was a nightmare. I would never recommend lactulose for a cat with megacolon.

When was your cat's last bowel movement? If it's been more than 2 or 3 days, I would get her in to see the vet first thing tomorrow.

Welcome to TCS and please let us know how your little girl is doing.