Megacolon in Booberry

laura mae

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I'm so exhausted, and I've looked at a lot of info on surgery, food, for cats with megacolon. I just sprung my cat Booberry from the vet specialist after 4 days of enemas and golyte treatments to clear out a colon blockage. I was worried foremost about his survival and not far behind, the cost. If it happens again, I don't think I can spend thousands more. So naturally, I don't want to make the wrong decision on treatments and foods from here on out. I've looked at the board and some threads are older than Booberry so I thought I'd renew the megacolon discussion again to see what other folks strategies are.

Booberry is already a Cisapride and Miralax cat with extra water in his food. We managed the constipation for over 2 years this way without a need for an enema. We did have to increase the Cisapride concentration in the compounded liquid which he gets 2x a day and he wasn't a consistent 1 time a day pooper.

My Booberry is a rescue. He arrived at our house, injured with what turned out to be a fractured pelvis. We took him in, and with a lot of vet intervention, got him healed up. At that time, he needed an enema because his colon was full. Certainly it was because it was far too painful for him to assume the pose for enough time to have a BM.

The vet was initially concerned that the fractures and injury destroyed nerves, or blocked passage. At the time in 2013, the consult with a specialist showed that his pelvis was marginally smaller but not enough to obstruct. Until 2014 he got canned cat food which he enjoyed with gusto. Typical for a megacolon cat, his feces were larger than normal cat size. He had to have an enema.  After that I had to come up with a variety of solutions that included increased water that he would eat and that's when his medications had to start too. We did great until now.

Today I just sprung him from the vet specialist for a $2,400 worth of enemas, golyte treatments over 4 days. I was referred to them by the regular vet who felt that the problematic feces placement was too precarious to dislodge there.  

As he is a terrible water drinker, I have fed him food with water mixed in. He had been doing fantastic on Stella and Chewy's and especially Primal freeze dry raw but the varieties are quite limited. I would alter it with Rad Cat often because I liked that their calcium source was not the ground up bone. I introduced a bag of Northwest Naturals and boom obstipation.  The food had psyllium husk fairly high up in the ingredient list and the ER doc thought it was either that, or maybe a bone ratio in the food that was too high for my particular cat because of the pelvis challenge. While he enjoyed that food, it is off the list.

I was very concerned the specialists prescribed Royal Canin Fiber Response which seems like terrible food. I see all sorts of positive reviews of how it helps their megacolon cats and a few that show cats have experienced terrible health problems. 

My regular vet called me this afternoon and told me that she really didn't think I should use the food because, as I had suspected, bulking up stool in a cat with a narrowed pelvis seems like a bad idea.  The specialists are well aware of it, and had briefly mentioned a surgery to widen Booberry's pelvis. And of course, we discussed the colon removal surgery (which may not matter in a cat with a narrowed pelvis).

My regular vet said "You've been managing this pretty well for him with wet food." We discussed maybe high energy food that is low residue instead but he isn't fond of canned food after his 2 years of luxury food. Although after 4 days of enemas, he was very eager for canned food today in small quantities throughout the day.

 I'm also considering slippery elm bark but can't find scientific info on that. Lots of anecdotal stuff. I have read that Slippery Elm and Marshmallow root are okay to give cats. 
 

denice

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Several kitties here are given Slippery Elm.  I haven't used it but I know many hear do.  The only thing to be careful with is any medication,  There should be at least two hours between giving slippery elm and medication,  The slippery elm coats the digestive tract and can affect absorption of medication.

I have a kitty that has IBD and is prone to constipation.  He isn't into megacolon though.  I did ask the vet about fiber, kitties prone to constipation, and megacolon.  She told me that generally kitties that have progressed to megacolon do best with a diet that has as little fiber in it as possible.  I don't know much about raw diet but I do know that too much bone can cause issues with a kitty that is prone to constipation.

Since you have been feeding raw you might want to consider starting a thread in the raw food forum. http://www.thecatsite.com/f/65/raw-home-cooked-cat-food  
 
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mrsgreenjeens

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If you don't want to feed  Radcat all the time because of their limited flavors, would you consider making your own raw, and using eggshell powder as your source of calcium.  I did that for my kidney cat when I was feeding raw and needed to reduce the amount of phosphorus she was getting.  (eggshell powder has less phos then actual bones).  One bonus to making your own is that is much less expensive than Radcal...unless they've substantially reduced their prices. 

But I tend to agree with your regular Vet in that increases fiber really doesn't seem like a good idea, and OUCH on the surgery to widen his pelvis.  You didn't mention his age, but I would think the recovery on that type of surgery would mean quite a bit of cage time...how would he cope with that?  Would that resolve his issues, or has it been too long now and is his colon pretty much non-functioning as far as being able to push things along, no matter the size of his pelvis?  These are things to ask,I would think.   Colon removal surgery?  Would he get a colostomy bag or something?  I don't quite understand this one.

 
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laura mae

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I think Booberry is probably 4. 

The surgery is is an operation called bowl resection. It results in quite a bit of time with loose stool and most cats systems do recover and start forming softer stool eventually, but some apparently do not.  It makes the passage shorter so less time for feces to stay put and get dried out and completely block the cat.

When we first learned he had a broken pelvis, doing an operation to pin his hip bones back together was reviewed with a specialist. My regular vet was concerned about the narrowed pelvis then. But the specialist didn't find it substantially narrow to where it would be a problem. He had to be still and rest for 8 weeks. So any surgery to add bone to his pelvis would definitely be as long. He had to stay in a room by himself with no leaping, jumping around. Litter box close by, etc. I'm sure it would be as painful as the original break. He got pain meds then.

The stools he passes are fairly large so they do get through his pelvic area okay. He is on cisapride to help motility.

I put another box out near an area he occupies to see if he has the patience to stick with going when the urge hits.

Eggshell powder! I'll look for it.
 

mrsgreenjeens

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OK, yes, I'm familiar with the bowel resection surgery...thought you were talking about something else.  Some members have had good luck with that...some not.  As with everything, you hear good and bad.

Maybe just not giving him anything with bones will be the key, since he did well before getting that new food
  Seems if he is able to pass fairly large stools, he wouldn't need the pelvic surgery, in my way of thinking.
 
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laura mae

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Booberry update: he's doing well and so far, I seem to have come up with a regime that keeps him well. I could frame his poops! Those of you who have battled constipation in kitties probably can identify with that goofy statement. I am getting him to play more and keeping track of his habits as much as possible. 

 I think it was the case that raw just wasn't for him at all. It gave him great teeth, for sure, but after a $2,400 bill for the last incident, I'm staying away.  I even tried some more Rad Cat and then the freeze dried Feline Natural (the New Zealand stuff) without bone. I saw him strain a couple of times with no production and so eliminated that completely from his diet.

I still have him on the cisapride and the miralax, but I have been able to lower the dose of the later. I didn't want to feed him the prescription diet recommended by the specialists (and the thumbs down from my vet) but in reading what it does, it seemed worth incorporating a bit of it.  I feed him smaller, more frequent meals. AM, PM and bed snack.  I offer less than an 1/8th cup of the prescription a day as a treat. It is supposed to make his gut bacteria healthy to do its job. I'm not jazzed about the psyllium since that was in the offending bag of food that he was enjoying when the emergency situation occurred. Anyway, the small amount of prescription kibble and the canned food diet seems to be suiting him.  Anyway, he went from straining and producing enormous stool to easily being able to go and producing cat size stool daily! He's never been a daily kind of cat before. Everyone is happy.
 

denice

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I am so happy you have found what works.  There just doesn't seem to be a one size fits all when it comes to kitties that have issues with constipation.  It is a matter of trial and error and I am happy you found what works.
 

mrsgreenjeens

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This is great news
  So glad you've found what works and that Booberry doesn't have another surgery ahead of him (colon resection)
 
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laura mae

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Me too. In fact just a few days after the episode, the specialist did an x-ray and saw that his colon was returning to normal cat size.  We sure will be keeping an eye on him though.
 

Antonio’s Abla

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Hi Laura,

i have a cat 12 years old who is just diagnosed with megacolon :( I am looking for ways to treat it but vet say it is not curable.It gave me hope when i read your cat’s colon is returning to normal! That’s awesome!

can you tell me what you are feeding him?What dry food, wet food and/or supplements/medications?

we have royal canin gastro intestinal fiber response but it doesn’t seem to be working for him.
 
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