Partial obstruction and constipation

Emma2

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Hi everyone,
A few week ago, i posted about my 5 years old cat who had two enterotomy since January to treat constipation and remove fecal impaction (because enemas and manual extraction were not working). The constipation is probably due to a mass outside her intestin, pressing on it and making it difficult to pass hard stools (the vet was not able to remove the mass).
Even with the diet change, she started getting constipated again last week, the vet gave her docusate (rectal gel) and it worked. But he said to put her down if she gets constipated again.
She is now constipated again and wasn't able to defecate for a few days (she strains in the litter box but nothing happens). I gave her Docusate again, but it isn't working (I'm not sure why). I thought about giving her another laxatif (polyethylene glycol 4000 aka magrocol 4000), but i read that it is not advised in case of obstruction.
I tried to take her to other vets, but they don't know what to do and advise me to take her back to her usual vet.
I feel helpless, It breaks my heart to even think about euthanizing her because except for the constipation, she is still her usual self: active, playful and wants to eat.
Except for surgery (because the vet doesn't want to do it again), what are the solutions for constipated cats with partial obstruction? Any help or advise would be appreciated!

PS: i don't live in the US, and vets in my town are very few (four vets in total) and have limited equipments.
 

FeebysOwner

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Hi. It sounds to me like she needs more testing/exams to determine what might be behind her issues. Do the vets know what this mass is about and what it encompasses? You say they could not remove the mass - because?? They should have done an analysis of the tissue from the enterotomy to determine what the mass is comprised of.

Where are you located, as that might help members in your area to advise on where you could take her to be looked at more thoroughly.
 
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Emma2

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Hi. It sounds to me like she needs more testing/exams to determine what might be behind her issues. Do the vets know what this mass is about and what it encompasses? You say they could not remove the mass - because?? They should have done an analysis of the tissue from the enterotomy to determine what the mass is comprised of.

Where are you located, as that might help members in your area to advise on where you could take her to be looked at more thoroughly.
He doesn't know what it is exactly and there's no way to do a biopsy where i live (Africa). He couldn't remove the mass because it was attached to the bone i think.
I'm looking for advice or meds that can help her defecate this time or suggestions that i can tell my vet to try (in case he didn't think of them) because right now we're out of ideas and i feel completely helpless.
 

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Hi
What does your vet thing about the polyethylene glycol?

Would your vet be willing to consult with a university, either there or maybe even in the US?
Emma2 Emma2 I have gone this route and was very surprised at how thoroughly they reviewed my guys records and how many suggestions they had. (This was not for constipation problems.). I emailed and called several until I found someone to take his case. I would definitely recommend exploring this idea. ❤
 
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Emma2

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Hi
What does your vet think about the polyethylene glycol?

Would your vet be willing to consult with a university, either there or maybe even in the US?
Hi, thank you for your reply. I asked the vet about the polyethylene glycol and he didn't know what it was, turned out it is not sold here. I ended up ordering it from abroad but I'm not sure when it'll arrive.
Vet departments in universities here basically treat animals for free because they learn on them but since they're students, i find it hard to trust them. As for the US, sadly it is not possible for both paperwork and money issues.
 
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Emma2

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Emma2 Emma2 I have gone this route and was very surprised at how thoroughly they reviewed my guys records and how many suggestions they had. (This was not for constipation problems.). I emailed and called several until I found someone to take his case. I would definitely recommend exploring this idea. ❤
Hi, thank you for your reply. As i mentionned in my reply to Furballsmom, universities here treat animals for free because they learn on them, but since they're students with not a lot of experience, i find it hard to trust them.
 
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Emma2

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Update: i took her to one of the vets that previously saw her because she started vomiting after straining, they offered to perform enemas + manual extraction (under anesthesia). It was done in the afternoon, and apparently they were able to extract poop not sure how much. We picked her up in the evening and when the anesthesia started to wear off, she started looking for food. She is leaking liquid poop, I'm not sure if it's due to the enema or if it is diarrhea. The vet gave some instructions on what to feed her (wet food with extra liquid + pumpkin or zucchini for fibers), i hope it'll work this time. I'm scared she'll start straining and not pooping again.
 
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Emma2

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Are you able to keep her contained to a smaller area so cleanup is easier?

There may be something here that you can use also for her;
Tips To Increase Your Cat’s Water Intake - TheCatSite
Thank you for the link, I'll try some of the tips so that she doesn't become dehydrated because of the liquid poop.
For the cleanup, since she's already been through so much, i don't want to bother her more so we'll just clean after her it's fine.
 
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Emma2

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Emma2 Emma2 I hope she's doing better tonight. :hugs:
Thank you 😊 She seemed okay (maybe a little tired), she kept looking for food, and she was able to poop so that's good. The feces seemed a little dry which worries me, but other than that her behavior is normal.
 

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Thank you 😊 She seemed okay (maybe a little tired), she kept looking for food, and she was able to poop so that's good. The feces seemed a little dry which worries me, but other than that her behavior is normal.
This is great news! Maybe adding a little extra water to her food would help?
If you can, feed her a little bit at a time, as often as she wants to avoid over-loading her tummy. Is she drinking water as well?
 
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Emma2

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This is great news! Maybe adding a little extra water to her food would help?
If you can, feed her a little bit at a time, as often as she wants to avoid over-loading her tummy. Is she drinking water as well?
Good idea, I'll split her food to smaller quantities so i can feed her more often. For the water in the food, if it's too watery, she doesn't eat it so i can only add a little.
And no, she doesn't drink water at all. It's been like this for the last three months, i have to give her water in a seringue. I asked the vet about it, and he said maybe because she's eating wet food, but it doesn't seem to me like the liquid in wet food is enough.
 

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Hi Emma2 Emma2

The feces/stool being "a little dry" is concerning.

In light of what you described as a mass that's obstructing/restricting the passage of stool, you'll need to keep the stool as soft as possible (without causing diarrhea). And, you'll need to act fairly quickly, I think.

You mentioned Lactulose. Do you have that?

You also said " I thought about giving her another laxatif (polyethylene glycol 4000 aka magrocol 4000)...." Do you have that?

The magrocol will be easier to administer. It should be mixed with water and can be put into food or (very carefully) given by mouth. Lactulose isn't tolerated very well by many cats (it's a thick, sugary syrup) - and it can be dangerous given by mouth should the cat aspirate (breathe it in/choke) it.

If your Vet has spoken about these already, then it's your decision. If not, best is to consult w/him.

Here's some information about how much to use: Osmotic Laxatives

Magrocol is very similar to Miralax - 1/8 teaspoonful once/twice a day to start is normal (I would likely do 2x day) - if the result is too loose feces, reduce dosage, if stool is too hard, increase the dosage.

Keep us updated!
 
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Emma2

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Hi Emma2 Emma2

The feces/stool being "a little dry" is concerning.

In light of what you described as a mass that's obstructing/restricting the passage of stool, you'll need to keep the stool as soft as possible (without causing diarrhea). And, you'll need to act fairly quickly, I think.

You mentioned Lactulose. Do you have that?

You also said " I thought about giving her another laxatif (polyethylene glycol 4000 aka magrocol 4000)...." Do you have that?

The magrocol will be easier to administer. It should be mixed with water and can be put into food or (very carefully) given by mouth. Lactulose isn't tolerated very well by many cats (it's a thick, sugary syrup) - and it can be dangerous given by mouth should the cat aspirate (breathe it in/choke) it.

If your Vet has spoken about these already, then it's your decision. If not, best is to consult w/him.

Here's some information about how much to use: Osmotic Laxatives

Magrocol is very similar to Miralax - 1/8 teaspoonful once/twice a day to start is normal (I would likely do 2x day) - if the result is too loose feces, reduce dosage, if stool is too hard, increase the dosage.

Keep us updated!
Hi,
I agree, the stools should stay soft otherwise she won't be able to pass them.
She is currently on lactulose and has been for the last few months, but she always ends up constipated. I'm not sure why it isn't effective on her.
For now i have something called Movicol which is Magrocol 3350 + electrolytes (sodium chloride + sodium bicarbonate + potassium chloride). Now that she isn't obstipated anymore, i could give her that but I'm worried about the electrolytes. If anyone knows if it's safe to give cats electrolytes, please let me know.
20230324_173706.jpg

I ordered Macrogol 4000 without electrolytes, but haven't received it yet.

PS: i asked the vet about the movicol, but he didn't know it.
 
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white shadow

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She is currently on lactulose and has been for the last few months, but she always ends up constipated. I'm not sure why it isn't effective on her.
OK. So, continue to use Lactulose.....but, in a larger/greater amount
.
Increasing the amount of Lactulose will cause a wetter, softer stool.

How much more Lactulose should you give? You will only know by trial, because every cat and every circumstance is different/unique.

If too much is given, the stool will become very watery.

You might make a judgement by considering how much of a difference in stool softness occurred with the current dosage. If the stool was no different, you might try doubling that dosage and then observing for a change in the next following stool she produces. If the difference was only minor, you could try with an extra 1/2 of the amount....i.e. 1 1/2 times the original dose. Small increments are the way to go, and then increasing or decreasing if necessary.

What is the dosage you've been using?

In the long term there is an another related issue that you'll have to monitor for, but we can address that once you have her producing a sufficiently soft stool.

While your Vet may not have heard of Macrogol use, because the question is more related to the added electrolytes.....ask him if your cat could/would be harmed by the amount of those electrolytes in there. My understanding is that an otherwise healthy cat would not....but, he is the Vet!
 
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