Urgent - Obstepation / Megacolon Help Needed

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LarrysAngels

Member Since 2012
This is a non-diabetic issue, but I know that there is a lot of knowledge on this board so I’m hoping that maybe I can get some helpful feedback. If I can’t solve this soon, I will have to have him euthanised.

I have a civie, male, probably 7-9 years old that stopped eating and became very lethargic. Doctor diagnosed it as obstepation / megacolon. Basically, his colon is full of rock hard feces that he simply can’t pass. The normal course of treatment for this is enemas, stool softeners, etc., and as a last resort they would put the cat under and go in through the rectum and literally pull out the blockage. His problem lies with the fact that the physical exam revealed that he has an old pelvic injury that did not heal properly, resulting in a pelvic canal much smaller than normal. The doctor feels that the restricted pelvic canal probably rules out the anesthesia / manual de-obstepation option, meaning that if we can’t figure out a way to soften the blockage to the point that he can pass it, he will die. She feels that “he has a poor prognosis for an enema to be effective at this point”.

Right now my course of action is 2 enemas a day, 2 or 3 sub-q’s a day, and lactulose (given orally) twice a day. Also high fiber food and/or supplements. Since he can’t pass stool, we’re racing the clock, and his days are numbered.

If anyone has any comments or suggestions, I would appreciate your taking the time to respond here. This is all new to me. I can’t bear the thought of losing him.

Thanks,
Larry
 
I'm so sorry you're going through this :(

The only thing I don't see mentioned is a suppository. I'm not sure if the vet might think this unwise in your case for some reason so do check with them before trying. Recently, on my vets recommendation, I gave one to Vyktor, a human variety bought from the chemist, you just don't stick the tube in so far for a cat. This product (I'm in Australia, I used something called Microlax) causes contractions in the back passage. I screwed up the first time because I didn't hold the tube pressed in while withdrawing it from his butt but after I got it right on my second attemp the result was instantaneous. I used it after 2-3 days of administering stool softener as that wasn't having the desired effect and Vyk's tummy was hard and the spot between tail and ribs on each side was very tender so he was obviously in discomfort/pain. This was only a month after a sedation and manual removal.

Going forward cold pressed coconut oil - 1/4 tsp a day (most cats will lick it straight off the spoon) plus puréed pumpkin (start with a 1/4 tsp twice a day mixed in with food) has been effective for resolving Vyktor's problems.

Wishing you the best of luck with your boy.
 
Hold off on the suppository if the feces are rock hard. Too much movement of rock hard feces can tear delicate tissues. The enema would be safer because it softens the feces so they can pass. Think gentle.
Ask the vet about low residue diet for the moment as pushing from the mouth end may do the same thing.

Take a breath and dive in reading about the feline GI tract at Feline Constipation, plus options for treatment there.
 
Hi Larry,
Rhiannon sent me a pm to see if I could add anything.
I'm so sorry about your kitty. My sweet Manx kitty, Maggie (GA), had megacolon and at first was treated with Lactulose. That didn't seen to help, so we added Miralax several times a day, mixed in with her food or something she liked. We eventually stopped the Lactulose, as Maggie hated it, and it didn't seem to help. We soon added Cisapride. Has your Vet mentioned Cisapride. It helps move the intestines.

Maggie did have enemas at the Vet's office and seemed to do well with them in the beginning. The enemas seemed to really help, but because Maggie also had spina bifida, they became too painful and hard on her. I'm not so sure about the high fiber food though. Maybe someone else here can contribute. I had Maggie on wet food because of her diabetes. Serryn had some good suggestions with the pureed pumpkin.
Please keep us posted.
All my best to you and prayers.
 
Thank you all for your thoughts and comments. I appreciate your taking the time to help.

Began the at home treatment today, 2 enemas, 2 sub-q's and 2 doses of lactulose. Also bought some psyllium husks for fiber and have added that to the mix. He did go into a spell this evening where he passed some diarrhea, all liquid and not solid, but at least it is something. I'm trying to convince myself that that is a good sign.

Still praying for a miracle. If you'd like to join me, I would appreciate it.

Thanks,
Larry
 
I mix half a spoon of canned pumpkin and lots of water with his wet food. I make a soupy meal for him and he's to the point where he refuses to eat anything unless it has pumpkin in it! It keeps him regular although every couple of weeks he'll have an episode where he's a little constipated, he'll go around the house squirting a little diarrhea and then the solid poop will come out. I think it's a good sign your kitty has a some liquid poop coming out at this point.
 
Did vet do bloodwork? The enema's will potentially cause low potassium which weakens muscles. He may need potassium supplementation but it's critical that the potassium levels be watched carefully when using supplementation. He needs strong muscles to help move things. I have a civie with the same issues - his descending colon and anus are very small which causes things to back up also. He gets Miralax 2x day and Reglan when I notice that he's not moving things well again. The reglan is in place of cisapride which was too expensive as it's no longer being made so it's sometimes hard to find too. The cisapride works a lot better but the reglan does help. Those do cause stronger muscle contractions in all muscles so you may see muscle rippling. I second BJ's comment - if hard feces is trying to move, it can cause tears.

HUGS and prayers!
 
Hi Larry

Sending lots of healing and poo vines for your kitty.

My 13.5 year old kitty has been dealing with constipation for the last two years.

Two years ago after watching Anne and Maggie deal with megacolon and noticing Sid's poo every other day turn into every 3 days I decided to talk to the vet.

We started her on cisapride and fluids. The Cisapride is from a vet compounding pharmacy. We started the fluids every other day. I thought she would hate the fluids but she actually looks forward to it. We also added the Miralax.

Then 1.5 years ago we went to vet who did acupuncture focusing on the colon area. Wow. That really helped.

Then just recently the vet acupuncturist (she also happens to specialize in felines) added senna. The cisapride over time will lose its effectiveness so the senna is helpful. She orders it for me so it's made for kitties.

So,at this time Sid has avoided getting an enlarged colon but this will be ongoing with her. PM me if you have any questions.
 
Wow, thank you all so much for your concern, help. and prayers. You don't realized how much it means to me. I have a very understanding vet and will bring these comments to him and see if he feels they would help in our particular situation.

No bloodwork has been done yet. That may become necessary at some point, but for these first couple days the only thing that matters is getting a bowel movement. If that doesn't happen, I will have to let him go.

Thursday went well, but he really fought the enema, which surprised me because the two I did yesterday were easy. I wonder if maybe he's getting a little sensitive back there. Asked the vet and he said it was possible, so only did one today and will try again tomorrow.

Was out most of the day, so wasn't able to monitor how he was doing. When I got back home I was stunned at how well he was acting. Absolutely 100% normal, both energy and catitude. Haven't seen that in quite a few days. I found some droppings in the litter box that were irregular, like semi-soft diarrhea chunks, so I'm hoping they were his (I have multiple cats) and he's taking another step forward, but I'm really not sure. I'm off tomorrow, so should be able to keep a close eye on him.

His name is Angel. I rescued him during a brutal upstate New York winter and named him Snowball (he's pure white). Took him to the vet and got him a clean bill of health with the intention of taking him down to the shelter to have him put up for adoption. He grabbed my heart, though, and I knew I could never let him go, so I renamed him Angel (he really is), and adopted him myself. Sometimes you hit the jackpot.

Thanks again and please keep the prayers coming. Maybe we're pulling this off.

Larry
 
When I got back home I was stunned at how well he was acting. Absolutely 100% normal, both energy and catitude. Haven't seen that in quite a few days. I found some droppings in the litter box that were irregular, like semi-soft diarrhea chunks, so I'm hoping they were his

Hi Larry,
This is so wonderful to hear with the change yesterday in Angel regarding his energy and cattitude. The irregular poo was how Maggie started moving her bowels when she was so blocked. What an amazing story of Angel's rescue. You both hit the jackpot there with each other.
Maggie was also a rescue.

More healing and poo vines and prayers on the way and especially for today to go well.
 
Larry,
I agree with Ann - the irregular poo is also how Snow does when things begin moving again. It takes time for things to return to normal. Snow will always have to have Miralax daily but as long as we continue that AND be sure hard food never goes in his mouth, he does good.

Angel's story makes me grin. :) All our fuzzy feetz are rescues....
 
Angel is definitely starting to move his bowels. It's not as firm as normal, but it is formed. Smaller chunks, not much bigger than rabbit droppings, but hopefully that's the way his system is getting rid of the blockage. Going to drop back to one sub-q a day and try to get another enema over the weekend, while continuing with the lactulose and fiber water. There's still a long way to go with him, but this would be a huge hurdle to cross.

Thanks again to everyone posting here. The help, support, and encouragement is greatly appreciated.

If a fairy tapped me on the shoulder last Wednesday night and told me I could have one wish - either a brand new Mercedes or my cat takes a poop, I'd take the poop. No thought or hesitation needed, either. I'm willing to bet that if you're reading these words, and you were in my position, you'd do the same thing.

Ya gotta admit, we're a rather strange bunch.

Thanks again,
Larry
 

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I'd keep up with the subQ fluids until you're certain things are moving successfully. The lactulose is an osmotic - it draws moisture into the bowel to keep the feces moist and moving.
 
LarrysAngels said:
If a fairy tapped me on the shoulder last Wednesday night and told me I could have one wish - either a brand new Mercedes or my cat takes a poop, I'd take the poop. No thought or hesitation needed, either. I'm willing to bet that if you're reading these words, and you were in my position, you'd do the same thing.

Ya gotta admit, we're a rather strange bunch.
Click to expand...

This made me smile! :joyful::joyful: We're not strange, we just care a lot! Continuing prayers for your Angel!
 
LarrysAngels said:
If a fairy tapped me on the shoulder last Wednesday night and told me I could have one wish - either a brand new Mercedes or my cat takes a poop, I'd take the poop.
Click to expand...
:joyful::joyful::joyful:

Am SO pleased that you have some poop! Great news!

Sending 'continuing-to-poop' vibes to Angel, and a reassuring (((hug))) to you.

Eliz
 
Was out again today and when I got home he had diarrhea stains on his rear quarters, so not sure that that represents progress. Not sure about bowel movements because I have multiple cats and I really don't know who does what. I think I'm going to have to isolate him so I can positively determine exactly what's happening. He acts perfectly normal and is eating, certainly doesn't come across as a cat in pain or distress, so at least there is that good sign. Continuing with one sub-q a day, lactulose, and fiber water, going to try another enema tomorrow, but he wasn't to angelic last time I tried, so I guess we'll see.

Please keep the prayers coming, there's still a long way to go.

Larry
 
Sometimes a cat will appear to have diarrhoea but in fact has constipation, and the runny stool is simply what can squeeze around the solid dry stool. Prayers continuing!
 
What do you mean by "fiber water"? Psyllium powder will actually hold water in the feces and give loose feces some form. the soluble stuff may be unhelpful, See Feline Constipation for more great info.
 
One thing I did to take the guesswork out of when Sid would poo and who,left the poo on the litterbox was to get a Dropcam and point on the box. I know exactly when she goes and if she is having any issues. I have athe Dropcam app on my iPhone so I can watch from work and develop a plan before arriving at home and the vet is closed. I know...I'm a bit anal. :)
 
By fiber water I mean psyllium powder. I mix it with water per instructions on the can and then syringe it into him.

I was home most of the day today and didn't see him use the litter box once, and that concerns me a little. He acts and eats fairly normally, however, so I'm a little confused. Tomorrow I am putting him into isolation so that I can determine exactly what is being consumed and what is being put out. He's going to hate that, but at this point I don't feel I have a choice, I have to know.

Gave 2 enemas today, along with a sub-q, the lactulose and the fiber water.

Thanks again for the concern and help. Keep the prayers coming. Will post again tomorrow with the latest news.

Larry
 
I fear that Angel is taking a turn for the worse. Ate very little today, practically no bowel movement. Maybe its because he's being locked up, maybe we're starting to lose the battle. I have a bad feeling. I'm scared to death. Continuing with the medications and treatments, still hoping for a miracle.
 
LarrysAngels said:
I fear that Angel is taking a turn for the worse. Ate very little today, practically no bowel movement. Maybe its because he's being locked up, maybe we're starting to lose the battle. I have a bad feeling. I'm scared to death. Continuing with the medications and treatments, still hoping for a miracle.
Click to expand...
So sorry you and Angel are going through all of this. Sending you many prayers from the Southwest.
 
Another bad day for Angel. Ate practically nothing and no bowel movements at all. Beginning to think that we're approaching the time.

I'm going to try to get in tomorrow with a different vet just for a second opinion. I trust my vet entirely, but when it comes time for this decision I need the peace of mind of having a second set of eyes come to the same conclusion.

I'm back to 2 a day enemas and sub-q's, since that is what I was doing last week when it appeared we were making a little progress. Also bought some Miralax and have added that to the mix.

I'm not doing well.

As long as his little heart is beating, though, there's still a glimmer of hope. Please pray for both of us.
 
(((((((((((((((((((((((( Larry and Angel ))))))))))))))))))))))))

I feel for you. :(

As the saying goes, where there is life there is hope. I am keeping you both in my prayers. I hope he poops soon. Will keep an eye out for your updates.

:bighug:
.
 
So if Angel hasn't eaten much there might not be anything in there to come out. Can your vet feel or see (x-Ray) anything in her colon? Maybe she just needs an appetite stimulant so she can eat more? Just wondering, prayers being sent.
 
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Well, it's not over yet.

Went to another vet in town, have gone there before for spay/neuter services for the feral colony I take care of. Explained everything in detail and she felt he was a "perfect candidate' for a nasogastric tube. As I understand it, it is a tube through a nostril that delivers a solution via drip into the stomach. It eventually works into the colon and starts to breakdown the blockage. She said she has seen similar situations before and it has been successful. I think its basically what humans take before a colonoscopy to cleanse their colon, although they usually just drink it.

So he goes in early Thursday morning (New York time) to see if they can save him. I'm tying not to get my hopes up, but maybe positive vibes can help.

I agree that if he's not eating there's nothing to come out, but the vets can actually feel the colon and determine that it's full, which the both did. He's on an appetite stimulant which I believe has helped, but very little.

If ever we needed your prayers, its now. Will post again tomorrow when I have results. Thanks again for the help and support, you have no idea how much it means to me.

Larry
 
So glad you got the second opinion and that there's something else to try. Sending tonnes of positive vines to you and your Angel.
 
A slow drip of food in will help prevent a refeeding syndrome where the unused GI tract reacts poorly to eating too much, too fast.
Fingers crossed.
 
LarrysAngels said:
I agree that if he's not eating there's nothing to come out, but the vets can actually feel the colon and determine that it's full, which the both did. He's on an appetite stimulant which I believe has helped, but very little.
Click to expand...

I've read here that constipation can sometimes cause vomiting, so I wonder whether it might make a cat nauseated? (Speculating here - no experience of this.) I do know that when Saoirse had no appetite during her flare last year that she needed both the appetite stimulant and anti-nausea treatment. I wonder whether it might be a good idea to ask your vet if anti-nausea treatment might be appropriate for Angel? Maybe other members might know more.

Positive vibes on their way to Angel from across the pond, along with a :bighug: for you, Larry.
 
When Dusty is constipated he'll usually vomit but I think it's more from straining than anything else because he'll still eat normally; no loss of appetite with this little piggy... I've been very successful at keeping him regular with pumpkin and water mixed in with his food to make it soupy. Praying for Angel and you!
 
It worked.

Perhaps the two most pleasant words I have ever typed. Dropped him off Thursday morning, called back around 2:30 and he was pooping. Called back again after work, about 7:45 pm and it was still coming out; poor little guy have been going to the bathroom all day. He's so backed up that they will need to keep him overnight and finish up tomorrow. Barring unforeseen complications, he'll be home tomorrow. He'll be a special needs cat for the rest of his life, but I can handle that with a smile on my face. Going to get some sleep now (finally), will post again tomorrow when he gets home. Thanks again to my "angels" here at FDMB, you have been a godsend.

Larry
 
Oh wow!!:):):):smuggrin::smuggrin:That is so amazing and makes my Friday!! So it was the nasogastric tube that really was key! You've done a wonderful job of caring for Angel and doing everything in your power to help him and not giving up. More vines and prayers for Angel and you as he comes home soon. He's a very special kitty.
 
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