Megacolon new diagnosis

KSRS

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Hello everyone. I'm new here and have been reading old posts and feel I'm on the right track but thought I'd post to see if anyone can relate. My cat Rocky is a 14 yr old male that I rescued years ago when he was barely a year old. He began to display some constipation issues a couple of years ago. He has been taking Miralax all this time, slowly being upped to one teaspoon daily. That along with occasional hairball gel when needed has managed him. I have also been able to deduce over the years the things he CANNOT eat, such as any dry food or foods with veggies, high fiber, fruits, bones, chickpeas, etc. He will be bunged up really bad if so. So, I've been feeding canned Tiki cat canned or natural balance limited ingredient pumpkin and tuna (pumpkin in the cat food seems ok but not if I add it on my own). Right now I'm trying a low residue food that he likes called Royal Canin digest sensitive. I thought maybe it would be gentler on his tummy.

Earlier this month, Rocky began displaying lots of gas and foul poops. He had two or three big cowpie consistency poops that smelled AWFUL followed by vomiting. I gave him probiotics and all seemed to clear up, only to be followed by constipation that ended us at the vet for enemas. He pooped a couple of nuggets before I got him to the vet and one at their office. Then a week went by and no poop. I was referred to a specialist and they did radiographs, another enema, and bloodwork. Bloodwork was fine. Radiographs showed loose stool in the colon that wasn't moving. I had already had him on lactulose for two days, so they thought that loosened the stool but it was just sitting there. I was prescribed cisapride and he's been on that for a day and a half now. No poop but small pea sized or runny stuff (he's trying to go).

The specialist vet said to go back to Miralax at a teaspoon and a half, and use lactulose as needed if his poop looks too hard, and add cisapride daily. He got a good cleaning out (in his pet carrier on the way home) Thursday from the vet specialist and has since done some small (pea-sized poo that is sometimes runny sometimes harder more formed in balls). I have been under feeding him to allow his digestive tract to heal. He has a great appetite and always has (he is a little chunky so he could use to lose some weight). Today, he's trying to go but nothing is coming out.

I don't know if I should panic since it's been barely two days since all this cleansing and starting meds? Should I add lactulose? He vomited a hairball after straining in the litterbox. He has allergies so he licks a lot when itching. I put a t-shirt on him to block some licking and give bromelain and hairball gel. It all helps but I am worried. He is trying to poop and not producing anything. Maybe the meds are kicking in and trying to clean out what's left? I don't know.... I've been through a lot with other cats in my life and now I'm down to my last one. Rocky. I'm worried...
 
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KSRS

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The cisapride is .5ml twice daily. Miralax is 1 and 1/2 teaspoons daily. I thought he was maxed out at one teaspoon but apparently he can go up. They said lactulose as needed but his poops have been runny or softish small beads. He strained today and vomited some hair. I gave hairball gel and bromelain for allergies. He's scratching a lot so I put his tshirt on him. They did say his colon was enlarged near to end so poop is sitting in there but it's not very hard. He used to do LARGE poops but with miralax they were soft enough to pass. I guess I should give cisapride more than one full day to work?
 

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Welcome to The Cat Site although I am sorry that this condition has brought you here. I have not personally dealt with megacolon but do understand what you are facing. Hopefully others will reply to give you more support. In the very short term, I would continue the protocol that they have given you and continue the cisapride. From my experience with my own father, some of these types of meds seem to need a little bit of time to get through the system....but I am not saying that is what is happening with Rocky. I would get back in touch with the specialist if this does not improve or if Rocky seems more unwell.
 
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KSRS

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Welcome to The Cat Site although I am sorry that this condition has brought you here. I have not personally dealt with megacolon but do understand what you are facing. Hopefully, others will reply to give you more support. In the very short term, I would continue the protocol that they have given you and continue the cisapride. From my experience with my own father, some of these types of meds seem to need a little bit of time to get through the system....but I am not saying that is what is happening with Rocky. I would get back in touch with the specialist if this does not improve or if Rocky seems more unwell.
Thanks. I'm just getting ahead of myself and wanting my cat back to normal. He acts fine and wants to eat. He's very food driven but I am making him wait and eat at timed intervals. He can overeat, so no leaving food down in large quantities. He has some arthritis forming from an old injury and they saw some on the xray in another leg, so they gave me gabapentin but I haven't started yet. I feel like I'm throwing too many new meds at him too fast as is. This sucks...
 
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KSRS

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To add, I've tried slippery elm over the years since I am familiar with it that I used to give to another cat that has since passed. It doesn't seem to do anything for Rocky. Cascara Sagrada was more effective at giving him a good colon cleaning (he doesn't mind the taste), so I gave him once a week in addition to Miralax but this time, something is just not working. I prefer holistic but am trying cisapride. This is so weird and random...
 
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I forgot I had prescription food diets from the vet (not the specialist but my original vet) but she wanted me to wait until he was eating so as to not make him hate the prescription food. I am not big on prescription diets but hey, if it works I'll try it. So, I went and picked up the royal canin gastrointestinal fiber response can food and the w/d hills dry (only as a topper because he loves dry stuff). Small portions to start the transition. I hope he does well on it...
 
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KSRS

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Rocky is really trying to go but producing little to nothing. Maybe a drop or two. Called the vet specialist that treated him but she's not in so the Doc on call will review his case. They may try something else. They said Cisapride should work in a couple of days. It's not and Rocky is frustrated trying to go a lot...
 

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You are doing the right thing to call the vet. Rocky is upset and uncomfortable and needs another evaluation. I am sorry this is not improving.
 
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You are doing the right thing to call the vet. Rocky is upset and uncomfortable and needs another evaluation. I am sorry this is not improving.
The Doc wants to give it a little more time. He was cleaned out pretty good Thursday and hasn't eaten a lot (my doing) and is on a low residue diet. I wonder if the cisapride is working his colon and there's just not a lot in there? The Doc was actually happy I'd seen a few pea-sized poops and one nickel size mushy one. I'm just used to his being much bigger and he seemed frantic to squeeze out the poop... he has since calmed down and has eaten a little and drank water. I groomed him and he was happy with that. I will take him in if need be asap in the event of anything out of the ordinary happens.
 
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Well, he strained this morning and vomited from it. So, now I have to decide if I go back to the same place or get a third opinion. I called them early this morning, they've yet to call me back...I have a vet teaching hospital here but one of my clients (I do pet sitting) who was in vet school at the time, took her cat for treatment there, well they nearly killed her cat with an overdose of meds. So, I'm not feeling very confident in the vet system here and I live in a medical research area. So, go figure...
 

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There can be good or not so good treatment anyplace, but that is not a lot of comfort right now. You are the judge of Rocky's care and condition and if it were me and I saw continued signs of distress I would stay in touch with the vet and/or look for another opinion. Do you have the Nextdoor app? You could ask for opinions of vets from people in your general area. Is your client now a vet? Any input from her on a next step?
 
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KSRS

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There can be good or not so good treatment anyplace, but that is not a lot of comfort right now. You are the judge of Rocky's care and condition and if it were me and I saw continued signs of distress I would stay in touch with the vet and/or look for another opinion. Do you have the Nextdoor app? You could ask for opinions of vets from people in your general area. Is your client now a vet? Any input from her on a next step?
I have an appointment to take him in to the specialist and went ahead and set up an appointment with a new vet for second opinion. My current vet has pretty much dumped me off on the ER/Specialist hospital. I don't feel very confident in their care at this point either but no other option. The second opinion vet is scheduled for tomorrow. I may be broke after this and then I won't get care anywhere...
 
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I joined the megacolon group. I was with the CKD group for my other cat that passed in 2017 and it was a godsend, so I hope to get some insights there. I value the experience of others when it comes to cats...
 

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Those special groups are really helpful and I am glad that you have joined. At least you have an appointment for tomorrow for another evaluation. When you get a chance, let us know what happens. As for the expense, yes, we all understand what sophisticated vet care costs. I hope that you get some definite answers so that this can be resolved.
 
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Those special groups are really helpful and I am glad that you have joined. At least you have an appointment for tomorrow for another evaluation. When you get a chance, let us know what happens. As for the expense, yes, we all understand what sophisticated vet care costs. I hope that you get some definite answers so that this can be resolved.
He's getting fluids and cleaned out at the ER vet. This vet actually said everything the megacolon group has said needs to happen, so I feel better. I'll feel even better when he gets home!
 
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So far, the ER visit has yielded no hard poop findings, just a lot of diarrhea after a night of one enema, fluids, and manual check under anesthesia. They think it's just a motility issue. I wonder if all his straining after the initial problem of diarrhea that swung back to constipation caused his colon to just stop working momentarily. He's done nothing but strain since these past two weeks with little to no poop. They may want him to be on a higher dose of cisapride coming home. I hope it's temporary. However, the motility drug did its work but he just strained with nothing moving and vomiting if he strained too much. This is so weird... Has anyone had experience with this? I'm not getting responses on the megacolon group yet.
 

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My ARtie had a motility issue. It was treated as megacolon. Cisapride, lactulose, miralax, RC Fiber response food, daily sub-q's.

I kept a daily log of his stools. He had a w day transit time: meaning, that whatever the amount of lactulose given; the effect would be seen 2 days later.

It was an endless battle.

(((hugs)))
 
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KSRS

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My ARtie had a motility issue. It was treated as megacolon. Cisapride, lactulose, miralax, RC Fiber response food, daily sub-q's.

I kept a daily log of his stools. He had a w day transit time: meaning, that whatever the amount of lactulose given; the effect would be seen 2 days later.

It was an endless battle.

(((hugs)))
Thanks. I have all those things ready for when he comes home. Luckily he likes the RC food (I got the canned). Maybe it will all be ok once things get in his system and get regulated. I'm familiar with giving fluids per my cat that passed away at age 20 from kidney disease.
 
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KSRS

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Here is hoping that you are getting close to some resolution to this!
I hope so. He's staying in the hospital one more night. They said a lot of runny poop came out last night but still needs a little more. I went to see him and bring his meds and food. He wants to escape lol. That's a good sign... hope we can get him straightened out. Thanks for your response.
 
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