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Continuing Problems With Constipated Kitteh - Are We Medicating Him Improperly?

Discussion in 'Cat Health' started by crazycatlass, Apr 27, 2019.

  1. crazycatlass

    crazycatlass Thread Starter Professional Cat Furniture Young Cat

    24
    57
    Feb 29, 2016
    Midwest United States
    So, long story short, we've been having problems with our younger cat Skidd for a good while now. (several previous posts on it, in fact.) Skidd will be fine for a while then get constipated, blocked up, and end up 'losing it' at the worst possible time. It's incredibly painful for him and sometimes causes him to vomit.

    The little house-goblin in question, sporting his super-cute 'bomber vest.' (He gets skittish and jumpy on occasion and it works like a Thunder Jacket for him. Also keeps him warm and comfy when it's cold.)
    Buttoning up his overcoat.JPG
    Recent changes: we mentioned the routine constipation to the vet yet again, he finally checked the boy out, and it turned out he was packed solid despite our best attempts at clearing him out...and despite several successful box-deposits. An enema, manual evacuation, TWO all-day vet trips, and an incredibly angry kitty later, Doc put Skidd on Lactulose...and didn't tell us anything about how to dose him besides "mix .5 to 2 mls with canned food. You'll figure out the dose with trial and error." He wouldn't explain any further because he intentionally put off letting us pick Skidd up until the office was closing. SERIOUSLY. This guy has a tendency to not give us the whole story on things AND be vague/misleading which is precisely why were were seeing a DIFFERENT vet at that clinic...but apparently our vet left the clinic and we were reverted to his caseload.

    This vet is hard to understand (not on account of any language barrier, either) and, given our previous experiences with him, he's even harder to trust. We're paying a little less for our two cats because we're on the clinic's wellness plan, so this doc tries to milk us for whatever extras he can think of. Before the plan, he didn't give a hoot that Goldie was overweight and Skidd had a nasty case of recurring stomach trouble; after the plan, even a little bit of dark wax in Goldie's ears threw him into a tizzy. The slightest sign of anything even remotely abnormal and he puts on as if it's going to kill our cats. "I don't know how to say this...but...it looks like Goldie has... *rattly steadying sigh* ...ear mites. Now, don't panic, it's treatable if we catch it quickly enough but we have to start treatment now or--" ...you get the picture. A while back, he tried to put her on antidepressants because she doesn't get much exercise. She doesn't get exercise because she's a lazy eleven year-old sixteen pound indoor-only lump of lard. (...and very much loved.) As for Skidd, he's been going nuts trying to make as much money off of us as possible in hopes of 'treating Skidd's potty problem' and saying "We really need to refer you to a specialist at one of our branches - the price is a little intimidating but they may be able to help and if we increase the payment tier of your wellness plan again..." (note, by FIVE TIERS up to 'we feed our baby from a gold-plated bowl) "it'll take off X% of the price--" ...etc.
    Last time we got Skidd's teeth cleaned, the vet gave us a hand-written paper showing all the teeth he needed removed and about half a dozen were clearly marked "missing." Skidd would be left with literally no teeth in his mouth, which would mean - guess what? - we'd have to shell out over $100 a month for special prescription canned food sold by the vet. Yeah. NO. We checked Skidd's teeth for ourselves; the 'broken' teeth appear intact, we saw no signs of damage to the others, and every one of those "missing" teeth are still in Skidd's mouth, right in plain view, right up front. Confronted the vet about it; "I don't know what you're talking about. My assistant filled that out." ...in the vet's handwriting...the same handwriting he signs our prescriptions and paperwork with. I absolutely do NOT trust this vet any further than Skidd could throw him, but we don't really have a better option at this point.

    So. Back to medicating the munchkin. We've called the office several times and asked for clarification but haven't gotten any answers, and the vial has even less information. (there's not even a label on the blasted thing.) THIS is our normal routine once weekly: warm 1/4 cake of canned pate in the microwave for 30 seconds, add 1 ml of medicine, and about 1-2 tablespoons of water to render the texture similar to soupy vomit. If he's been showing warning signs (again, agitation, discomfort with being held or petted, crying, straining in the box and whining, walking like a cowboy after a week of driving herds, etc) I increase the dose to 1.5 mls and add a bit more water. If after a day or so he's not improved, second dose, same method and mix. If the weekly dose rolls around and he's been defecating just fine, I drop the medicine dose to .5 mls or give him a full half-cake of pate and just keep an eye on him. I'm highly reluctant to give him an entire 2 mls at once no matter how bad it gets - the one time I resorted to that, he wound up lying limp on the bathroom floor messing himself and wailing in pain for over an HOUR, too tired and sore to do anything but stare at me as if asking me "WHY?" He was so miserable and there was nothing I could do except keep him comfortable, rub his side and scratch his cheeks, clean up as necessary, and offer support and love. I couldn't stand seeing him hurting like that...it was enough to make me cry. This happened after midnight and our emergency/after-hours vet recently closed up shop; the closest one is now well on the other side of the state line, over an hour away. The next day he was sluggish and visibly sore...I hated seeing him so miserable.

    Anyway, I ramble, sorry. What we're doing clearly isn't working for him, and our vet won't answer us without trying to sell us a hundred more things we absolutely can't afford and which might not even work. Just Thursday afternoon I gave Skidd a whole 1.5 mls in his food because he was clearly blocked, then about an hour or so ago (Saturday around Midnight) he started howling, vomiting, and squatting on the office floor...still just as blocked up. I dosed him a second time - 1 mls with extra water - and he managed to pass something. He's a little more comfortable now, flopped bonelessly on his desk pillow and whistle-snoring.
    Someone told us that giving Lactulose to a cat with a present stool blockage can end up hurting them (I'm not going to repeat the explanation as it was highly graphic and full of intentionally gross descriptors) but the idea was it could increase bowl pressure with looser materials then rupture his colon) but I'm not entirely sure whether that's true or a myth.

    For anyone else whose cats are on Lactulose, what dosing instructions were you given?
    Are we supposed to be dosing him daily? Weekly? Do we just watch him, see if he starts getting agitated and cranky (warning signs of constipation for him) then dose him for a couple days to clear it up? We've got to figure out something to keep this little guy regular. He's clearly suffering - when he's blocked up he gets agitated and aggressive but every time he's finally "empty" he's the sweetest, clingiest, most purr-happy cuddle-bug you've ever met. This Mama just can't stand watching her furbaby suffer anymore...
     

  2. carolcatone

    carolcatone TCS Member Kitten

    6
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    Apr 23, 2019
    Omg u are going thru hell and it seems the vet is not much help? We had a 16yr old cat that I gave real can pumpkin about 1 teaspoon a day not the ones with sugar in and we had to give him water infusions from an IV bag into the back of his shoulder area. It worked like a charm but of course his constipation was due to his age and kidney failure. We did that up until his congestive heart condition got past treatment anymore. The entire time we did it he was able to have normal bm's. I did all this with help from vet, I feel the vets u saw were horrible. Being backed up is extremely uncomfortable as well as dangerous.
     
    crazycatlass purraised this.

  3. carolcatone

    carolcatone TCS Member Kitten

    6
    3
    Apr 23, 2019
    Of course as I assume u know that I would never suggest u try anything without a vet's ok. I forgot to say that at my last post response. Good luck.
     
    crazycatlass purraised this.

  4. di and bob

    di and bob TCS Member Top Cat

    9,170
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    Dec 12, 2012
    Nebraska, USA
    I would definitely try the pumpkin mixed in his food DAILY, he definitely needs more fiber in his diet. Try to increase his water intake too, set little water bowls around the house for him to find, they can't resist looking and often drink. Or get a fountain, the noise attracts them. Get Miralax and dose him with that after checking with the vet, I started with 1/4 teadpoon mixed in a beaten egg yolk and increased it to 1/2 teaspoon. This can be given daily. It draws in the water from the body and makes the stool softer, so he must be well hydrated. He shouldn't be straining that hard, that poor sweet boy! But he sounds just like the senior humans we took care of, and most of their's was caused by inactivity, so playing with him with a wand or any kind of running play would help too, all the luck!
     
    crazycatlass purraised this.

  5. crazycatlass

    crazycatlass Thread Starter Professional Cat Furniture Young Cat

    24
    57
    Feb 29, 2016
    Midwest United States
    First off, thanks carolcatone and di and bob for offering your advice here!

    Carolcatone, I wouldn't say we're going through Hell, per se - more like the a-bit-warmer-and-muggier-than-comfortable hike down TO Hell. :think: Skidd IS doing a bit better on the Lactulose but it's not working completely, whether because it isn't lasting long enough or because we're not dosing him properly. If I was panicking, I'd definitely drag him out to the vet clinic and demand to see one of the other vets for a second opinion. He's ordinarily a happy, clingy, lovable cat; he just gets blocked up easily and we're fighting it. As tired as I am (been up making sure he's still doing well and he is) I didn't realize that post might come across as panicky...?

    I'm incredibly sorry to hear you lost your furbaby. You clearly did everything you could for him, and it's obvious he was very much loved. I know he appreciated you and appreciated how well you cared for him. Cats always know these things.

    Regarding pumpkin, that was actually one of the things we tried before. We'd mix about a tablespoon or so of pumpkin (regular canned, no additives, spices, sugar, etc) in with a full can of wet food (Generally turkey) and split it between the two cats. The extra fiber from the pumpkin kept Goldie from diving up to her ears in the food bowl as frequently, and we THOUGHT it was helping Skidd. Key word there: THOUGHT. It turns out either it was making his constipation worse, or it was getting worse on its own and the pumpkin wasn't helping matters any. We were sure the pumpkin was helping and mentioned it when he went in for his comprehensive. Tech came out and asked "How long has it been since he had a bowel movement?" He'd gone the night before so we figured he was fine, but he was packed solid despite it. About gave me a heart attack. THAT was going through Hell because being that blocked up CAN kill cats...hence the two visits, 'squish-out,' and enema. We were told to discontinue the pumpkin for him, and actually warned against adding more fiber to his diet. :ruminating: I can't quite decide whether that vet is intentionally making Skidd worse so we'll pay him more to fix it, or whether he's actually got Skidd's best interests at heart for once, or whether he's just a bleedin' idiot. Normally I'm not the sort to be so critical OR unkind about someone but this vet...yeah, he tried convincing us Skidd was going to die because he had a patch of ringworm on his paw, then spent weeks treating it with everything that WOULDN'T work until we had no choice but to sign up for the plan just to pay the bill. By that point the poor baby was nearly bald and had infected lesions all over his paws and neck from the spread fungus and scratching at it...THEN doc said "He's probably got an immune disorder, we need to refer him to our main branch hospital and see about getting tests done to see why he won't heal and--" Doc, he couldn't kick that fungal infection because you dosed him with antibiotics, you money-grubbing walrus.

    Ahem. Anyway.
    Since the enema, Skidd's been getting the Lactulose at least once weekly and he's maybe 40-50% better. The one thing the vet HAS made sense about was something I apparently forgot to mention in my first post. (sorry, again, tired) Skidd's innards and digestive system appear to be functioning properly - at least from what can be seen without more invasive (and EXPENSIVE) testing. He seems to just have a bit of a nerve defect in his colon or rectum. He's eating, drinking, and digesting properly and he should be EXPELLING properly, but for whatever reason his disposal isn't functioning properly. Considering our other cat has a mild birth defect we didn't find out until she was about eight (a negligible alteration in the range of motion of one of her knees, only became noticeable because she started getting old and fat) this wouldn't surprise me. It might explain why he always had such RANCID gas as a kitten no matter what we did. :barfgreen:

    Actually, my family lost a cat to a sudden and MASSIVE case of Struvites when I was a child so I'm always extra vigilant about my furbabies water-intake. I may actually get a little obsessive about it... :sweat: It's worth it, though, if it means not going through what happened to Percy. Someone wants to drink out of the faucet? Go for it. They went snorkling in my water glass? Whatever, it's theirs now, I'll get another. Fancy filtered water fountain? We're on our third now, we always keep it well-stocked and clean, and when it's stupid-hot outside we even toss in a couple cubes of ice to help them keep cool. We keep a regular glass bowl of fresh water in the bedroom in case someone gets locked in there, or if Goldie's too lazy to walk to the kitchen for a drink. On top of that, we mix water in with their canned food as mentioned and after Goldie's had her 2ml dose of Meloxicam, she gets a syringeful of plain water from it just in case because we were warned it might dehydrate her. So far they're good - these two probably slosh when they roll over. :lol:

    I've heard about trying Miralax - I'll have to take that up with the non-money-grubbing vet later. As nasty as his gas can be, though, I think we'd better avoid giving him eggs. :noway: That might be even worse than the few times he found a piece of fresh broccoli and munched on it...and THAT cleared the apartment for a good HOUR. If he needs a daily dose of anything, we can always just keep mixing it with water and pate; he readily takes it like that unless, like last night, he's too uncomfortable to even think of food.

    Yeah, we make sure he gets some running around, climbing, jumping, and whatnot done every day but he can be a bit of a loafer at times. He is an indoor-only cat living in an apartment. He's always much more reluctant to get up and about when he's already uncomfortable in the gullet which surely doesn't help matters any. When this all started up, he was significantly overweight - he was maybe 14 pounds and his sister was over 16 - and we started putting everything we could into paring them down. Well, Goldie's still a moose but Skidd's down to about 11 pounds and you can feel a hint of his ribs without digging. As hairy as he is, he still looks fat. :redtabby: We love that fluffy boy.

    One of our most recent photos of his floofiness. (Yes, it's from December. This hasn't been an easy year.)
    Buttoning up his overcoat.JPG
    Note that he has a visible waist, you can clearly see where the haunches end and the back begins, and you can see the floof around his cheeks and neck popping up like a mane. Our last vet (the one who left the practice) said if we could get him down even half a pound more, he'd be at an ideal weight. THIS vet says "he's still over by two pounds" - he probably wants to play xylophone on Skidd's ribs so he can charge us for weight-improvement prescription food.

    Now, an even more recent photo of his moo-cow sister begging for treats she didn't need OR get.
    IMG_4915.JPG
    Now consider that she's about 1.25 egg cartons' length in the body - sans tail and stretched out legs - and her belly fat spreads out even more when she's lying on it. She's somewhere between Dachshund and Basset Hound in size, mostly blubber. This cat is HUGE and she's nearly given me a hernia before. We haven't yet been able to keep the weight off her for long...but boy is she a happy camper and loved to bits.​

    Lastly, just a quick update: He's been fine since his little floor-mining episode and dose last night. He's not clingy yet so he's probably still a bit uncomfortable, but he's not visibly upset. He's actually curled up in a ball on his pillow by my desk, whistle-snoring and presumably dreaming about beating up his sister. I'm not worried about him at this point; I just want to try and keep this from happening, if at all possible.
    Carolecatone, di and bob, thanks for your advice, you two! Not quite what I was looking for, but I appreciate it anyway! Good luck and well-wishes for your furbabies!
     
    maggiedemi purraised this.

  6. lisahe

    lisahe TCS Member Top Cat

    4,000
    2,349
    Mar 23, 2014
    Maine
    Just a quick question about Skidd's diet: what foods are you feeding him? I ask because any foods with bone (which can be a component of byproducts) could be contributing to his constipation. We have seen this with one of our cats.

    Also... motility declines with age, increasing the risk of constipation. Egg yolks are thought to be helpful in supporting motility -- we use it in our cats' food. (Our cats also have tricky digestive systems and can get gas from odd things, like potato!... but egg is not a problem.) We also give our slightly constipated cat small amounts of pumpkin, which seems to keep her under control. If overdosed, pumpkin can have the opposite effect -- it is used to stop diarrhea, too. Another site member has also reminded me that fat can be helpful in combatting constipation; I do not trim fat when I prepare meat for homemade food. Our big challenge, though, is to cut back on the bone in the cats' diet. It's a common ingredient in freeze-fried raw foods, which are a big part of what we feed and which they love.
     

  7. Burts

    Burts TCS Member Adult Cat

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    Apr 26, 2017
    Walls of texts

    I remedied Olivers Constipation by giving him Iams Hairball Kibble that has 8.5% fiber, I mix it with healthy digestion.. Since doing that I stopped Lactulose and he poops every early morning..

    The underlying problem is what needs to be addressed, indoor cats get no fiber..Indoor kibble all has significant amount of more fiber for good reason
     

  8. di and bob

    di and bob TCS Member Top Cat

    9,170
    8,794
    Dec 12, 2012
    Nebraska, USA
    I just wanted to add, Miralax is tasteless and can be mixed with anything, and that when my senior was severely constipated it was the ONLY thing that worked. Many people on this site have used it with their pets. Unlike Latalose, Miralax does not cause gas or cramping, and it is bought in any store. It is THE one most often given in senior nursing homes too, because it has the least side affects/
     

  9. carolcatone

    carolcatone TCS Member Kitten

    6
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    Apr 23, 2019
    You have really dedicated a lot to trying to figure out what works. I see lots of great suggestions but u have tried many things and u said the vet thought it was a defect in Skidd. U did say he is better so u have gotten results, it seems like u are hitting on some right moves. His picture looks good. The way the vet seems to be talking is that the stool itself is good but the problem is in his body's ability to move it out. I have used Miralax also in our 16 yr old at times, it all worked. As u said u will talk with vet on that, wonder why he did not suggest it? As for your heavy cat well I have a male cat that is 21 lbs and he is a big strong cat, need to get his weight down and will again try DM food in little doses along with regular Fancy Feast foods but for now I had stopped all changes in foods until their stools are normal and currently they are now back to normal but will give it a week. Hope u get results with Miralax. Good luck.
     

  10. carolcatone

    carolcatone TCS Member Kitten

    6
    3
    Apr 23, 2019
    Small after thought did the vet ever suggest cat FortiFlora probiotic? Ours did when cats first experienced loose stools 2 months ago. It will not stop loose stools but does help balance good bacteria in body. I keep them on it, it takes at least a week or more to see results and it works on the same idea as human probiotics. I myself started on a pobiotic in April and was not a believer but I got a big surprise it did wonders for me. The FortiFlora is ok even if your cat has no problems going to bathroom, or only bouts of bm problems. As I said as of today they both are having normal bm's. The last time the female had a small hair ball spit up which always results in a small pudding stool after, she recoved faster back to normal bm's, I am thinking it was due to probiotic in her system. Altho I do realize your problem is different maybe u can ask vet on a probiotic, as it all hinders on digestive area and bowel area issues.
     

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