Our cat with megacolon is stumping our vet. What now?

crazycatlass

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I wish that headline was a joke but, unfortunately, it's no laughing matter. I hope someone has some advice on where to go next. A little background so this makes sense.
Buttoning up his overcoat.JPG

Our boy Skidd was a very gassy kitten who became a gassy juvenile, then a gassy adult; he started developing problems with recurrent constipation a few years ago, give or take. We're on our third vet and have tried countless medicinal, dietary, and 'etc' treatments. To list a few:
  • Canned pumpkin had no positive effect and occasionally made him more constipated.
  • Lactulose couldn't soften what he already had "waiting in the wings" and gave him diarrhea on top of it; it left him plastered to the floor crying, messing himself, and sometimes even bleeding once he finally passed the plug. We tried several doses but even daily dosing didn't fix the problem.
  • Hill's prescription diet dry kibble (Gastro-Biome) blocked him up HORRIBLY.
  • The equivalent "Royal Canin" dry kibble blocked him up even worse than Hill's; instead of plugs, he started passing giant conglomerate chunks while crying and wailing.
  • Psyllium husk, in the form of supplements, chews, and mixed into food, blocked him up worse.
  • 'Feeding' him water by mouth (using a syringe or baster) is generally ineffective because we can't get him to take in enough to make a difference. A few tablespoons and he's scratching, biting, growling, and fighting, and I'm bleeding.
  • We've tried coaxing him into drinking cat broth to get more fluids in him. Nope. He tries to bury it. Even diluted with water he thinks it stinks too badly to drink. If we mix it in with his canned food, he refuses to eat it.
I know we've tried other things but at this point, I can't recall everything. He's had several enemas, a visit to the emergency vet because he was blocked stem-to-stern and hurting too much to even pee, x-rays, subcutaneous fluids, manual clean-outs, and that's just what I can think of off the top of my head. He started out with just 'plugs;' by this point, he's graduated to full-blast megacolon despite all our attempts to prevent it.

Skidd is an indoor-only kitty with only one non-human housemate - our senior cat, Goldie. She's over eleven years old, over sixteen pounds of pudge, pride, and poofiness, she's terribly bossy and jealous, and she bounces between cuddling with Skidd and wanting to chew on him because he's too clingy. As soon as Skidd was switched to a special diet, yep, she had to have a 'special diet' too; mixing canned food with kibble is expensive on top of Skidd's treatment and prescription food, but it's either that or she sprays. (Yes. This spayed female cat sprays. We love her anyway. They probably broke the mold when she was born.)
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Currently, we have four litterboxes available and in use - two electric ones in the hallway, a large traditional box in the bedroom, and a small one in the kennel. (The kennel is for feeding Skidd where Goldie can't get to his food, 'time out' when the two are fighting too much, and when necessary, confinement when someone's vomiting or Skidd has been messing on the floor again. It's a little under 3' x 3' x 4'; we line with accident pads and keep the litterbox clean, there's always a fresh bowl of water in it, and unless time-out is in progress, there's a folded up towel or blanket for comfort. It's pretty comfy, bars aside.) Skidd is the only one who has regular access to the bedroom litterbox because he sleeps with us every chance he can get; he gets locked in there with us overnight with his food, water, and box because he's so clingy. Water is always available. We have a pet fountain in the hallway and are looking into purchasing another. There are bowls of regularly-replaced water in the bedroom and kennel, and we have no qualms about turning on the tub faucet for someone to drink from. Water also gets mixed in with the cats' daily food.

The current treatment is a mouthful and very expensive. Skidd gets one to one-and-a-half cans of Science Diet canned "hairball" food every day, split into breakfast, dinner, and 'snacks' in between if he gets hungry. This is actually over-feeding according to the guidelines - 1.5 cans per 10 lbs of cat - because he's dropped to just over eight pounds. When he first started getting constipation problems, he was pushing 16 lbs; now, he gets cold easily, his fur has gotten thin, we can feel part of his spine through his skin, and I can carry him around for an hour without my shoulder getting stiff. He's finally at a healthy weight, but the way he got there is NOT good. Skidd's breakfast and dinner both have these doses of medicine mixed in: 1 ml of Cipraside, about 1/2 tbsp of Laxatone, and about 1/8 cup water. This food and medicine combination was directly ordered by our current vet, and until recently, it was helping a little.
...until recently being the keywords there. The week before last, Skidd started a new "Mom, I don't feel good" habit - peeing in places that have never been 'a peeing place.' We're talking right in front of the front door, on a plastic bag while I was putting away groceries, on the floor underneath a nightlight, on one of our good bathmats - all these places are within 3 yards of a clean litterbox, have been the site of found "Skidd bombs," and have been repeatedly thoroughly cleaned after incidents. This new development prompted yet another vet visit, during which Skidd wouldn't stop panicking. The vet literally brought a toe-breaker of a reference book into the room to see what options we had left, and couldn't find anything new. He gave Skidd most of a bag of sub-cu fluids and sent the rest home with us for dosing a few days after. (It did NOT go well. It took us four tries, and even with my partner holding him still and me distracting him, the little guy managed to get loose before he could finish off the bag. Yes. I got to clean that stuff off the wall because I couldn't get the line 'blocked' quickly enough with Skidd's teeth in my wrist.)

We've gone through several vets by this point trying to find an effective treatment for Skidd. We've tried all the medications and diet changes we've been suggested, we're following the dosing instructions to a T, and Skidd is just getting worse. It's starting to feel like surgery is the only option we have left, but the vet has stated several times that he'd "rather avoid it." I can't say I blame him if what I've read about it is accurate, but what can we do? Our vet has admitted that Skidd's run out of options and that he's lost on how to proceed. Meanwhile, my furbaby is suffering and it feels like I can't do anything to help him. This entire post, I've written with him curled up in my arms on the tabletop, and half of the time he's been bodily wrapped around one of those arms; he always needs more cuddling like that when he's feeling awful. Does anyone here have any new ideas or any advice?
Mama's boy.jpg

...and now he's snoring. At least the poor little guy is comfortable.
 

Furballsmom

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Hello!
A couple things came to mind, -- would a heating pad set on low and covered with a towel help him for those times you don't have an arm available?

Is he getting any pain meds? Would CBD Oil help, if it's legal-ish where you are?

Would your vet possibly consider consulting with a university medical veterinary department?

At home, do you have Feliway or Comfort Zone diffusers? Try cat music too, there's Spotify, YouTube and Alexa, RelaxMyCat and MusicForCats to help everybody to be calmer.

Ask the vet about gabapentin for vet visits.
 
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mrsgreenjeens

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I have never had a cat with Magacolon, but have had three cats with chronic constipation, and do know from experience in that arena that Lactulose losing it's efficacy after time. Our Vet had us switch from that to Laxatone, which is actually over the counter. Also, what about Miralax? Have you ever tried that with him? That was what worked the absolute BEST for us, and recently we used it for one of ours who isn't one of the three above that I mentioned. WE took our latest guy in because he wasn't eating and was vomiting quite a bit, and it turned out he was very backed up. Our Vet said give him 1/2 teas. Miralax twice a day for a week or two, and a little Laxatone for a week or two. Well, within a day or two we got a nice big poop out of him, and he repeated that every few days. He went back to the Vet today for an already scheduled dental and when they called to update me they said his colon was nice and empty :) Anyway, I realize megacolon is a motility issue, but it sounds to me as if one if Skidd's issues is large and hard stools. That hairball formula food I believe is higher fiber food that increases the bulkiness of the stool. Have you tried a different food one that does NOT include more fiber? I think some people say with Megacolon extra fiber is good, and others say No!

You said at the Vet they gave him an entire bag of fluids? 1000 mls? That's a huge amount for an 8 pound cat! I can see why you were unable to gave that much to him. We used to give fluids to our kidney cats, and were lucky to get 50 ml in before they got antsy. Holy cow!!!

Also, there are all kinds of different broths out there. I tried many on my cat Tinky before I find one he would drink. Many different brands and flavors. And seems like every day more brands are putting them out, so you might just keep trying. How about bone broth? You can make it yourself, or buy those too. Or just keep adding water to his food.
 

LTS3

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artiemom artiemom has some experience with megacolon and many of those treatments your cat is currently taking.

Our vet has admitted that Skidd's run out of options and that he's lost on how to proceed. Meanwhile, my furbaby is suffering and it feels like I can't do anything to help him.
Ask your vet to consult with other vets. Most vet schools offer a courtesy consult for vets. This vet hospital does too: Referral Services • MSPCA-Angell VIN.com is a popular vet only forum where vets from all over the world can discuss complicated cases and get advice on how to proceed with treatment.
 

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We have an issue with constipation with one of our cats. Several trips to the vet to surgical remove the hard mass of poop. What is working for us is a combination of Lactulose and Cisapride. We give our cat this combination every 8 hours along with laxative in his food. We give .25ml (2.5mg) of Cisapride and 2.5ml of Lactulose. We adjust the Lactulose if his poop is runny. Both are prescribed by our vet and we purchase the Lactulose from Chewy.com for $14.99 for 1 pint. The Cisapride is bought from Care First for $38.95 for 60ml. We feed him a prescription dry food, Royal Canin Gastrointestinal Castro-Intestinale from Chewy. This has worked for us.
 

artiemom

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I am sorry I am late to this conversation. I just saw this.

I had a guy with Megacolon and IBD. I managed the megacolon for about 2-3 years. The IBD was longer. Artie really did not have megacolon; It was more of a motility issue... and his stool was so hard... getting so stuck, and then getting diarrhea... He had so many enemas.. some emergency...
I really understand what you are going through.

All I can say is from my experience and what I have read on line. If you happen to look on
Facebook, there is a private group for MegaColon kitties.
They are kind of judgmental in the use of miralax for kitties.. anyway.. I digress

I was giving Artie a ton of meds, at the end.

Have you seen a specialist? An internist? I think your baby needs the specialist..
I ended up going to 2. The first one was horrible. The second one was AWESOME!!!! I still keep in touch with him, with my new kitty.

Did you try adding some Miralax to your guys food? You would start with 1/4 tsp, mixed with a bit of water, added to his wet food. I did this once a day.

Lactulose was another drug. You start slowly. I had to syringe Artie, the lactulose. He was fussy with his food, and could taste anything added to it. I was up to a possible 5 cc per day with Artie...
IT IS DOSE TO EFFECT... meaning you change the dose, daily, as per effect on poop..

Artie was also on daily Cisapride.
Daily sub-cutaneous IV fluids were also ordered.
~~~~~
Since You have discovered that the high fiber foods are making Skidd worse, I read that a low residue diet is better for many cats with Megacolon... you may want to try that. I have not had any experience with the low residue foods, since Artie had a motility issue, I had to use high fiber foods, but you may want to ask about this.
~~~~~~~
Also, To find out how things are going, with meds, and food, I charted Artie's progress.

I got an unused yearly calendar. Daily, I posted what his poop was like. I also made a flow sheet for this meds. I could look back at each thing, and see how the meds were affecting him. I discovered, through this, that Artie's transit time (the time from meds, to poop) was about 2.5-3 days.
Meaning that what I did on Monday, would not show results until Wednesday.....
~~~~~~
It was a really really hard journey, for both of us.. I understand how frantic you are. I really do...

I am sorry to say this; but, if your regular Vets are stumped, then it is time to take Skidd into a specialist. Hopefully there are some good ones near you...

I understand you frustration and fear... so many times, I cried.. and cried, and cried.. My boy was so brave... so so so brave.... my

The members on this forum, were my prime support..

I was allowed to write about our journey. The forum was so supportive.
If you would like, You can skim through it... I hope, it may help you.... as what was the purpose in allowing me to post over 200 pages...

It is titled: ARTIE AND HIS ISSUES

Sorry, I could not post the link, but search on my name, and you will find me as a member, so look up my posts...

I hope this helps... at least a little....

If you need anything more, I hope I can be of help... just do and artiemom artiemom or PM me....

(((((((HUGS))))))))
❤

Artie, my Heart, Soul-kitty...
 

EGrunt

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Hi! Just to ask and not to hijack the thread, but does that come in a canned version and do you have water bowls and fountains?
We have several water bowls of water at the house. We also get our cat (Little Man) injected with a Subcutaneous fluid and it is done at the vet. The prescription cat food I mentioned earlier is sold in can or in a bag. Little man does not like the wet version and prefers the dry version.
 

artiemom

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We have several water bowls of water at the house. We also get our cat (Little Man) injected with a Subcutaneous fluid and it is done at the vet. The prescription cat food I mentioned earlier is sold in can or in a bag. Little man does not like the wet version and prefers the dry version.
He may prefer the dry.... but....... is it working? Have you really tried the wet food.

And, I forget, what is the prescription food? I know RC Fiber response does not come in a wet form.

As I stated in my post, Skidd could be one of the kitties who respond better to low residue diet... meaning wet food.....
 

EGrunt

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The food we are using can only be bought with a prescription from the vet. The name of the food is: Royal Canin Gastrointestinal Castro-Intestinale. Per my first post in this thread the combination of the medication, food, and fluid injections at the vet have worked for our cat. The downside is he sometimes leaks his poop since it is watery. It is a small price to pay for him to be able to pass his poop.
 
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