Slippery Elm Bark, Wet food, Managing Constipation

[ghibli]

 
http://www.thecatsite.com/a/transit...-to-a-new-type-of-food-canned-raw-or-homemade   will help with the transition.  Be patient it could take awhile.  Kitties are huge creatures of habit that is why it is difficult to switch them to another type of food.  Many companies don't play fair with their kibble either.  They spray it with animal digest which kitties love.  You can use a probiotic called Fortiflora that has animal digest in it to entice kitties to eat another food.  Just sprinkle some on the new food, sort of the same thing that the companies do with their kibble.  

Thanks Denice.  He has been mostly on wet food for a few years now, but he gets picky about it.  I will check out the thread because I'm sure there will be some good  tips for finicky eaters  And I was sure there must be some kind of yummy tasting thing I could sprinkle on food from time to time.  The vet gave me a few pills to use as appetite enhancers if I needed them, but the pills are quite large and difficult to trick a cat into eating them when he won't eat food!

He ate well tonight and chased a bug.  Maybe things will go well tomorrow!  (Ugh- found out the specialist is in an industrial park-  it will cost me $70 in taxis to get there and back...I'm hoping to take a cab there and get a bus back.  Now I wish I knew anyone with a car! Usually completely unnecessary in Montreal!)

 

[oneandahalfcats]

 
If the vet pushes high fiber food...I guess I can give it a try.  I looked at the ingredients for RC Fiber Response dry food and it's pretty...underwhelming.  What is in RCFR that makes cats go?  I've tried fiber in Dory's wet food and it hasn't made any difference.  The fiber I've tried are pumpkin, cauliflower and grass.  Pumpkin used to help long ago when Dory's constipation was mild--like lasting two days.   It hasn't worked ever since her constipation became severe overnight.

My concern is that the fiber will enlarge her colon.  I'm assuming the special dietary foods will have a large amount of fiber to 'force the issue.'

I know cisapride has side effects--but I feel at this point, Dory needs something to increase the frequency of her deposits, but not necessarily the volume.  Miralax is keeping it soft so that's not an issue.  She doesn't seem to be in pain when she goes.  I feed her a wet diet with added water, so I don't think she's dehydrated.  I just need her to move away from the 5 day schedule.  Her sister, Josie, is going every other day.  So she has responded somewhat to all the things I'm doing.  But Dory just won't budge.  To give Dory some benefit of the doubt, Josie is more tolerant of coconut and fish oils, is more active and has been on half the dosage of prozac.  Which I think probably have some bearing on Josie's more robust BM schedule.

I have started weaning them off prozac.  They are dosed every 3rd day now instead of every other.  I started 2 weeks ago and it hasn't impacted their BM schedules.  I don't know if that means prozac isn't the issue or if it just takes a long time for the drug's influence to decrease.

I just looked at the ingredients and they have changed the formula, AGAIN! The Fiber food used to at least feature chicken as a first ingredient and now its Brewers Rice! This really p--ses me off as the food seems even junkier than before. But to answer your question, I believe it is the psyllium husk and other grains that are the active ingredients in this food. Psyllium can be an effective solution to constipation, IF your cat responds to fiber well. If Dory's problem is one of motility, then the fiber might help to create some sensation but there has to be a careful balance. I tried pumpkin with Max which he enjoyed eating, but it didn't have much of an impact on his BMs. Its too bad the ingredients are so trashy in the RC, because it does work on some level.

EDIT: If you wanted to try just some psyllium, there is a product which is a chewable tablet that was designed as a hairball and digestive aid called Vets Best Hairball Relief Tabs. This product also contains Slippery Elm and some strains of probiotic. So, it might be a safe way to introduce both some psyllium and slippery elm. Here is what you are looking for : http://www.vetsbest.com/products/cat-supplement-tablets.php.

The fact that you have tried so many things that should have improved Dory's situation, leads me to believe that you may still be looking at a behavioral issue that will require something 'other than' medication to address.

Glad to read that the Prozac weaning is going well 

I would think this will continue to have a residual in wearing off gradually effect until you stop it completely, which is probably a good thing. Josie's activity level can definitely explain her more frequent schedule. Maybe once Dory is done with the Prozac, you might see an improvement and she she too may start feeling more energetic and in turn become more active.

Let us know how things go at the vets. Keeping good thoughts and fingers crossed for Dory. 

 

 

[tdonline]

 The fact that you have tried so many things that should have improved Dory's situation, leads me to believe that you may still be looking at a behavioral issue that will require something 'other than' medication to address.

Well, my thinking is that Cisapride may be the way to go.  Start her on the medication, restart her BM schedule, get her used to going regularly again and then taper off when she's back in the groove.  Cisapride will make Dory "feel" the call of nature and override her behavioral issue.  Does that make sense?

I'll update as soon as I can tomorrow.

 

[oneandahalfcats]

 
Well, my thinking is that Cisapride may be the way to go.  Start her on the medication, restart her BM schedule, get her used to going regularly again and then taper off when she's back in the groove.  Cisapride will make Dory "feel" the call of nature and override her behavioral issue.  Does that make sense?

I'll update as soon as I can tomorrow.

Totally makes sense. I hope that the cisapride can be the catalyst for change, I really do. 

  There is no harm in trying it. Doesn't mean forever.

Will look for your update. Good luck with your girls at the vet.

 

 

[tdonline]

The vet agreed with my plan too.  I didn't bring up Cisapride he did, but it turns out he was thinking along the same line--using Cisapride on a short term basis to jumpstart Dory's BM schedule.  I was given 20 5mg chicken melt tabs and instructed to give one daily to Dory.  I am to report after 7 days.  Once again, he reassured me Dory looked to be in good health and he was positive she doesn't have megacolon...

I gave Dory her first dose today just before lunch.  Needless to say, I have my heart in my throat in anticipation.

 

[raintyger]

Just to be sure you got instructions on cisapride, you need to give it about 30 minutes before a meal. It sounds like you did, but I just wanted to be sure. When I got cisapride the vet never told me that.

 

[tdonline]

No...I was told I could pop the pill in or add to Dory's food.  I didn't add it to Dory's lunch because there's no guarantee she finishes it in one go.  Josie will usually come by and clean up.  I was thinking of adding the Cisapride to her snack-size breakfast--to avoid the drama of pilling her.  

I'm assuming Cisapride won't be effective if given with food?

 

[tdonline]

Wow, the Cisapride is working already.  I'm amazed just because Dory had resisted so many other ways to help her go.  There were deposits in both litter boxes tonight.  I'm pretty sure one of them belonged to Josie.  That in itself was a happy event as she had gone yesterday.  She stabilized into going every other day so I didn't expect anything from her until Sunday.  It's the first time in a long while since she's had back to back BM days.  It could just be a one-off. Or it could be because I have decreased their Prozac dosing from every other day to every third day.  Or because I've reintroduced a teaspoon of pumpkin to their dinners.  In any case, it would be terrific if Josie can return to her old 24-36 hour schedule.

I was about to go to bed when I noticed a deposit in the bedroom litter box.  I didn't see Dory go but it's unlikely Josie produced two BMs in one evening.  I'm definitely intrigued as whether they will produce tomorrow of if this was just a flukey BM day for them.

 

[oneandahalfcats]

Quote:

 
The vet agreed with my plan too.  I didn't bring up Cisapride he did, but it turns out he was thinking along the same line--using Cisapride on a short term basis to jumpstart Dory's BM schedule.  I was given 20 5mg chicken melt tabs and instructed to give one daily to Dory.  I am to report after 7 days.  Once again, he reassured me Dory looked to be in good health and he was positive she doesn't have megacolon...

I gave Dory her first dose today just before lunch.  Needless to say, I have my heart in my throat in anticipation.

Great to hear that she doesn't have megacolon! ..

 
Wow, the Cisapride is working already.  I'm amazed just because Dory had resisted so many other ways to help her go.  There were deposits in both litter boxes tonight.  I'm pretty sure one of them belonged to Josie.  That in itself was a happy event as she had gone yesterday.  She stabilized into going every other day so I didn't expect anything from her until Sunday.  It's the first time in a long while since she's had back to back BM days.  It could just be a one-off. Or it could be because I have decreased their Prozac dosing from every other day to every third day.  Or because I've reintroduced a teaspoon of pumpkin to their dinners.  In any case, it would be terrific if Josie can return to her old 24-36 hour schedule.

I was about to go to bed when I noticed a deposit in the bedroom litter box.  I didn't see Dory go but it's unlikely Josie produced two BMs in one evening.  I'm definitely intrigued as whether they will produce tomorrow of if this was just a flukey BM day for them.

Happy for you and Dory that things have started out well, and great to hear that Josie is improving as well in the BM department!

It will be interesting to see what the next few days and weeks produce, but definitely sounds like an encouraging start!

As Raintyger pointed out, the recommendation is to give the cisapride 30 minutes before food but if you gave the cisapride with food and are seeing results, this may not  be necessary. Best to speak with your vet about this. Its also important not to skip a dose but to give missed doses as soon as possible, and to do the cisapride separate from other drugs such as the prozac.

Thanks for updating us .. Positive vibes and fingers crossed for more good news ..

 

[abbyntim]

@tdonline, I am so happy to hear the cisapride may be helping Dory! I never gave cisapride before a meal, I just didn't want to do that to Tim (see Lisa Pierson's page on the dangers of dry-pilling). I always mixed it in with the first plate of wet food so he would be hungry and gobble it up. Now that I am weaning Tim off cisapride, I see it was effective in keeping him on a very strict 24-hour schedule, so I think you will be fine giving it with food. But as others suggested, check with your vet. (Our vet never told us anything, other than once per day).

 

[raintyger]

If you give cisapride with food it's not like it won't work. It's just that the maximum effectiveness is achieved by giving it 30 minutes ahead of meals. This preps the body because by the time you feed the cisapride is starting to work. So when the food comes the gut is primed to move the food in tandem with its natural digestive movement.

 

[tdonline]

Dory, Super Constipation Cat strikes again?  No BM yesterday.  I placed the Cisapride in her snack-sized breakfast but she sussed it out and ate around it.  It's supposedly chicken-flavored but Dory really hates it.  I placed the pill in a capsule and she did end up eating it.  I wonder if the capsule neutralized the pill's effectiveness?  It is a melt tab, perhaps its effectiveness is activated in the mouth?

Gosh, I hope it's not the case of Dory resisting Cisapride's powers.  She finished dinner the night before so she should have had waste to move.  Today, I popped the pill in.  I made sure it went in and she ran under the bed, poor thing.  I waited about 25 minutes and served lunch.  She's eaten every meal since Saturday night so there shouldn't be any question of a payload...

 

[oneandahalfcats]

 
Dory, Super Constipation Cat strikes again?  No BM yesterday.  I placed the Cisapride in her snack-sized breakfast but she sussed it out and ate around it.  It's supposedly chicken-flavored but Dory really hates it.  I placed the pill in a capsule and she did end up eating it.  I wonder if the capsule neutralized the pill's effectiveness?  It is a melt tab, perhaps its effectiveness is activated in the mouth?

Gosh, I hope it's not the case of Dory resisting Cisapride's powers.  She finished dinner the night before so she should have had waste to move.  Today, I popped the pill in.  I made sure it went in and she ran under the bed, poor thing.  I waited about 25 minutes and served lunch.  She's eaten every meal since Saturday night so there shouldn't be any question of a payload...

LOL! .. Super Constipation Cat indeed! .. I doubt that the gelcap interfered with the cisapride, and would suggest to keep using this technique as dry-pilling is not healthy for the esophagus.

You were off to a good start there, but its important to keep in mind that cisapride can take a bit of time to work through the system. It's an accumulative effect over time, which is why its important not to miss doses. I have seen references to give cisapride 15 minutes before food and so you might want to play with the time a bit.

Come on Dory! .. You can do it girl

 

[tdonline]

One, I remembered I was pretty horrified when I read how long a pill hangs around when dry-pilled.  Though it's still not ideal, when I have to dry-pill, I do follow up immediately with kibble snacks so at least the eating process will hopefully move the pill along.

And thanks for bringing up how Cisapride works.  I wasn't sure if it was like a laxative--it works to move things along on a one time basis or if it's cumulative.  If it doesn't work over the next couple of days, I wonder if it worked the first day due to beginner's luck.  Now that Dory knows what to expect, is she working hard on holding out?  She's had a lot of practice the last 5 months.  

 

[oneandahalfcats]

 
One, I remembered I was pretty horrified when I read how long a pill hangs around when dry-pilled.  Though it's still not ideal, when I have to dry-pill, I do follow up immediately with kibble snacks so at least the eating process will hopefully move the pill along.

And thanks for bringing up how Cisapride works.  I wasn't sure if it was like a laxative--it works to move things along on a one time basis or if it's cumulative.  If it doesn't work over the next couple of days, I wonder if it worked the first day due to beginner's luck.  Now that Dory knows what to expect, is she working hard on holding out?  She's had a lot of practice the last 5 months.  

  .. Maybe! .. You've got to admire the determination though. (Going 5 days without a BM) which would be very consequential for another cat, doesn't seem to phase her and the kicker being that the poops are still soft when she does produce them !

When Max was on this stuff, we didn't see much of a difference between BMs. There were still delays and we wondered at times if it was working at all. In your case its only been a couple of days. I would give it until the end of the week when you speak with the vet and see where she is at then. I'll take a look back in my records to see what dosage Max was getting for comparison.  

 

[abbyntim]

Yes, give it time. When Tim first started Cisapride, he was such a wreck from multiple enemas, but I remember the vet saying it would take a little time. In addition to what oneandahalfcats posted, my understanding is that Cisapride starts working farther up the digestive system, not just the colon, so it does take some time before you will see a bowel movement. Based on what I am seeing as I take Tim off Cisapride, it seems to take close to 24 hours for him, but I would guess each cat is different.

 

[tdonline]

The vet office called for a follow-up chat.  I have to say though I have had some issues with them, I really appreciate that they do this after every visit.  The office person said my vet  had prescribed cisapride to move Dory toward going every 2 or 3 days...so maybe expecting her to go everyday is unrealistic.

Since both cats had off-scheduled BMs on Saturday, I wonder if they were stimulated by the chaos of the vet office more than anything.  I know Josie poops when under threat (like when Dory attacked her).  She cried the entire time she was in the car.  Luckily, they are reasonably okay once they're at the office.  They come out of their carriers and explore.  Josie being smart, retreated to her carrier once the vet started examining Dory

 

[oneandahalfcats]

 
The vet office called for a follow-up chat.  I have to say though I have had some issues with them, I really appreciate that they do this after every visit.  The office person said my vet  had prescribed cisapride to move Dory toward going every 2 or 3 days...so maybe expecting her to go everyday is unrealistic.

That is a valid point. Every couple of days would certainly be better than every 5. Still, this is a process and so its conceivable that once you start seeing improvements that she may do better. Its early days. Stay positive.

 

[tdonline]

Dory finally went this morning--making it four days after her last movement.  Granted it's an improvement over 5 days but not as much improved as I hoped considering the seriousness of the medication prescribed.  Hopefully Dory is one for slowly ramping things up...

 

[oneandahalfcats]

Glad to hear that she went.

It could be that in her case, the cisapride will need to build up in her system to get things going on a more consistent basis.

How many times a day is Dory getting cisapride and how soon before meals are you giving this? I checked back in my records and Max was getting cisapride 3 times a day (5mg), and we were giving this 15 minutes before each meal, rather than 30 minutes.