Repeating Rectal Prolapse

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Jabzilla

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Aaaaaand back to the hospital we go. Cosmos had another prolapse through his purse string. Sugar water didn't help and I learned from last week that if it doesn't work the first two times, trying for four hours wont make it work either. So this time we're going back to the people who can actually fix it. It's REALLY exhausting having to rush to the vet literally every week now. He also continues to be tired of rabbit. He ate 32 out of 60g for breakfast and only because I added some pork to it. Even then, he had to be bribed with some freeze dried kangaroo sprinkled on top.
 

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I caved and offered him some pork in desperation. After looking at it for a bit, Cosmos picked it up, growled at his sister, and carried the chunk away to eat on the other side of the room. I continued giving him more chunks and he ended up eating 50g of it, the most he's eaten in one sitting since the trial started. Prior to this trial, eating 50g per meal was normal for him. I'm going to let the specialist know this as well. If she thinks he might have an allergy, I'd much rather remove things like beef, lamb (which he already rarely gets since it gives him chin acne), and any other protein that's potentially problem, rather than removing everything and only feeding him one thing. Doing that makes the most sense for allergy testing and I understand why it's done. But if he won't eat then that's not solving anything and creates another problem.

I looked through my daily notes (I record what he eats, how much, and the contents of the litter box every morning and evening) from a couple of years ago and saw that Cosmos used to throw up hairballs multiple times a month before I found out about egg yolks and added them to his diet. Since then, he only throws them up a couple times a year. Removing them for a trial is an example of returning to a problem that'd already been solved. I also saw a note from 2020 saying his pudding poop stopped when he isn't given beef or lamb. I'd clearly forgotten about that since beef has been a weekly staple in his diet for almost two years now. Coincidentally, I'd removed beef and turkey from his homemade food last week to see if anything would happen. I can easily continue that while feeding Cosmos rabbit, pork, kangaroo, venison, quail, blue lipped mussels, pheasant, egg yolks etc in various combinations that he will happily eat.

I'm looking forward to hearing what the specialist will say about this. I asked what happens when he gets tired of rabbit and the technician said to feed him the next food on the list and to keep doing that each time he tires of the previous thing. Which doesn't seem like much of a trial since Cosmos tires of eating the same food after a couple of days. When the vet he was seeing prior to the specialist said to do a Hills Science Diet trial, I asked him what happens when Cosmos refuses to eat it. He laughed and said to believe.................................... :confused:
Ignore me if I overstep: one of my cats did the same. I don't know about Cosmo, but for mine it meant the food was not agreeing with him / making him nauseous without the classic lip smacking etc etc. "The CNS also memorises substances that have made us sick in the past to avoid future harm, a phenomenon called conditioned taste aversion (CTA)." While for humans, I'm sure it's valid for cats too.

Ex: I told the hospital that my cat HATES purina dm wet. Normal temp on admission. He is given the usual meds, including mirataz, and he eats like a champ ... Purina DM. His metronizadole is lowered; his temperature spikes to 104 ( dr is notified ), BG off the roof ( but hey, he's either acro either insulin resistant ); pudding poop. He is growling ( he never ever did ) and 'agitated'."
After figuring out a few things - he would eat the same food day after day without being bored or miserable. He wouldn't even cared for my other cat's commercial food.
I knew from the protein profile that rabbit will not work for my cat. Yet I tried it and I was right ... I would add some pumpkin and cut anything fish - at least no bloody stools / straining when pooping for us. It's a bit mind blowing that so many cats with the same symptoms, yet vets have no idea ( or care to listen ). I've sent you a private message, but probably you missed it ... good luck to dear Cosmo -
Oh, and hydrolized food - yes, good humongous poop ( RC dry ), with a 4cm diameter, he jumped from the litter box without covering it. Yes, colon inflammation probably went down, but the rice in it - still had massive abdominal pain, lethargy and sleeping ... and not covering pee.
 

fionasmom

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I am so sorry that you are doing all of this one more time. Let us know. As for the food, no one could be trying harder with this and he does have to eat. My vet, no matter what has ever gone on with my cats, has said that they have to eat, bottom line.

Being told to believe.......wow!
 
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Jabzilla

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Thank you Gizzieblue and Fionasmom. Gizzieblue, I got your message. I just haven't had a chance to respond since my life has been taken over with working overtime at my job and Cosmos's issues. I will get back to you though.

I just got a call from the hospital. Cosmos is ready to come home. They were able to get the prolapse back in without having to do much. A few applications of dextrose reduced it a little, but they ended up sedating him and preparing to push the tissue back in. The doctor said when she came over with the lube and such, the prolapse had already sucked itself back in. So it turns out if Cosmos is relaxed and not pushing outwards, the tissue will go back in on itself. The sad thing is that the only way to get him to that state once the prolapse occurs is to knock him out via sedation. Since if he's awake, he's pushing on it to some degree, despite pain meds. The vet gave him a new purse string while he was sedated. She also spoke to the internal med specialist to let her know what happened and to tell her about the failed food trial. The specialist gave the go ahead to feed Cosmos whatever protein he will eat for now and we'll talk more about it in our check in tomorrow.

And yeah, I was absolutely FLOORED when that previous doctor told me to simply believe. He also said there's no way to know that switching to raw fixed the weird inflammation Cosmos had on one side of one section of his small intestine as a kitten, yet insisted that feeding him Hills z/d would solve his current problem. I'm so glad Cosmos isn't seeing that doctor anymore and is in much better hands!

Overall, Cosmos seems to be feeling much better since the start of all of this. He doesn't sleep on his cat tree all day and is instead active. He chases his sister, relaxes in multiple locations in the apartment, and plays with toys. I think the marbofloxacin is working. <3 He's no longer on Prednisone, as he took the last of that on Sunday. Cosmos is also no longer taking Tylosin. Just the Marbofloxacin, Nordic Naturals fish oil, Restoralax, S Bouardii, Lactulose, Animal Biome Kitty GMP, and the Adored Beast Gut Soothe.

Oh, also I haven't seen any blood on his bottom after pooping. If there is blood it's accompanied by a prolapse and the blood is on the prolapsed tissue. But no more blood on his anus or fur from prolapse free poops!
 
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gizzieblue

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That's fantastic! Glad to hear he's full of energy! Marbofloxacin started working for my other cat in 24 hours. RC my other guy cry in pain, no matter how much water I would add to the biscuits.
 

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I am so glad to read good news and, once again, I hope that you have possibly resolved this. It is understandable that the prolapse might go back in if Cosmos relaxed, but it probably feels so odd or disturbing that he can't, poor guy.
 
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The saga continues, lol. Cosmos had a prolapse on Tuesday night, but it went back in with some dextrose. He prolapsed again last night and I wasn't able to get it to go back in, so I took him to the hospital. The vet was able to get the tissue to go back inside via dextrose w/o having to sedate him, thankfully. At this point, the internal medicine specialist says if he prolapses again to have the doctor who sees him remove the purse strings, as she wants to see how he does without them and suspects they might be making it harder for the tissue to go back in on its own. Cosmos also has a recheck appointment with her in a few weeks and the specialist will decide on whether or not she wants to have a colonoscopy done since the prolapsing hasn't stopped.

The poop test results have come in and it's negative for dry FIP. Cosmos is continuing on the marbofloxacin and supplements. He's doing well and there isn't any blood when he poops. It's just the weird repeating small prolapses that are his only issue.
 

fionasmom

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Interesting about the purse strings complicating this. Hopefully this will end and you won't have another episode, but this has to be so wearing on both of you. If it does not stop, I suppose that proceeding with the investigation might be warranted. There is a certain amount of preparation for that like withholding food, using a laxative, possibly an enema but it might give some conclusive answers.
 
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Jabzilla

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Time for a quick Cosmos update. Sorry for taking so long, it's crunch time at work so my life has been 98% that. Cosmos is doing very well. He's the most playful on a daily basis than he's been in months. <3 He had a recheck with the specialist last week and she said his bottom looked perfect. The prolapses still happen when he poops, but they've been small and going back in on their own sooner and sooner. The one for this morning went back in within a minute after happening. The tissue is also finally returning to the more normal pink color instead of being so bright red from inflammation. Last week the specialist said we would give him a short course of Prednisone if the inflammation isn't improving. I sent her a photo on Monday showing the increasingly pink tissue on the prolapse, so it seems like the steroid won't be needed. He's still taking Marbofloxacin, Adored Beast Gut Soothe, the Animal Biome Kitty GMP, Nordic Naturals fish oil, NOW Gi Probiotic, Restoralax, and S Boulardii on a daily basis.

As for the purse string issue, Fionasmom, the specialist was saying that the fact that the strings reduce the diameter of the opening made it harder for the prolapsed tissue to go back in. Since he was still prolapsing with the strings in, she felt like they were making things more difficult instead of helping. Cosmos is definitely having a much better time without them. The specialist also said to keep track of how long it takes the prolapses to go back in. If they aren't consistently going back in sooner, instead of staying out for 15-35 minutes, then she will schedule a colonoscopy. Thankfully, almost all of his prolapses this week have gone back in within 5 minutes or less so far. Last week it was 15 minutes and one that took the 35 min to go back in.

I've also continued keeping him away from beef and lamb. His mysterious red spot on his gums has disappeared and his stud tail that strangely came back despite having been neutered for years is gone as well. <3
 

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First of all, thank you so much for the update. Members really do ask about threads in the future and it is a big help to have updates and, hopefully, good endings. It is wonderful news that Cosmos seems to be turning a corner with this and that he did not need the pred. It is interesting that the strings made everything worse and something to remember for others in this situation. Cosmos must be so much more comfortable and happy about life. It sounds like he is improving all the way around!
 

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Jabzilla - I hope Cosmos is doing great! For Thor - his nasal discharge as well as the stud tail, as well as his stinky breath and 'stridor' - all this went away w/marbofloxacin.
My feral cat ( he is 12, TNR 11 years ago ) recently was not feeling well, he didn't show up for dinner, he did came 4 days later when I called him, but not eating his food, and he ran away from his other 'new' friends. I can pet him, and I guess he trusts me enough coming to me when he is sick while hiding from everybody else - but I can't pick him up, and to take him to the vet he needs to be trapped ( not eating-> not going in the trap ), and regular vets would not treat him - he is feral, acts 'stray' towards me, I would need to contact the org that helped me neuter him/ register him [ this comment is for whoever would urge me to take him to the vet ] - no vet would prescribe medication because 'they haven't seen him'.
Long story short: I noticed ( on the 5th day ) that he had a rectal prolapse - maybe 1.5 cm. Maybe I am being crazy - he never pooped in front of me, maybe he wanted me to see what's hurting him?
He's got the reddish dirt thing on his face, and yes - the stud tail ( again - I've neutered him 11 years ago ). I don't have any zeniquin. He didn't touch the food on the 5th day. I used some Homeopet - digestive advantage to get him to eat a little bit, but he would not get in the trap.

So out of desperation, I found this: BestLife4Pets - Rectal Prolapse and Anal Gland Pain Relief for Cats on amazon.

I crushed 4 pills and mixed with some raw turkey, I added one Vetriscience Antioxidant - and 2 days later I didn't had to call him, he was waiting for me, very vocal, demanding his food. Not hiding from neighbors. Now 4 days later, he still has the prolapse, but it's getting way way smaller, he can actually sit on his butt, pale pink in color. And he didn't poop in front of me again.

For Mango - seems to be working. I don't know - nor do I care - why. It might worth a try if Cosmos still has problems from time to time - the company says it accepts returns if it's not working. Check with the IM, of course, and this is just my experience with my feral cat - it seems to have made him more comfortable - of course, without zeniquin, it's just a band aid.

Mango's been Mouser in Chief@ The Cliffs for 12 years:-)
 
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Jabzilla

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Hey Fionasmom and Gizzieblue,
Thanks for sticking around for this long saga! Cosmos is doing well. His prolapses are now going in on their own within less than five minutes of happening, about 2-3 min on average. I got a nice look at the tissue this evening and it's no longer bright red! Instead it's a mixture of varying shades of pink, with some darker and some lighter areas. It's still crunch time at work so I haven't had time to be around on here. But I saw you'd both commented and wanted to get back to you. His food, medication, and supplement regiment is the same as previously noted, in case anyone needs that info for future reference.

I also agree about the importance of updating these threads too. I've looked through so many in the hopes of finding help only to frequently find the person had stopped updating on whatever the issue was. I want to continue this thread until Cosmos has fully recovered. It's quite possible that this granulomatous colitis might be more common than vets think since it isn't something that's normally checked for due to the idea that cats don't get it.

I'm sorry that your stray, Mango was having some prolapse issues and was feeling unwell Gizzyblue! It sounds like he's recovering though, so that's a relief. I'm glad the things you found were able to help him out!
 

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Most importantly, Cosmos is doing well and seems to be on the mend.

We are always happy to hear from you!

Granulomatous colitis is considered to be very under reported in cats with the suspicion that it may be more common than was thought. I do not believe that I have ever had a cat with it, but the fluorquinolones like marbofloxacin are what is used to treat it.
 

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That's great news!!! Yay for Cosmos! And yay for Mango - if it wouldn't have been for Cosmos, I wouldn't have known what a rectal prolapse is and what was going on with Mango! He was in high spirits last night - I woke up at 2am and he was still on the patio - so I fed him again and crushed 4 tiny pills - and today is the first time I saw outside in the daytime - and prolapse is GONE! Like completely gone. His eyes have those reddish pucks - so I am incline to believe in his case is c perfringens ( he gets highly digestible fresh mice, ff feast from me - and he got some high carbs biscuits from one neighbor). But I don't know if he is pooping normal, if he has diarrheas' or is constipated.
Since Cosmos did not have diarrhea when you added the supplements - Animal Biome Kitty GMP didn't make him constipated I assume? I'm thinking to order it for Mango along with the probiotic you use ( go figure, I don't have that one:-) ), miralax and cat enzymes and feed him raw. May I ask - do u add any fibers to the raw food? I have to add for Miau pumpkin, otherwise he gets depressed ( oh, he hates pumpkin all right! ), but Mango won't touch pumpkin.
I have 2 weeks to fix Mango - Miau is stable but not OK - as I'm going away, and it's stressing me out.
Please thx Cosmos from us! And thank you for coming back to update!
 
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Jabzilla

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Hey folks,
I'm back with a quick Cosmos update. He continues to do very well. Playing and eating enthusiastically w/o any circus. He pooped this morning and for the first time since this started, didn't have a prolapse when he left the box! Fingers crossed that this is the beginning of him consistently pooping without also producing a prolapse! <3 There have been a few changes in his supplement routine. I ran out of Animal Biome Kitty GMP and didn't buy another bottle to replace it since I wasn't sure it was needed. He's up to a full 1ml of Nordic Naturals fish oil twice a day. I ran out of the Now GI Probiotic and have been using Renew Life Ultimate Flora Daily Care Probiotic (once a day with dinner) instead since it was available at Whole Foods, whereas the Now probiotic has to be ordered from iherb. He still gets the Adored Beast Gut Sooth, Renew Life S Boulardii, .5ml of Gabapentin, and 1/8 tsp of Restoralax twice a day. Cosmos is also still taking Marbofloxacin every morning.
 
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fionasmom

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Thank you so much for letting us know! All updates are welcome! This is wonderful news that he did not prolapse today and I certainly hope that you are closing that chapter of both of your lives.
 
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Jabzilla

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That's great news!!! Yay for Cosmos! And yay for Mango - if it wouldn't have been for Cosmos, I wouldn't have known what a rectal prolapse is and what was going on with Mango! He was in high spirits last night - I woke up at 2am and he was still on the patio - so I fed him again and crushed 4 tiny pills - and today is the first time I saw outside in the daytime - and prolapse is GONE! Like completely gone. His eyes have those reddish pucks - so I am incline to believe in his case is c perfringens ( he gets highly digestible fresh mice, ff feast from me - and he got some high carbs biscuits from one neighbor). But I don't know if he is pooping normal, if he has diarrheas' or is constipated.
Since Cosmos did not have diarrhea when you added the supplements - Animal Biome Kitty GMP didn't make him constipated I assume? I'm thinking to order it for Mango along with the probiotic you use ( go figure, I don't have that one:-) ), miralax and cat enzymes and feed him raw. May I ask - do u add any fibers to the raw food? I have to add for Miau pumpkin, otherwise he gets depressed ( oh, he hates pumpkin all right! ), but Mango won't touch pumpkin.
I have 2 weeks to fix Mango - Miau is stable but not OK - as I'm going away, and it's stressing me out.
Please thx Cosmos from us! And thank you for coming back to update!
I'm so glad Cosmos's experience has helped you with Mango and that his prolapse has stopped! That's also why I wanted to post about it here, in the hopes that it would be helpful for folks in the future. As for the condition of Mango's eyes, I haven't had that experience with my cats before and don't know what caused it. If I had to guess, swelling and irritation around the eyes sounds like an allergy of some kind. It could be from the biscuits or an ingredient in the Fancy Feast.

The Kitty GMP didn't give Cosmos any constipation. He's been getting Restoralax twice a day though, so I'm not sure if that would have been the case otherwise. The probiotics I've used for Cosmos are:
Clinical GI Probiotic | Natural Vegetable Capsules | NOW (nowfoods.com) <- I ran out of this and now use the Renew Life one.
Renew Life® Probiotics Ultimate Flora® Daily Care™ Probiotic, Helps support your body's natural digestive system, 30 Billion Active Cultures, 30 Vegetarian capsules : Amazon.ca: Health & Personal Care
Renew Life BoulardiiMAX, Intestinal Targeting, Antibiotic-Associated Diarrhea, Travel Support Probiotic, 30 Vegetable Capsules, 1 Count : Amazon.ca: Health & Personal Care

As for fiber, Cosmos gets 4 grams of Psyllium Husk added to his weekly batch of food. I dont know how much that would be per day since I mix it all in as part of the food making process and then portion it all out into daily containers. Feeding Mango raw is an excellent idea, as I always advocate for raw food for cats. The only thing though is that the majority of commercial raw food has way too much bone. It's cheaper to just make the food yourself and that enables you to be in charge of every single ingredient. I use this sheet to put together the recipes for both of my cats food. Raw Fed and Nerdy Formulation Sheet - Raw Fed and Nerdy It's extremely helpful and ensures you're giving your cats every vitamin, mineral, protien, and fatty acid that they need based on their weigh t& activity level. No guess work on how much food or how much of what ingredient your cat would need. I also highly recommend taking their nutrition class as well. It seems daunting at first, but the info it very helpful if you read through it and helps make their spreadsheet make sense.
 
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Jabzilla

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Hey folks,
I have an update on Cosmos. He's still doing well despite the prolapses continuing to occur. For some reason, this month has had more prolapses that take longer than 2min to resolve. No hospital visits though, thankfully. I got a call from the internal medicine specialist's assistant yesterday to check in on him and discuss the next steps. Since he's been on the Marbofloxacin for over 3 months now, the doctor wants to take him off of it in two weeks. She's going to call me back in three weeks to see how he's doing without it. If things get worse, then she said we'll do the colonoscopy and biopsy for further diagnostics. If things improve, then nothing needs to be done. If there aren't any changes then she'll talk about other options. Cosmos is to continue taking the supplements and Gabapentin until the specialist says otherwise.

I made a bar graph with all of the times that it took for his prolapses to resolve from March to now. I'll updated it each day and will send it to the vet on the third week. Hopefully that will help to determine how things are going. Even looking at it myself, it's hard to tell. Each month has multiple days where his prolapses resolved within 2 min or less, some days where it resolved within 5-10 min, a couple that were 10-20 min and then a few random days where it took 30-90 min for it to resolve. Before doing the graph, I was hoping the results would show a clear path of improvement but instead it shows lots of variation in the time taken for the prolapses to go back in.

It's still so strange that all of that is happening while Cosmos is completely normal aside from the prolapses. When they happen, they're still very small, smaller than they were back in February and early March when he had all of those hospital visits. Sometimes it barely comes out at all. The fact that the tissue isn't completely red and has pink areas sounds like an improvement to me. It's just weird that this is still occurring and with such variability. For example last week he had a prolapse that slowly resolved over 90 min and then the next day, his prolapse resolved within 2 minutes. Nothing between those two days was different in terms of his food, medication, or supplements, etc. So I have no idea why there was such a huge difference between the time it took for the prolapse to resolve.

I dont remember which member on here says "healing isn't a straight line" but Cosmos is clearly showing that to be true. I am very grateful though that things haven't been getting worse and that he's his usual happy self despite these prolapses. I'll report back again once he's off the Marbofloxacin.
 
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Here's what I have for the graph so far, in case anyone is curious. The y axis is the time in minutes that it took for his prolapses to resolve, and the x axis is days of the month. Some days have letters beside them because they were days where he pooped more than once and thus prolapsed more than once. February only has two entries since I didn't start timing the prolapses until the last couple of days of that month.
Cosmos Prolapse Resolution Time.png
 

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mrsgreenjeens

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It'll be interesting to see what happens when he comes off that med. Thanks for the update. We'll be waiting for the next one. Hopefully it will be better, not worse :crossfingers:
 
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