Repeating Rectal Prolapse

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Jabzilla

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Ooooh, thank you MrsGreenJeans. I'll look online and see if I can find that one too.

After a string of wonderful days, Cosmos is back at the vets for a prolapse that didn't want to go back in. I spent four hours trying cold water, cold water mixed with sugar, cold compress with sugar and gentle pressure, and slathering on Preparation H. It started out small and Cosmos didn't notice or mind it. After I poured cold water on it though, his attention went to his bottom. He kept trying to groom through his cone and that made it worse. His plastic cone now has blood all over the bottom part from him rubbing it against the prolapse over and over. My afternoon/evening was spent trying to keep him from doing that while also trying to get it to go back inside. I took him to the vet about an hour after trying the Preparation H.

He saw a doctor that we haven't seen before tonight. She had me buy another bottle of Prep H (since I hadn't brought it with me) and she put some on his bottom as well. She's going to wait a few hours and see if it helps the prolapse to go down. If so, she'll push it back in and send him home. If not, then he'll have to have the purse strings put on again. When I got there I asked if he still needed to have the Restoralax twice a day. Yesterday he had a nicely formed poop that was squishable and no prolapse at all. Then his poop from today was very soft. He also pooped multiple times w/ the prolapse out and thus contributing to the difficulty of getting it to go back in. All of todays poops were very soft, with the last bits being squirts. That makes me wonder if having firmer poop would be better. I asked about that when I got there, but didn't get an answer. I ask again when they call me to let me know what they're going to do w/r/t purse strings or no purse strings.

Cosmos also took the last of the Tylosin this morning. I'll give it a full day to go through his system and then will bring in a stool sample for another PCR test on Tuesday.
 
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Jabzilla

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I got an update from the vet. The Preparation H didn't work, so they're going to have to sedate him and do another purse string suture. They're keeping him over night since its already almost 10pm and the procedure hasn't been started yet. Fingers crossed this upcoming week of sutures goes well and we dont have anymore issues with it. I really feel like the fact that he was desperately struggling for so many days with the last one due to the stuck poop prevented things from actually healing.

I wish I had pressed them back when it was happening to make them do something. I had called so many times and brought him in twice to tell them that he is straining so hard his body is shaking, only to be told to either give him more Lactulose or for them to stick a thermometer in his bottom and declare everything fine since they could get it in there. When the overnight doctor calls or when I go to pick him up tomorrow, I will ask them how much Restoralax Cosmos should be given with these sutures in. I dont want a repeat of the previous experience.
 
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I spoke to the vet this morning. He said the next step at this point would be surgery. He isn't worried about the prolapse itself since it's still very small and short. The vet just says it's exhausting that this keeps happening and doesn't want to keep putting Cosmos through all of this. He's going to send some blood out to a lab for a feline leukemia/aids screening (he was vaccinated for that as a kitten) just in case since everything else has already been done. At this point he's at a loss as to why the prolapse keeps happening since every test, exam, x ray, and ultrasound have all been normal except for the colitis that they found.

At this point I dont know what to do as far as when to have the colopexy done. Originally, I was planning on taking Cosmos to a different clinic for a second opinion once the antibiotics were done and the PCR results were in. Now though he's back on antibiotics since they put the purse strings in again. Having a second opinion would be great since its so strange that this is happening. Cosmos is very stressed though. The doctor said he bit three people, which is highly unlike him. Cosmos has never bitten anyone before and has always been very kind and sweet. I asked the vet if the surgery should be done asap or if I should wait until the purse string is removed. He said that's up to me. He said the only benefit of waiting is that if Cosmos prolapses again, I can take him right to the surgical hospital and the doctors there can see it for themselves. He then said they also have photos from the previous prolapse and can send those too.

I've called the surgical hospital to try to find out what they suggest as far as a timeline goes. The person at the front desk is going to have someone from their referral team call me back since she couldn't answer that herself. What do you all think? I really dont want to have to put Cosmos through even more stress of going to another medical facility asap, but I also don't want these prolapses to keep happening.
 
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I spoke to the referral person at the surgical hospital. They've booked Cosmos for an initial consultation on Thursday afternoon. They also told me Gabapentin can be used to help with stress/anxiety before vet visits, so I'll ask about that when I pick him up in an hour.
 

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Oh my goodness. So much has happened in the past 24 hours, and not good stuff :frown:. I'm so sorry all this is happening to you and poor Cosmos I'm sure you're just about at wits' end by now. Him too, I'm guessing, that's why he's biting people at this point. Poor baby.

I don't know what to advise, but am hoping the surgical consult will be of help. But maybe, just maybe, as you said, he will heal from this as long as he doesn't get obstructed again like he did last time :crossfingers: Why does he think possible FeLV? That seems far fetched, and let's hope it is!

When do you get to bring him home?
 

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All I can add is that I am overwhelmed reading this and can only imagine how you and Cosmos feel. No wonder he wants to bite people. I hope that the specialist has something constructive for you.
 
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Thanks for the support MrsGreenJeans and FionasMom! <3 All of this has been exhausting for both Cosmos and myself. I'm going to tell the surgeon all of what's been happening and will ask her to please think outside the box for this case. Both this and his weird one side of one section small intestine inflammation as a kitten (it happened 7 days after him being fed Royal Cannin dry hypoallergenic food by his vet at the time's insistence w/o there even being a problem. They just insisted that he eat this food during his first appointment with them and kept insisting it on his regular kitten visits so I finally caved and bought it for him. Seeing as how RC had carrageenan and a bunch of other garbage in it, I highly suspect his strange kitten inflammation was the fault of that food) seem to be a mystery and don't fit by the book cases of anything. As multiple vets have now said they've treated hundred of cats and dogs w/ clostridium and none of them have been like this. Yet they're unable to find any other source of the problem. As for the FelV, the vet wanted to try that test simply because it's something that hadn't been done yet. Neither of us think it will come back positive. It's just that everything else has been done and the doctor was at a loss for what to do.

I picked Cosmos this afternoon during lunch. His prednisone wasn't given to him last night, despite my asking about it three times. I also saw a bowl of kibble in his kennel. :argh: The technicians had me come to the back to remove him from the kennel due to this mornings incident. No one wanted to touch him after that. They said everything was going well. They'd taken him out for his exam when suddenly he bolted. They tried to catch him while wearing cat gloves, but he bit three people through them. Cosmos bit them so hard that he has two small bruises on his mouth. He also scratched someone so hard that three of his hind foot claws broke down to the quick. Cosmos had reached his limit. He was very happy to see me and cautiously came out of his kennel and I placed him in his carrier w/o issue.

Since being home, he's been purring almost constantly. <3 He's also acting like he hasn't eaten in days, which very well could be the case. The only meal I know he's eaten before coming home was his breakfast from yesterday. Who knows if he ate any of the food he was given while at the vets. Since he's been home, Cosmos has already eaten 100g of food and just ate an additional 51g for dinner. That's already a full days worth of food and he hasn't gotten to his before bed meal. :lol:

No poop so far. The vet said to keep him on 1/8 tsp of Restoralax rather than increasing the dosage for the purse string sutures. Fingers crossed there wont be any issues!
 

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That poor little boy has been through the mill. His extreme acting out is not his fault and I always feel that vets and vet techs need to be aware that this can happen, especially with a cat. I hate to think that they did not feed him the right food but it is great that when he got home he relaxed and ate a nice meal. He was so stressed and anxious.

Did you get gabapentin? Given where you are right now, I would go to the specialist.
 

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I just can't imagine what was going through his mind when they came after him with cat gloves on. He probably thought he was being attacked, poor guy :alright: . It really is no wonder he bit them.

I'm just glad he's home now getting the love (and food) he needs :catrub:. Fingers crossed that all goes well with the new purse strings and that the consultation goes well.
 
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Yeah, I dont blame him either. He was tired of being there and having his bottom messed with. I do have the Gabapentin. I'll give him some an hour or two before his Thursday appointment w/ the surgeon. No poop so far since he's been home. He didn't poop while at the vets either. Early this morning he kept going from one box to another, sitting there thumping his tail in the litter. He left and came back twice before finally producing something. He squatted and peed. Fingers crossed he poops today. His back and forth this morning makes me suspect that he has to but isn't. I really hope there isn't a massive vet food poop sitting in his colon and blocking the way.
 

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I don't have experience w/rectal prolapse, but unfortunately I do w/c perfringens. It's a long/sad story - He was on tylan + weekly b12 + SBoulardii+MOS ( and commercial low carb food, ff, as he was diabetic ) yet he tested 2000+CPA, 2500+CPX. Was resistant to metronizadole and amox/clavulanate, and obviously tylan. Whenever the diarrheas' stopped he was miserable; as your kitty - my giant cat was the mellowest ever, yet after getting cp his personality change. I assume that was because of toxins getting absorbed; too long of a story only now I might have an understanding - but I might be totally wrong. Besides the d. panel, there is a stool test for e coli d [ I'm not sure vets even know! ], but so many other bugs can contribute.

Other members had success with Tummy Works - from what you said about SB having tapioca and this being a problem, he might have some SI inflammation [ imo ] that might impair his protein digestion ( then gets fermented in colon, the colon is getting even more inflamed due to toxic metabolites etc etc ). Some users started w/miralax and tummy works, and than managed to reduce the miralax.

His poop on prescription food might be great because of all the carbs and fibers, and that is soothing for his colon. But imo, it won't solve the problem ...
 
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Thank you Gizzieblue. It's so infuriating for the vets to just write off the C Perf simply because Cosmos's symptoms aren't the same as every other cat and dog they've seen with a clostridium over growth while at the same time scratching their head from not finding some other source of the problem! I'm sorry you too have had to deal with C Pref, it truly is awful. Thank you for your insight too. This morning I ordered a bottle of NOW FOS to add to Cosmos's arsenal. He's still taking the Renew S Boulardii, NOW Clinical GI Probiotic, and the Grey Wolf vet probiotic. I just looked at Tummy Works and sadly, their website doesn't ship to Canada.

Thanks for mentioning E coli too. I just ordered the Animal Biome probiotic that has the anti pathenogenic E Coli bacteriophage. I considered getting some Inulin too, but read that it feeds clostridium and contributes to their growth so I left that one off the list. It's so exhausting not having a doctor to talk to about all of this. I feel like I'm throwing the whole medicine cabinet at him and it really sucks that doing so seems like more than the vets are trying to do. Cosmos isn't eating a prescription food. I refused to give him Hills z/d and instead have him continuing to eat his raw homemade food. I have a spreadsheet from Raw Fed and Nerdy that calculates the how much of every vitamin, mineral, protein, fatty acid, and calories he needs based on his age, weight, and activity level. I've looked at commercial raw foods and haven't found anything that comes close to being as exact and tailored for either of my cats as that amazing spreadsheet. Raw Fed and Nerdy Formulation Sheet - Raw Fed and Nerdy

Thankfully he doesn't have diarreah from the Clostridium. The only diarreah he's had was due to being given so much Lactulose. It's weird that colitis is supposed to cause diarreah due to not removing water from the stool like it normally would, yet Cosmos hasn't had any of that. This whole thing seems to be as far from the standard by the book case as one can be. I'm also grateful that his ultrasound from last week didn't show any inflammation in his small intestine. Everything was normal except for the colitis/prolapse.
 
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The results of the feline leukemia blood test came back tonight. The doctor called and said everything was normal. He then gave me a horrible scare. The vet said the results say Cosmos's red blood cell count is dangerously low and that it means his bone marrow isn't producing new blood. He wanted me to bring him in asap so another CBC could be run to see whether or not the results were accurate. Both he and the pathologist were astonished by how low the test claimed his red and white blood cell count was, especially when everything else is normal and getting the blood wasn't difficult. I told the vet Cosmos had two CBC tests when he was there last week. He checked both tests and with relief said the results for them were normal. The vet had me check Cosmos's gums, which are nice and pink. Thankfully all of that plus Cosmos's ravenous appetite, lack of any symptoms of anemia, and the fact that he hasn't suddenly lost a large amount of blood over the course of a week has led the vet to conclude that there must have been a technical error and the horrifically low blood cell count was incorrect.

He's going to send the results to the surgical hospital anyway but with a note explaining what happened. He told me to tell them as well and let me know that the doctor there will probably want to do their own CBC. I am so very grateful that those awful results are wrong! It's absolutely insane how all of the results for things can be normal but then there's one thing that incorrectly flies in the face of everything else and claims that Cosmos is suddenly dying. Lol, it seems like there's hardly ever an inbetween for him with these doctors. Either Cosmos is fine or Cosmos is fine but also inexplicably dying of insert some awful wtf worthy thing here. Lmao, this is enough to drive me to drink. :flail:
 

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I am glad that the results appeared to be incorrect and that Cosmos seems to be okay. One more thing to add to this entire escapade...
 
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Another day, another update. Cosmos prolapsed again and I took him to the hospital he was referred to. I'm glad we went there since the surgeon came in to see him (he was being treated by the general ER doctor) and got to see the prolapse for herself. She told me that there's no need for him to see her tomorrow for a consultation because there isn't anything she can do. His prolapse has always been very short and round, like a flower bud. The surgeon said she's called in for pets who have the horrifying long tube prolapses. Instead she said Cosmos will be seeing their internal medicine specialist tomorrow morning so we can figure out why this keeps happening.

I am relieved that he wont have to be put through an invasive surgical procedure! Now I have my fingers crossed that the internal medicine doctor can figure out why these prolapses are occurring. They've got his full medical history too and they've sent some blood out for a new CBC test since the last one was so strange. I am also ecstatic that the doctor was able to get the prolapse to go back in on its own. I asked if the sutures could be tightened a little so the prolapse cant happen again, but that would require redoing the purse string entirely. The doctor didn't want to do that because the current purse string is allowing him to poop w/o difficulty. She also gave me a bottle of their amazing dextrose solution and told me how much she used to get the prolapse to go back inside. I'm so grateful for that since I spent five hours this morning/afternoon trying to get it to go back in with cold water, cold sugar water, Prep H, and then just dumping spoonful's of sugar directly onto it. I'm glad to have a bottle of the same solution that the doctor used to get the prolapse to go back in! They also said I can put some Vaseline on it as well if the dextrose doesn't work, to keep the tissue moist.
 
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Cosmos's appointment with the internal medicine specialist was excellent! She's the first vet I've ever spoken to who supports raw food, is glad he's on S Boulardii and human probiotics, and approves of the Animal Biome anti E Coli supplement I ordered. She said Cosmos's CBC results from the blood they took yesterday was normal, confirming the previous results were an error. She looked at his entire veterinary history and his ultrasound from last week. The vet said she saw some dark nodules in the tissue and suspects its granulomatous colitis from an E Coli infection within the tissue. Cosmos was sent home with two weeks of marbofloxacin to target the suspected E Coli. I showed her the Kitty Biome supplement that I ordered and she said that should help as well.

The specialist also said to do a raw food trial as well to see if a possible food intolerance is part of all of this. We decided to go with rabbit since Cosmos likes it and I have access to multiple forms of it. She also said to use Nordic Naturals fish oil rather than feeding small amounts of sardines for omega 3's, and recommended using Gut Soothe from Adored Beasts. If these things don't work, then the next step is a colonoscopy to do a tissue biopsy.

I bought a carton of Big Country Raw Pure Rabbit and will start Cosmos on that for dinner. Over the weekend, I'll go through his spreadsheet to put together a homemade recipe using only rabbit and vitamin/mineral supplements to make up for the other protein sources that are removed.

I am ecstatic to have finally found a vet who supports raw feeding and actually knows about feline nutrition! I feel very positively about Cosmos's treatment with her and hope we've found the source of the problem! <3
 

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I am so glad to hear that this is hopeful! Please let us know how this all plays out. Vets who understand nutrition can be few and far between.
 
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Cosmos is not doing well on this food trial. Each day he's been gradually eating less and less food. He's used to eating multiple proteins with each meal and has already tired of rabbit. Today he's only eaten 86g of food despite a full days worth being 152g. I've tried offering rabbit chunks, ground rabbit, freeze dried rabbit, and rabbit treats. Normally he really likes rabbit, but only having that is wearing on both of us. I also suspect he has a hairball, as he's been doing a lot of grooming and doesn't have any egg yolks due to this trial. I called the vet this morning to tell them about this, but the specialist wasn't there. She doesn't come in until Wednesday. Not wanting to eat also means Cosmos isn't getting anything to drink. He has a water fountain and multiple water bowls but only uses them occasionally.

I bought some cat grass tonight since he was refusing to eat dinner, and he eagerly munched away on it. Hopefully if he does have a hairball this grass will get him to cough it up. He can't continue to eat less food each day. On Saturday he ate 142g, yesterday it was 122g, and now it's not even 90g. At this point I'm wondering if I should just offer him something else to eat entirely as I don't want his food refusal to continue. He's also been given slippery elm syrup just in case nausea is the issue, but that doesn't seem to have helped.
 
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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:
 
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