Kidney failure...constipation...should I put my cat to sleep?

[extradimensions]

My 12-13 yo cat had been having problems with constipation on and off a few years. In the past 6 months it's gotten bad...she began straining a lot and scooting on her butt. The vet put her ok lactoluse which worked for awhile. Then I switched her to an all wet food diet and placed water bowls every where.

Gradually it got bad again. I raised the dosage but still she was straining and ended up starting to vomit everywhere. I brought her back to the vet who said she was dehydrated from stage 2 kidney failure, although she drinks lots of water and eats only wet food.

He gave her an enema a few days ago and since then she is having leakage everywhere. It ruined my bed so I am staying over at night and hanging out with her during he day. She leaks poop everywhere and she seems to be in pain and miserable. The other cat won't go near her, she has lost weight and hair. I don't feel like I am able to deal with this problem but I feel selfish. She is still eating and drinking a lot, and still trying to get my attention, then sometimes pacing to pee or have diarrhea but otherwise she is lethargic and has trouble moving.

I don't know if it's appropriate to put her down. I don't want to wait too long as she suffers, but I don't know if I am overreacting at kidney failure related constipation. What would you do if it was your cat?

 

[red top rescue]

It sounds to me like she may have some partial intestinal blockage and may be in pain. You could certainly go to a Dollar General or a drugstore and get some incontinence pads -- they are inexpensive and very useful for sick cats or kittens, and then she could sleep next to you without ruining your bed tonight.  The most important thing to consider is her QUALITY of life.  If she is in pain, there is pain medicine to help that which you can get from your vet, but she may be at the point where she can't eat or drink enough to keep herself hydrated and will need to have subQ fluids on a regular basis.  Some people do this daily and keep their kidney failure cats alive for a long time that way, but those cats are pretty much happy and not in pain at that point.  Nobody can tell you if you should or should not put her to sleep, but if you do it for selfish reasons, you will probably feel very guilty about it.  What you need to do is listen to her, her body language, her behavior, and even how she relates to you.  In my experience, my cats actually let me know when it's time for them to go to the Rainbow Bridge.  They clearly state without words but with actions that they don't feel well and living is getting too hard and then it's the kind thing to do.  The most impressive one I ever had was my 18-year-old flamepoint longhair.  He had been circling the drain for awhile but never was clearly ready to go until one day he just got into the covered litter box and lay there, clearly saying "I feel like crap."  That was the day I let him go, and I know he was ready.  The hardest time for us caretakers is that time you are in now, when you know it's coming but you aren't quite sure when, and it's hard dealing with their illness -- for you, and for them too.  If you really listen to your cat, she will tell you when it's time, and you won't feel selfish or guilty, you will just know it's right.

 

[goholistic]

Hi @extradimensions. I'm so sorry you're having a difficult time with your kitty. While kidney failure can cause constipation, chronic constipation can also lead to a condition called megacolon.

Megacolon: A Terrible Outcome for Constipated Pets

http://healthypets.mercola.com/sites/healthypets/archive/2012/11/26/megacolon.aspx

Your kitty sounds like she could be at high risk for megacolon. Has she had x-rays done recently to take a look at her colon? Does your vet think she is lethargic from the constipation and related discomfort? Enemas can cause leakage. If this is stressful for you, you could make her a plush, comfortable bed with food and water in a quiet room such as a bathroom that you could easily clean and just toss out ruined bedding/towels until it subsides. Leakage can also be caused by the constipation itself, and may appear as though she has diarrhea. This occurs with too much straining and any soft/liquid stool gets pushed past the impacted stool. You did the right thing to put her on a wet-only diet. Do continue this.

I would highly recommend you talk to your vet about Miralax. It has been a lifesaver for some megacolon/constipated kitties when lactulose was not helping. Sometimes it takes a little bit of adjusting up and down to get the dosage just right.

If you do a search here on TCS, many related threads come up:

http://www.thecatsite.com/newsearch?search=constipation+miralax

http://www.thecatsite.com/newsearch?search=megacolon+miralax

Here's another site you can take a look at:

http://www.felineconstipation.org/introduction.html

Megacolon and constipation are sometimes also treated with Cisapride, which helps with motility. It is a prescription, so you would have to talk to your vet about this. There are natural remedies that people have found successful for their cats' constipation, such as Slippery Elm Bark and pumpkin. Due to the severity of your kitty's constipation and the critical point at which you've reached, this why I suggest you talk to your vet about Miralax. Lactulose alone may not be working for your girl.

 

[mycatwasthebest]

I have never heard of a cat (or dog) getting an enema (another thing learned today!)

did the vet express her anal glands lately? 

Ever?her original symptoms are ones I would associate with impacted glands(not sure if that's the right word)

 

[denice]

My kitty has had several enemas.  His is from IBD.  Miralax works wonders for him.  At some point you will also need to make a decision about giving sub-q fluids at home.  It is easy to do and many kitties tolerate it very well.

http://www.felinecrf.org/   is a good resource about CRF and caring for a CRF kitty.

 

[mrsgreenjeens]

kidney disease and constipation seem to go hand in hand, but the other, the seeming to be in pain and losing fur, could be something else. 

I had an old guy who had chronic constipation and was on Lactulose, and he acted the same way you described, including straining so hard he would then vomit

.   And he drank tones of water too, but it turns out he was dehydrated because he ALSO had kidney disease

.  We switched him from the Lactulose to Miralax, and it was like a miracle

.  No more squatting and straining all over the house...he started having regular bowel movements - like clockwork as long as he got his Miralax twice a day.  And the best part about it is that it's not sticky like Lactulose, and it's completely tasteless too, so can be mixed right into their food.  And it's not prescription either

.  (I even used the generic stuff).  I think we used between 1/8th and 1/4 teaspoon dissolved in a little bit of water, then mixed into his wet food, once in the morning and once at night, but be sure to check with your Vet first because the dosage is based on the weight of your cat.  We never had a diarrhea issue with

Sven

if he got too much, but what would happen is sometimes he might leave a little tiny shell shaped turd (I don't know of nicer way to say it

) in his bed and not even realize it.  I wouldn't skip his next dose if that happened though, but would just cut back on the amount a little bit. 

Our dear boy definitely let us know when he wanted to leave us for good, when he was fed up with all my begging him to eat, the sub-q fluids, etc.  They have a way with their body language of telling you things. 

 

[extradimensions]

Thank you guys very much!! She actually seems a little better today, so I am going to give her a little miralax tomorrow if she's still doing okay.

 

[stephanietx]

Is she on any kind of laxative?  If you're not giving her something, that would be my first recommendation.  Many kidney kitty parents I know give Miralax or slippery elm bark.  Also, if she's not on some canned food, that will also help her.  It's very, very, very common for kidney kitties to have hard stools, constipation, small poops, and to poop every other day or every 2 days.  It's not an obstruction, but one of the side effects of renal problems. 

 

[mycatwasthebest]

I thought I was done worrying about bowel movements other than my own

BUTT---

how is she?