Help me figure out a solution to my cat's constipation

Laroo

TCS Member
Thread starter
Young Cat
Joined
Jun 19, 2021
Messages
27
Purraise
21
Hi, my 13 year old cat was diagnosed with stage 3 kidney disease about 6 weeks ago. Since then (almost immediately it seems) we have been plagued with this terrible constipation that I can't seem to find a sustainable solution for. And I have Googled and checked tons of websites, articles, forums where people have posted web links and articles (including this forum) you name it and I have probably seen it. Unfortunately most of them have had repetitive information. Some things I have tried to help my cat with this constipation:
Wet food and treats only. I put out dry food just to have it there but she doesn't really do anything with it.
Pumpkin. She won't eat it, doesn't care for the taste. I have tried unsweetened canned and baby food. I have given it straight in a bowl and mixed it with food. Psyllium husk: I am currently trying this, she's been taking it for about 4 days and I have not seen any specific results.
Miralax: The magical remedy. She can't tolerate it, it gives her horrific stomach pain worse, even after several days it still does not produce any poo. I've tried starting with really small amounts and it doesn't make a difference. Still results in horrific stomach pain and I am not willing to try this again.
Cisapride: She has been taking .5 mL twice a day for three days, no poo
Lactulose: She has been taking .5 mL twice a for 2 days and then I bumped it up to 1 mg today because no poo
Enemas: She has had 3 in the last 6 weeks. This last one was on Wednesday and she bit the vet tech and is now on in-home quarantine lockdown per animal control for another week or so.
SQ fluids: She gets 100mL every night, sometimes 125-150. Her vet said don't give 125-150 every night, 100mL is the cut off for a 10 lb cat.
She got an enema on Wednesday like I said, she hadn't pooped for 4-5 days before that. The vet said she had very hard stool blocking the exit so the rest couldn't get out. That happened in 4-5 days, even with SQ fluids every night, even with wet food all day, a water fountain and a bowl of water out. She likes both. She eats a lot like 6-8 oz of food a day, and has mirtazipine every three days to help. She last pooped on Thursday and Friday but none today despite the laxatives and I am worried because apparently the stool dries up quickly in her, her vet wants to use gas on her next time she needs an enema (bringing total visit to $140) I really want to find an answer to this but I'm running out of money and I can't afford an enema every week. Plus, after that visit my sweet little snuggly kitty was jumpy and defensive and I really don't want to hand her over again cause it's so stressful.

I'm also thinking maybe this vet doesn't know what they're doing because my vet tech friend told me that gas is bad for kidney's and it's pretty obvious to me that they could have done more to avoid that bite. Yeah, accidents happen, but I have worked in environments that service animals and they should have used a cat muzzle, a plastic cone, or wrapped her up in a towel. Instead my cat ended up at risk of being confiscated and dissected by animal control, or being required to quarantine in their facility which owners are also charged for and god knows what would have happened to her, would she have even a smidgen of chance at surviving this ordeal.

Anyway, it's pretty hard to get a vet appointment around here these days, vets are overwhelmed with patients at the moment. I don't want to take her back to last one because I don't want to deal with the potential of her having a bad reputation there or risking them possibly being overreactive in future situations. I know that people say pets are forgiven for biting at the vet, but they actually weren't that pleased when I picked her up, and I get the feeling that the vet there is pretty much out of ideas.

So what I am looking for here (my apologies for the long post!) is any personal experiences that people may have had with a very stubborn case of constipation in a kidney disease cat. Has anyone had a cat that can't tolerate Miralax? What did you do?? I have not seen even one story using Google that said someone else's cat can't tolerate it. It's basically the magical answer. Everyone keeps saying pumpkin, how long is that supposed to take to work? I need this cat to poo NOW, like today, otherwise she is probably going to have to get an enema again and that is just not sustainable. Does anyone give their cat an enema at home? According to YouTube the "applicator" is inserted pretty far into the rectum, I'm worried that there will be a perforation if I tried that. No way. Unless there's an easier and better way? What do people feed their constipation cats? How long does it take Cisapride/Lactulose to work? I was under the impression that they were really strong laxatives, I'm stunned that the cat is not pooping. She is having extremely noxious gas pretty frequently and she is extremely nauseated today. Maybe getting used to the laxatives, but maybe because of the laxative driven expelling that is being cut off by hard stool. She is also really restless and just wants to do weird things like get into places that she was never interested in before. I'm just at a total loss here, what to do if these laxatives don't work at all??? I called a few ER vets to ask them if I could put a little olive oil in her bum with a syringe to hopefully help things slide out but they said not to and that it wouldn't have the effect I'm looking for. They said put it in her food. Is that going to help some already backed up stool? I have no idea where to go with this next.
 

SwissMiss

TCS Member
Kitten
Joined
Dec 5, 2018
Messages
16
Purraise
11
I had a cat who was constipated for the entire time I had him. After he didn't poo for several days I took him to the Animal ER. There was a long wait and I asked can I take him home and give him an enema? The vet tech said - Do you know how many people it takes to give a cat an enema? Sounded like the punch line to a joke. So I waited and the vet gave him a dose of lactulose orally which worked. For the rest of his life I gave him lactulose every day. It was a long time ago but I think I was giving him 3 ML of lactulose once every day with an oral syringe. But please check with your vet to see if that is an appropriate dose for your cat. My cat ranged from 10 to 15 pounds. I think some people split up the lactulose into 2 doses giving it twice a day. If lactulose or something you've yet to try doesn't work maybe you could learn to give your cat an enema if your cat is the calm type and maybe if you had someone to help you. You've probably read to never give your cat a human enema solution because it's toxic to them but I thought I'd mention it just in case. I'm very sorry you're having to go thru this. I too have a cat now that was diagnosed with stage 2 or 3 kidney disease in the last month. She's only 5 years old. She's another one who has always been constipated since I got her when she was 7 months old. She's been on a few different things for this but is now on the Miralax which thankfully is working for her. There's an online site I discovered in the last couple days that has EVERYTHING about kidney disease in cats called Tanya's Comprehensive Guild to Chronic Feline Kidney Disease - maybe someone on there would have suggestions about your cat's constipation. Sending warm thoughts to you and your kitty.
 
  • Thread Starter Thread Starter
  • #3

Laroo

TCS Member
Thread starter
Young Cat
Joined
Jun 19, 2021
Messages
27
Purraise
21
Hi, thank you for your response. The Lactulose I have says .5- 1mL once to twice a day. I've been giving it .5 twice a day but only just gave her 1 mL this morning. I'm going to do 1mL for her second dose here in a minute and hope for the best. I think it does make her very nauseated so I've given her some Cerenia and Pepcid, and have some Zofran on hand in case she gets super nauseated tonight. It's so stressful to watch them be sick! It sounds like Lactulose worked pretty quickly on the first cat you mentioned? I wonder why it's not working that quickly on mine. She has not eaten as much in the last few days because of the nausea so I think she couldn't be too backed up yet...
I did know that you can't use human solution for a cat enema, but thank you for mentioning it. I was planning on using warm water and a little bit of lube. Still having major doubts though, I don't think I will actually try to do it. I know how to calm her but still too risky...
 

LTS3

TCS Member
Staff Member
Forum Helper
Joined
Aug 29, 2014
Messages
15,904
Purraise
14,807
Location
USA
Were you dissolving the Miralax in water before giving it to the cat? Giving dry powder can upset a tummy and cause a cat to become even more dehdyrated which won't help the poop come out.

Not pooping but still eating normally is cause for concern. A blockage can result. What's stuck in the lower inesttines / rectum has to be mnaually removed by the vet using enemas and whatever else is needed. Surgery is a last resort.
 

suzeanna

TCS Member
Adult Cat
Joined
Mar 29, 2021
Messages
150
Purraise
225
Have you tried feeding her a little bit of olive oil mixed with her wet food? It can help.
 

Dos Gatos

TCS Member
Young Cat
Joined
May 6, 2021
Messages
31
Purraise
36
I am so sorry you are going through this. Unfortunately I don’t have much advice because it seems like you have tried most of the standard treatments. I can only offer my experience with the issue. My senior cat has dealt with constipation for years and it recently got much worse, likely due to kidney disease that is being uncovered as she is being treated for hyperthyroidism. She has had to have enemas every 1-2 weeks for the past 8 weeks, which has been very stressful. What we are currently trying and seems to be working is 1/4 tsp Miralax 2x per day, 2ml lactulose once per day, and 0.5ml cisapride 2x per day. How is your cat’s potassium? I know low potassium is common in cats with kidney disease and can cause constipation. My cat is on a supplement (Renal K+) that seems to help.
What kind of wet food is he eating? If it is high fiber, it is possible maybe he needs something lower fiber. I have found that my cat needs lower fiber because the fiber bulks up her stool too much and she can’t pass it. Also she cannot tolerate any hard food at all because it constipates her within a day of eating.
 
  • Thread Starter Thread Starter
  • #8

Laroo

TCS Member
Thread starter
Young Cat
Joined
Jun 19, 2021
Messages
27
Purraise
21
Were you dissolving the Miralax in water before giving it to the cat? Giving dry powder can upset a tummy and cause a cat to become even more dehdyrated which won't help the poop come out.

Not pooping but still eating normally is cause for concern. A blockage can result. What's stuck in the lower inesttines / rectum has to be mnaually removed by the vet using enemas and whatever else is needed. Surgery is a last resort.
I was mixing the Miralax into her wet food. She probably does have a blockage of hard stool, it's just so difficult to manage because it gets so dry so quickly and becomes a blockage. It takes a day to become too hard apparently, that's hardly any time. The vet said she passes it with an enema so I'm wondering if she will pass it on a laxative. She is just laying around today, not looking stressed but not asking for food, not drinking any water, so I doubt the SQ fluids will be even nearly enough. Does dissolving the Miralax in water first make a difference? At this point I would hate to experiment though...
 
  • Thread Starter Thread Starter
  • #9

Laroo

TCS Member
Thread starter
Young Cat
Joined
Jun 19, 2021
Messages
27
Purraise
21
Have you tried using an infant glycerin suppository? Shave a small piece to start with.
I have not, but suppositories were my next idea, thank you for bringing it up and reminding me! Definitely much more realistic than an enema and probably won't upset her stomach. I'm going pick some up today. Have you tried it? Can you share your experience?
 
  • Thread Starter Thread Starter
  • #10

Laroo

TCS Member
Thread starter
Young Cat
Joined
Jun 19, 2021
Messages
27
Purraise
21
Have you tried feeding her a little bit of olive oil mixed with her wet food? It can help.
I have not, but the ER vet I called last night to question suggested this. I had thought it was too late for this, but I'm going to do it today, no reason not to at this point either. Thank you
 

FeebysOwner

TCS Member
Top Cat
Joined
Jun 13, 2018
Messages
13,576
Purraise
18,100
Location
Central FL (Born in OH)
I have not, but suppositories were my next idea, thank you for bringing it up and reminding me! Definitely much more realistic than an enema and probably won't upset her stomach. I'm going pick some up today. Have you tried it? Can you share your experience?
I personally have not had to try it. But, I know of others who have, and it can require more than one use. But, I do think in your case, it is an addition to some of the other treatments are you doing, not a replacement.
 
  • Thread Starter Thread Starter
  • #12

Laroo

TCS Member
Thread starter
Young Cat
Joined
Jun 19, 2021
Messages
27
Purraise
21
I am so sorry you are going through this. Unfortunately I don’t have much advice because it seems like you have tried most of the standard treatments. I can only offer my experience with the issue. My senior cat has dealt with constipation for years and it recently got much worse, likely due to kidney disease that is being uncovered as she is being treated for hyperthyroidism. She has had to have enemas every 1-2 weeks for the past 8 weeks, which has been very stressful. What we are currently trying and seems to be working is 1/4 tsp Miralax 2x per day, 2ml lactulose once per day, and 0.5ml cisapride 2x per day. How is your cat’s potassium? I know low potassium is common in cats with kidney disease and can cause constipation. My cat is on a supplement (Renal K+) that seems to help.
What kind of wet food is he eating? If it is high fiber, it is possible maybe he needs something lower fiber. I have found that my cat needs lower fiber because the fiber bulks up her stool too much and she can’t pass it. Also she cannot tolerate any hard food at all because it constipates her within a day of eating.
She does have low potassium. I give her a supplement every day, but I did not know that low potassium causes constipation too. I don't think I give her enough. The one she takes is also renal-k I think, but it's powder. I should have gotten gel. It would be easier, probably more hydrating and the powder stinks. I haven't been able to determine if high fiber or low fiber is better for her. I feed her several different foods, there is a grocery store-brand one that she loves, I got prescription Hill's a/d (which I know she shouldn't have) and k/d from her vet, I mix them together. I went and bought a bunch of treats for her, things that were broth and soup consistency. I haven't gotten the diet part under control because she had started turning anorexic around 6 weeks ago when this stuff started happening and the vet said not to switch to k/d yet because a lot of cats don't like the blandness of it. I have been to 2 vets during this and neither of them made much comment about diet other than saying some cats won't eat a kidney friendly diet and never get switched to one. It can be hard to know what effect things are having though, and 6 weeks is not long. I have noticed that there are not many kidney friendly things on the shelves though, nothing that states low protein at least. But in the past, this cat has always had really wet poo. Now has hard poo. No idea what changed.
 
  • Thread Starter Thread Starter
  • #13

Laroo

TCS Member
Thread starter
Young Cat
Joined
Jun 19, 2021
Messages
27
Purraise
21
I personally have not had to try it. But, I know of others who have, and it can require more than one use. But, I do think in your case, it is an addition to some of the other treatments are you doing, not a replacement.
Yes, I agree that it would be an additional thing. Maybe it will be the missing link! I will look up how much can be safely given.
 
  • Thread Starter Thread Starter
  • #14

Laroo

TCS Member
Thread starter
Young Cat
Joined
Jun 19, 2021
Messages
27
Purraise
21
Well, my cat just went to the box and pooped. So that's wonderful. I have also read that in a lot of the threads made here, someone posts a plea for help and then behold: the cat poops soon after. Haha. It was a little hard and dry at the end though, so I suspect the dehydration. Might be worse now with these last 2 days of not wanting to eat or drink much, so I will see what I can do about that. Thank you for the replies and help! I got a few new things to do by responses to this thread.
 

LTS3

TCS Member
Staff Member
Forum Helper
Joined
Aug 29, 2014
Messages
15,904
Purraise
14,807
Location
USA
I was mixing the Miralax into her wet food. She probably does have a blockage of hard stool, it's just so difficult to manage because it gets so dry so quickly and becomes a blockage. It takes a day to become too hard apparently, that's hardly any time. The vet said she passes it with an enema so I'm wondering if she will pass it on a laxative. She is just laying around today, not looking stressed but not asking for food, not drinking any water, so I doubt the SQ fluids will be even nearly enough. Does dissolving the Miralax in water first make a difference? At this point I would hate to experiment though...
Yes. Miralax should always be dissolved in water first, just like it says on the label for a Human dose. Miralax works by drawing water into the colon. By dissolving a dose in water first, whether a Human sized dose in 8 oz of water or a cat sized dose in a few spoonfuls of water, the powder is fully rehydrated and is less likely to draw water from inside body and cause dehydration in the process. When a cat sized dose is dissolved in water, mix it into a small amount of canned food or moist treat and let the cat eat it all up.
 
  • Thread Starter Thread Starter
  • #17

Laroo

TCS Member
Thread starter
Young Cat
Joined
Jun 19, 2021
Messages
27
Purraise
21
:yess: It's a start anyway!
Agreed, haha. I'm going to call her vet tomorrow to see if she will adjust the Cisapride and Lactulose doses. Maybe my cat needs more. She appears to get terrible nausea from it though. I give her Cerenia and just gave her some Zofran as well because she was looking .... well, nauseated. I wonder if that is normal or if it will go away eventually. She still did not eat much or drink much today but she is also due some mirtazipine...
 
  • Thread Starter Thread Starter
  • #18

Laroo

TCS Member
Thread starter
Young Cat
Joined
Jun 19, 2021
Messages
27
Purraise
21
Yes. Miralax should always be dissolved in water first, just like it says on the label for a Human dose. Miralax works by drawing water into the colon. By dissolving a dose in water first, whether a Human sized dose in 8 oz of water or a cat sized dose in a few spoonfuls of water, the powder is fully rehydrated and is less likely to draw water from inside body and cause dehydration in the process. When a cat sized dose is dissolved in water, mix it into a small amount of canned food or moist treat and let the cat eat it all up.
Ahhhhhhh ... Ok, I was not told this when my vet told me to give her Miralax. And have never read it anywhere either, it appears to not be common knowledge to do this for cats. Apparently people are just dumping it in their food?? It makes sense why it would cause such issues though. Maybe I will experiment again later when I have everything sorted out properly. Wow, how terrible, Miralax certainly did injure my poor kitty, it was harrowing to watch her go through it.
 

Dos Gatos

TCS Member
Young Cat
Joined
May 6, 2021
Messages
31
Purraise
36
Yes. Miralax should always be dissolved in water first, just like it says on the label for a Human dose. Miralax works by drawing water into the colon. By dissolving a dose in water first, whether a Human sized dose in 8 oz of water or a cat sized dose in a few spoonfuls of water, the powder is fully rehydrated and is less likely to draw water from inside body and cause dehydration in the process. When a cat sized dose is dissolved in water, mix it into a small amount of canned food or moist treat and let the cat eat it all up.
I have never heard that. I have been giving Echo Miralax for years and just mix it in to her wet food. Her vet said there should be enough moisture in the wet food to dissolve the powder. However I do mix it in very liquid-y food so maybe that is why it has worked for her. But maybe I'll start trying to dissolve it in water first and see if it helps more.
 

KSRS

TCS Member
Kitten
Joined
Jul 18, 2021
Messages
18
Purraise
15
Hi, my 13 year old cat was diagnosed with stage 3 kidney disease about 6 weeks ago. Since then (almost immediately it seems) we have been plagued with this terrible constipation that I can't seem to find a sustainable solution for. And I have Googled and checked tons of websites, articles, forums where people have posted web links and articles (including this forum) you name it and I have probably seen it. Unfortunately most of them have had repetitive information. Some things I have tried to help my cat with this constipation:
Wet food and treats only. I put out dry food just to have it there but she doesn't really do anything with it.
Pumpkin. She won't eat it, doesn't care for the taste. I have tried unsweetened canned and baby food. I have given it straight in a bowl and mixed it with food. Psyllium husk: I am currently trying this, she's been taking it for about 4 days and I have not seen any specific results.
Miralax: The magical remedy. She can't tolerate it, it gives her horrific stomach pain worse, even after several days it still does not produce any poo. I've tried starting with really small amounts and it doesn't make a difference. Still results in horrific stomach pain and I am not willing to try this again.
Cisapride: She has been taking .5 mL twice a day for three days, no poo
Lactulose: She has been taking .5 mL twice a for 2 days and then I bumped it up to 1 mg today because no poo
Enemas: She has had 3 in the last 6 weeks. This last one was on Wednesday and she bit the vet tech and is now on in-home quarantine lockdown per animal control for another week or so.
SQ fluids: She gets 100mL every night, sometimes 125-150. Her vet said don't give 125-150 every night, 100mL is the cut off for a 10 lb cat.
She got an enema on Wednesday like I said, she hadn't pooped for 4-5 days before that. The vet said she had very hard stool blocking the exit so the rest couldn't get out. That happened in 4-5 days, even with SQ fluids every night, even with wet food all day, a water fountain and a bowl of water out. She likes both. She eats a lot like 6-8 oz of food a day, and has mirtazipine every three days to help. She last pooped on Thursday and Friday but none today despite the laxatives and I am worried because apparently the stool dries up quickly in her, her vet wants to use gas on her next time she needs an enema (bringing total visit to $140) I really want to find an answer to this but I'm running out of money and I can't afford an enema every week. Plus, after that visit my sweet little snuggly kitty was jumpy and defensive and I really don't want to hand her over again cause it's so stressful.

I'm also thinking maybe this vet doesn't know what they're doing because my vet tech friend told me that gas is bad for kidney's and it's pretty obvious to me that they could have done more to avoid that bite. Yeah, accidents happen, but I have worked in environments that service animals and they should have used a cat muzzle, a plastic cone, or wrapped her up in a towel. Instead my cat ended up at risk of being confiscated and dissected by animal control, or being required to quarantine in their facility which owners are also charged for and god knows what would have happened to her, would she have even a smidgen of chance at surviving this ordeal.

Anyway, it's pretty hard to get a vet appointment around here these days, vets are overwhelmed with patients at the moment. I don't want to take her back to last one because I don't want to deal with the potential of her having a bad reputation there or risking them possibly being overreactive in future situations. I know that people say pets are forgiven for biting at the vet, but they actually weren't that pleased when I picked her up, and I get the feeling that the vet there is pretty much out of ideas.

So what I am looking for here (my apologies for the long post!) is any personal experiences that people may have had with a very stubborn case of constipation in a kidney disease cat. Has anyone had a cat that can't tolerate Miralax? What did you do?? I have not seen even one story using Google that said someone else's cat can't tolerate it. It's basically the magical answer. Everyone keeps saying pumpkin, how long is that supposed to take to work? I need this cat to poo NOW, like today, otherwise she is probably going to have to get an enema again and that is just not sustainable. Does anyone give their cat an enema at home? According to YouTube the "applicator" is inserted pretty far into the rectum, I'm worried that there will be a perforation if I tried that. No way. Unless there's an easier and better way? What do people feed their constipation cats? How long does it take Cisapride/Lactulose to work? I was under the impression that they were really strong laxatives, I'm stunned that the cat is not pooping. She is having extremely noxious gas pretty frequently and she is extremely nauseated today. Maybe getting used to the laxatives, but maybe because of the laxative driven expelling that is being cut off by hard stool. She is also really restless and just wants to do weird things like get into places that she was never interested in before. I'm just at a total loss here, what to do if these laxatives don't work at all??? I called a few ER vets to ask them if I could put a little olive oil in her bum with a syringe to hopefully help things slide out but they said not to and that it wouldn't have the effect I'm looking for. They said put it in her food. Is that going to help some already backed up stool? I have no idea where to go with this next.
Thanks for posting your situation. I am in a similar predicament and am spending myself into debt with little answers. I noticed my cats potassium is low as per the bloodwork so I may try the Renal K plus. In my experience with a previous cat with kidney disease, I got more help from the support groups/forums than the vets. I only used them for diagnostics and emergencies. My cat is straining a lot and wearing himself out in the process but has passed tiny poos; for a almost 20lb male cat that's not a lot. I'm stumped too...glad I see your cat pooped. I hope mine does soon.
 
Top