I certainly have to hand it to you for your diligence in creating this. Very interesting that March 11 is so different from March 15, for example. Glad that there is some improvement; keep us posted.
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Repeating Rectal Prolapse
- Thread starter Jabzilla
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- #82
Thank you! My fingers are also crossed that things improve rather than getting worse! I'm glad I made the graph too. It's far more helpful for getting a clear idea of this than me simply saying "today his prolapse went in within 2 min and yesterday it took 5 min".
- Thread Starter Thread Starter
- #83
Cosmos's prolapse took about 45 minutes to resolve this morning (which is the longest it's taken since May 17th) and I was able to get some photos. I wanted to have some to refer back to since is the last week of Marbofloxacin. I emailed them to his doctor as well. Unfortunately, the first one is blurry since he kept walking around.
And these two are from when the prolapse was slowly resolving.
When I came back to check on him after that last photo, the prolapse was gone. I'm looking forward to finding out what the next steps would be once we see how he does without the Marbofloxacin.
And these two are from when the prolapse was slowly resolving.
When I came back to check on him after that last photo, the prolapse was gone. I'm looking forward to finding out what the next steps would be once we see how he does without the Marbofloxacin.
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- Thread Starter Thread Starter
- #84
Hey folks,
I have another update on Cosmos. He continues to do well and his prolapses have gone back to resolving within a short amount of time. His previous slow one took 22 min on Saturday. I noticed that his poop was a bit firmer on days where the prolapse resolved quickly, so starting on Sunday I reduced his Restoralax to one 1/8th tsp a day instead of two. Since doing that, his prolapses have resolved within 2min or less and this evening he pooped without producing a visible prolapse at all. I also had a check in with the internal med specialist's assistant to hear what the doctor's next steps would be. She said I can bring him in to do some blood work to test for toxoplasmosis, as that can cause rectal prolapses as well. And then based on those results a colonoscopy would be considered.
I'm wary of bringing him in when things are going well since going to the hospital is stressful for him. He also doesn't have any of the symptoms listed for toxoplasmosis. Aside from the prolapses, he's still completely normal. The assistant said since his prolapses are resolving quickly, I can continue to monitor him and she will check in again in a few weeks to see how he's doing and evaluate from there. In the meantime, if his prolapses go back to taking 20+ min to resolve then I'll call them and schedule an appointment to have to test done.
The assistant said it was odd that reducing the amount of Restoralax given results in faster resolving prolapses. She said usually its straining to poop that causes prolapsing to happen and that softening the poop helps to prevent that. Cosmos has never done things by the book, so it figures his body would do the opposite. As ever since this whole thing started, the softer his poop has been the longer his resulting prolapse would take to resolve. He's never had hard round ball constipated poops either. A normal poop for him is firm and segmented. I've been giving him Restoralax purely because the vets said to do so, yet from February to now he's gone from getting 1/4tsp twice a day to 1/8th tsp once a day as his prolapses continue to shrink and resolve faster.
I am quite pleased to be able to provide a positive update!
I sent photos from Saturday and an updated graph to the specialist as well.
I have another update on Cosmos. He continues to do well and his prolapses have gone back to resolving within a short amount of time. His previous slow one took 22 min on Saturday. I noticed that his poop was a bit firmer on days where the prolapse resolved quickly, so starting on Sunday I reduced his Restoralax to one 1/8th tsp a day instead of two. Since doing that, his prolapses have resolved within 2min or less and this evening he pooped without producing a visible prolapse at all. I also had a check in with the internal med specialist's assistant to hear what the doctor's next steps would be. She said I can bring him in to do some blood work to test for toxoplasmosis, as that can cause rectal prolapses as well. And then based on those results a colonoscopy would be considered.
I'm wary of bringing him in when things are going well since going to the hospital is stressful for him. He also doesn't have any of the symptoms listed for toxoplasmosis. Aside from the prolapses, he's still completely normal. The assistant said since his prolapses are resolving quickly, I can continue to monitor him and she will check in again in a few weeks to see how he's doing and evaluate from there. In the meantime, if his prolapses go back to taking 20+ min to resolve then I'll call them and schedule an appointment to have to test done.
The assistant said it was odd that reducing the amount of Restoralax given results in faster resolving prolapses. She said usually its straining to poop that causes prolapsing to happen and that softening the poop helps to prevent that. Cosmos has never done things by the book, so it figures his body would do the opposite. As ever since this whole thing started, the softer his poop has been the longer his resulting prolapse would take to resolve. He's never had hard round ball constipated poops either. A normal poop for him is firm and segmented. I've been giving him Restoralax purely because the vets said to do so, yet from February to now he's gone from getting 1/4tsp twice a day to 1/8th tsp once a day as his prolapses continue to shrink and resolve faster.
I am quite pleased to be able to provide a positive update!
I sent photos from Saturday and an updated graph to the specialist as well.
Great update! I hope things keep going in this direction 
Wonderful news! I would monitor before jumping into anything else if he continues to do well.
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Jabzilla - thank you for your updates! Glad to hear Cosmos is doing great. You really are helping a lot w/these updates. Mango is prolapse free - in addition to those magic pills I dewormed him ( w/diatomaceous earth, he wouldn't eat food w/otc deworming meds ), I added Proviable and he is doing so great for his age ( 13! as a feral cat ). Miau is not so good. He has high B12 [ I have done a bunch of biome testing on my own, some vets do know the cause for this, but not his vet ], had urinary ph 8, yet his vet 'is not concerned', and won't treat for 'unspecific pain' - aka postprandial dyspepsia, abdominal pain and oxidized blood in his stool. This is the same vet that told me years ago that diabetic cats are peeing standing because of the 'pee jet pressure'.
I can't figure the fiber part - none of my cats - including mango - seem to tolerate psyllium :-(
But re: Restolax ( I believe this is the same as Miralax? ). I learned from feline diabetes site something very important: ecid ( every cat is different ). I used to add Miralax 1/4 bid for Miau to help his poop ( despite not having diarheea, he had marked tenesmus - this is a sign for colitis imo - and for my human GI doctor, not for the vet). And it did made his poop softer and larger except ... he was not pooping. For 3-4 days. Cisapride did nothing. I would have to massage his belly, place him in the litter box etc etc etc. And finally he would poop this massive logs ( normal diameter, but after 4 days, you can imagine ... ). And there would still be straining ( and still red around his opening ).
Cats are really good at removing water from the colon, so I taught it should be related to that. Some probiotic I got in Singapore did wonders for his colon, but it has inulin, so the first part of GI was not happy ( maybe I should add acidophilus )
What I can suggest: try those miracle pills for prolapse - even Miau is straining less w/them. Might be just a muscle tone thing. Do a biome test - and if you need to do a colonoscopy, ask if it makes sense to do a fecal transplant. Cosmos was on tylan, and tylan is known to mess up si/li biome. For Thor, my diabetic kitty, it made tremendously difference.
Thanks again for updating!
I can't figure the fiber part - none of my cats - including mango - seem to tolerate psyllium :-(
But re: Restolax ( I believe this is the same as Miralax? ). I learned from feline diabetes site something very important: ecid ( every cat is different ). I used to add Miralax 1/4 bid for Miau to help his poop ( despite not having diarheea, he had marked tenesmus - this is a sign for colitis imo - and for my human GI doctor, not for the vet). And it did made his poop softer and larger except ... he was not pooping. For 3-4 days. Cisapride did nothing. I would have to massage his belly, place him in the litter box etc etc etc. And finally he would poop this massive logs ( normal diameter, but after 4 days, you can imagine ... ). And there would still be straining ( and still red around his opening ).
Cats are really good at removing water from the colon, so I taught it should be related to that. Some probiotic I got in Singapore did wonders for his colon, but it has inulin, so the first part of GI was not happy ( maybe I should add acidophilus )
What I can suggest: try those miracle pills for prolapse - even Miau is straining less w/them. Might be just a muscle tone thing. Do a biome test - and if you need to do a colonoscopy, ask if it makes sense to do a fecal transplant. Cosmos was on tylan, and tylan is known to mess up si/li biome. For Thor, my diabetic kitty, it made tremendously difference.
Thanks again for updating!
- Thread Starter Thread Starter
- #88
Hey folks,
I have a very quick update on Cosmos since I'm at work and have to be fast. He's still doing very well. No signs of illness or issues aside from the prolapse. It's been almost a month since he's been off the Marbofloxacin and there hasn't really been any adverse effect. He had the toxoplasmosis test done a couple of weeks ago and it came back negative, as expected. Tomorrow he's going to have a colonoscopy and some tissue biopsies will be sent out for a FISH test and culture. I am less convinced that the prolapsing is caused by granulomatous colitis like the specialist estimated because there hasn't been much of a change since stopping the medication for that and he doesn't have any signs of illness. To me, this seems like an injury of some kind. As if a piece of bone is lodged somewhere in his rectum and is the source of the continued irritation and prolapse. I dont know though and I'm trying not to get caught up in a speculation spiral. The FISH test and cultures probably wont have results immediately, but tomorrow we can at least find out if his entire colon is inflamed and/or if there's some kind of physical thing in there that's causing the prolapses to occur.
I'll try to come back on here tomorrow to respond to what folks have said previously! I'll also share answers from the colonoscopy once I have them.
I have a very quick update on Cosmos since I'm at work and have to be fast. He's still doing very well. No signs of illness or issues aside from the prolapse. It's been almost a month since he's been off the Marbofloxacin and there hasn't really been any adverse effect. He had the toxoplasmosis test done a couple of weeks ago and it came back negative, as expected. Tomorrow he's going to have a colonoscopy and some tissue biopsies will be sent out for a FISH test and culture. I am less convinced that the prolapsing is caused by granulomatous colitis like the specialist estimated because there hasn't been much of a change since stopping the medication for that and he doesn't have any signs of illness. To me, this seems like an injury of some kind. As if a piece of bone is lodged somewhere in his rectum and is the source of the continued irritation and prolapse. I dont know though and I'm trying not to get caught up in a speculation spiral. The FISH test and cultures probably wont have results immediately, but tomorrow we can at least find out if his entire colon is inflamed and/or if there's some kind of physical thing in there that's causing the prolapses to occur.
I'll try to come back on here tomorrow to respond to what folks have said previously! I'll also share answers from the colonoscopy once I have them.
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Good luck! Hope all will go smooth, for you and Cosmos!
Good luck! We will be waiting to hear how things go and what they say.
- Thread Starter Thread Starter
- #91
Alrighty, it's time for a Cosmos update! He did very well today <3 The specialist was able to look at his entire colon and took 15 biopsy samples. There weren't any masses or lumps, and the walls of the colon were good. There were some patches though that would bleed easily if touched by the scope. I looked at the photos that were taken during the procedure and they didn't look like the ones from the granulomatous colitis case that was published online. Escherichia coli-induced granulomatous colitis in a cat - PubMed (nih.gov) His didn't have that red swirling pattern of lesions, thankfully. I noticed the discharge instructions say suspected IBD vs granulomatous colitis, but of course the final result will come from the FISH test and histology. I got to see where the prolapse is coming from in the photos too. She said there's a small pocket between where the colon starts and the rectum, that's the source of the prolapse. The photo from that area showed very puffy pink tissue as opposed to the flat, pale colon tissue. It's so weird that this one specific section is having that inflamed reaction. Thankfully the tissue there was pink rather than the angry red of the early days of this ordeal.
Cosmos was given a steroid shot and will be placed on a short course of Prednisolone. The doctor said once we get the results from the biopsies she'll be able to put together a plan for moving forward. If it turns out that he will need to be on steroids longer, she will place him on a topical one (I forgot the name of it, it started with a B) since she said that one has less side effects. I was also told to remove duck from his food rotation since the level of fat in his blood was higher than it should be for a fasted cat. That made sense since his batch of food this week does contain duck. That will be an easy change to make. <3 Since coming home, Cosmos has been very happily eating to make up for being fasted since 4pm yesterday. He's been a bit loopy as the sedatives are still wearing off, but he purrs loudly whenever I pet him. <3 He also pooped this evening and either didn't prolapse or it resolved very quickly (within less than a minute).
Cosmos was given a steroid shot and will be placed on a short course of Prednisolone. The doctor said once we get the results from the biopsies she'll be able to put together a plan for moving forward. If it turns out that he will need to be on steroids longer, she will place him on a topical one (I forgot the name of it, it started with a B) since she said that one has less side effects. I was also told to remove duck from his food rotation since the level of fat in his blood was higher than it should be for a fasted cat. That made sense since his batch of food this week does contain duck. That will be an easy change to make. <3 Since coming home, Cosmos has been very happily eating to make up for being fasted since 4pm yesterday. He's been a bit loopy as the sedatives are still wearing off, but he purrs loudly whenever I pet him. <3 He also pooped this evening and either didn't prolapse or it resolved very quickly (within less than a minute).
Thank you so much for the update; it is good to read that you have good news for Cosmos. Interesting where the prolapse originates. Please let us know the results of the biopsy. You have certainly provided the best care for Cosmos that is possible.
- Thread Starter Thread Starter
- #93
Thank you! He's my sweet little muffin and I want to do everything I can to help him be well. <3 Even more good news, I haven't seen a prolapse from any of his poops so far since he was given the steroid shot and his prednisolone. Fingers crossed that'll be all he needed!
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- #94
Hey everyone,
I got some of the test results for Cosmos! The specialist's initial theory was correct with an infiltration of E Coli into the walls of his colon. The biopsy revealed high numbers of that and Enterococcus in the tissue samples. Thankfully, both bacteria are sensitive to Marbofloxacin, so Cosmos has been placed back on that. The biopsy revealed that he also has mild lymphoplasmacytic colitis in random spots in the colon, while other spots are normal. The specialist explained that's one of the three types of IBD. The one he has is when the immune system is overreacting and attacking itself, so the prednisolone will help with that. I dont remember the names of the other two types but one is IBD resulting from parasites and the other is IBD resulting from food allergies. No signs of cancer or mega colon were found.
The specialist said she's hoping the FISH test results will come in next week, but feels like the biopsy results are more than enough to return to the use of Marbofloxacin. She wants Cosmos to stay on the prednisolone for a month while resuming the Marbofloxacin. She said the two of them will address the inflammation and the bacteria. There has already been improvement with just the steroid. The prolapses are much smaller and resolve within a minute or less. Unfortunately, the prednisolone makes Cosmos tired (on top of being hungry all the time) so he doesn't want to run around and play. Hopefully he wont have to take it for more than a month.
I am pleased with these results as they show that his prolapsing is indeed treatable and there isn't an underlying life threatening issue. <3
I got some of the test results for Cosmos! The specialist's initial theory was correct with an infiltration of E Coli into the walls of his colon. The biopsy revealed high numbers of that and Enterococcus in the tissue samples. Thankfully, both bacteria are sensitive to Marbofloxacin, so Cosmos has been placed back on that. The biopsy revealed that he also has mild lymphoplasmacytic colitis in random spots in the colon, while other spots are normal. The specialist explained that's one of the three types of IBD. The one he has is when the immune system is overreacting and attacking itself, so the prednisolone will help with that. I dont remember the names of the other two types but one is IBD resulting from parasites and the other is IBD resulting from food allergies. No signs of cancer or mega colon were found.
The specialist said she's hoping the FISH test results will come in next week, but feels like the biopsy results are more than enough to return to the use of Marbofloxacin. She wants Cosmos to stay on the prednisolone for a month while resuming the Marbofloxacin. She said the two of them will address the inflammation and the bacteria. There has already been improvement with just the steroid. The prolapses are much smaller and resolve within a minute or less. Unfortunately, the prednisolone makes Cosmos tired (on top of being hungry all the time) so he doesn't want to run around and play. Hopefully he wont have to take it for more than a month.
I am pleased with these results as they show that his prolapsing is indeed treatable and there isn't an underlying life threatening issue. <3
Such good news!
Make sure that he is tapered off the prednisolone over a week or more. Stopping it cold turkey can make him sick.
I have a cat who has such bad allergies that he practically lives on pred. He eats like a horse and sleeps a lot, but tapers off periodically and his normal self shines through.
Good to hear his issue is curable. You’ve really done so much for him!
Make sure that he is tapered off the prednisolone over a week or more. Stopping it cold turkey can make him sick.
I have a cat who has such bad allergies that he practically lives on pred. He eats like a horse and sleeps a lot, but tapers off periodically and his normal self shines through.
Good to hear his issue is curable. You’ve really done so much for him!
- Thread Starter Thread Starter
- #96
Thanks Sarthur! It's good to know that tiredness is indeed a side effect of the medication rather than this being another weird thing that's specific to him. I'm also glad to hear that your cat's personality returns to normal when he's tapered off of the pred as well! <3
While this has been a very expensive venture, I'm glad we did it as these results are far better than what the first vet was saying. The one who wanted me to put him on Hills food and then said I'd have to make a hard decision in response to Cosmos' prolapses continuing. The idea of putting him to sleep over this is infuriating and absurd, just because that doctor didn't know why it was happening! I am so very grateful that there's an internal medicine specialist here in the city and that she's been able to work with us to get to the bottom of the issue! <3
While this has been a very expensive venture, I'm glad we did it as these results are far better than what the first vet was saying. The one who wanted me to put him on Hills food and then said I'd have to make a hard decision in response to Cosmos' prolapses continuing. The idea of putting him to sleep over this is infuriating and absurd, just because that doctor didn't know why it was happening! I am so very grateful that there's an internal medicine specialist here in the city and that she's been able to work with us to get to the bottom of the issue! <3
- Thread Starter Thread Starter
- #97
Hey folks,
I have another update on Cosmos. The FISH test results finally came back and he does not have granulomatous colitis! So the specialist says that just leaves IBD as the culprit based on the results from those diagnostics. She's increasing his dose of prednisolone for now in the hopes of that resolving what's left of the prolapsing. Since starting on pred in July, Cosmos' prolapses have been much smaller and almost always resolved in 3 min or less, often less. I took a picture of the one from this morning and showed it to her today, she said it looked almost normal. I'll include the photo to this post as well for reference. I asked how long he would have to be on the steroid and the specialist said once the prolapsing stops, he can be tapered off it after another few weeks. I'm SO glad her answer wasn't that he would need to be on it for life!
Cosmos was given a steroid shot after his colonoscopy and didn't prolapse for two days afterwards. So hopefully this higher dose of prednisolone will stop it completely and as soon as possible. As the less time he has to be on it, the better. The specialist also said to stop the Marvofloxacin, since the FISH test showed the bacteria was in the lumen where it belongs, rather than infiltrating into the lining of the colon.
I have another update on Cosmos. The FISH test results finally came back and he does not have granulomatous colitis! So the specialist says that just leaves IBD as the culprit based on the results from those diagnostics. She's increasing his dose of prednisolone for now in the hopes of that resolving what's left of the prolapsing. Since starting on pred in July, Cosmos' prolapses have been much smaller and almost always resolved in 3 min or less, often less. I took a picture of the one from this morning and showed it to her today, she said it looked almost normal. I'll include the photo to this post as well for reference. I asked how long he would have to be on the steroid and the specialist said once the prolapsing stops, he can be tapered off it after another few weeks. I'm SO glad her answer wasn't that he would need to be on it for life!
Cosmos was given a steroid shot after his colonoscopy and didn't prolapse for two days afterwards. So hopefully this higher dose of prednisolone will stop it completely and as soon as possible. As the less time he has to be on it, the better. The specialist also said to stop the Marvofloxacin, since the FISH test showed the bacteria was in the lumen where it belongs, rather than infiltrating into the lining of the colon.
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This seems like good news. Especially that he won't need to be on the pred for his lifetime.
Thanks for the update
Thanks for the update
Thank you for letting us know! The pic does look good and hopefully this long ordeal is winding down.
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- #100
You're welcome! I also really hope that things are winding down now. This has gone on for so long at this point. Thankfully, Cosmos doesn't seem bothered by it. The prednisolone is having far more of an impact on his life than the prolapses, as the higher dose has made him tired again, on top of always wanting to eat. Aside from those side effects though, he is doing well. <3
