Diabetic and constipated

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Mari

Mari

Member Since 2015
My vet diagnosed Zazu a year and 8 months ago. He was on Caninsulin (7.5 units). In August he went for a dental at our University's Vetenary Clinic. They placed him on Lantus (3.3 units) and on Hills MD.
We did a glucose curve on Sunday - highest measure was 15.8 and lowest measure 2.1. Since Sunday evening we are giving Zazu half a dose (1.75 units).
We are also having problems with the wet food (Hills MD) as he does not want to eat it. Due to the fact that he has become constipated from the MD dry food he is eating the normal wet food. However, he is still not going normally only a small one per day maybe. Zazu is turning 10 in March 2017 and has always had a problem with constipation, which we managed by giving him wet food. 3 Weeks ago his constipation started and we alerted the vet, who said to just give him water. Now 3 weeks later Zazu is in hospital receiving an enima.
He is also not drinking a lot of water the past week and am I giving him two teaspoons of cat tuna with water. I assume he's not drinking water because his blood sugar is too low and hence the constipation.
We tested his sugar yesterday morning before injecting him and it was 8.6.
It is very difficult to find a vet in our area, if not our country, who has experience with diabetic cats. My cats emotional well being is just as important as his physical well being. I really need support from a vet / someone who has knowledge of diabetes / constipation / Lantus.
 
Mari said:
My vet diagnosed Zazu a year and 8 months ago. He was on Caninsulin (7.5 units). In August he went for a dental at our University's Vetenary Clinic. They placed him on Lantus (3.3 units) and on Hills MD.
We did a glucose curve on Sunday - highest measure was 15.8 and lowest measure 2.1. Since Sunday evening we are giving Zazu half a dose (1.75 units).
We are also having problems with the wet food (Hills MD) as he does not want to eat it. Due to the fact that he has become constipated from the MD dry food he is eating the normal wet food. However, he is still not going normally only a small one per day maybe. Zazu is turning 10 in March 2017 and has always had a problem with constipation, which we managed by giving him wet food. 3 Weeks ago his constipation started and we alerted the vet, who said to just give him water. Now 3 weeks later Zazu is in hospital receiving an enima.
He is also not drinking a lot of water the past week and am I giving him two teaspoons of cat tuna with water. I assume he's not drinking water because his blood sugar is too low and hence the constipation.
We tested his sugar yesterday morning before injecting him and it was 8.6.
It is very difficult to find a vet in our area, if not our country, who has experience with diabetic cats. My cats emotional well being is just as important as his physical well being. I really need support from a vet / someone who has knowledge of diabetes / constipation / Lantus.
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You have certainly come to the right place for help! Many here have needed more assistance than they were able to get from a veterinarian, either because of access, lack of knowledge of vet, or vet's attitude. The people on this board have become experts on treating feline diabetes because they live with it all the time.

I won't overload you with too much information right now but I'll quickly address the things you've mentioned:

1. type of insulin: you've already experienced a change in insulin and have seen how they can act differently. Finding the right dose is key and many times the vet-assigned starting dose is too high and/or raised too quickly. We can help with that.
2. type of food: it's recommended that you feed a wet food only diet and it doesn't have to be a prescription diet. Supermarket canned food that is low in carbohydrates and high in protein works as well. I have no idea what's available in South Africa though. There might be other members here who can advise or you might have to do some research on this yourself.
3. constipation: certainly, hydration is important. If you find a wet food that Zazu likes, try adding warm water to it to make a sort of "stew". Many cats do well on - and like - a bit of canned, plain pumpkin added to their food to help with constipation. There are many members here who do that and can advise.
4. testing blood sugar: I see that you test before giving insulin. That's great! It is THE KEY to doing what we do to keep our kitties safe. We also recommend doing at least one test mid-day to see how low the insulin takes them. This can be done on weekends if you aren't at home during the day. We put the blood glucose data into a spreadsheet viewable by all members of the board. They can look at it and advise you.

One additional comment: you mentioned that Zazu's blood sugar was 8.6 when you tested him before injecting yesterday. We have specific recommendations on when to give a dose, withhold a dose or reduce a dose based on the pre-injection blood sugar value. A number of 8.6 is an excellent pre-injection value but, in my opinion, too low to inject insulin. The largest group on this board are people who use Lantus and they would be able to give you specific advice on what to do in a situation like this. It would be a good idea for you to introduce yourself on the Lantus forum as well.
 
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Thanks for the info. I feel a bit better.
Picking Zazu up from the hospital this afternoon. Vet spoke of possibly removing his colon, etc. before doing any tests! He's been coping very well for almost 10 years and pooing (which must mean that his colon is still working) I will continue him on the wet food he's been having for the past year.
I am definitely considering it to manage his insulin, testing, etc. from home. Just need the right support and I think this is the place.
More advice welcome.
 
Mari said:
Thanks for the info. I feel a bit better.
Picking Zazu up from the hospital this afternoon. Vet spoke of possibly removing his colon, etc. before doing any tests! He's been coping very well for almost 10 years and pooing (which must mean that his colon is still working) I will continue him on the wet food he's been having for the past year.
I am definitely considering it to manage his insulin, testing, etc. from home. Just need the right support and I think this is the place.
More advice welcome.
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The vet must be thinking that Zazu has a condition called "megacolon" in which the colon walls lose their ability to propel poop and the colon weakens and stretches out too large. I would certainly recommend trying other measures like wet food, etc. before taking a drastic step like this excision surgery!

You can manage Zazu's diabetes from home and this is the place to get the help you'll need. Sometimes, though, people find that their vet is less than pleased to find out they want to be much more "hands on" at home. I hope you don't get this reaction from your vet but Zazu is your cat and you want the best for him. You are the one in charge. I do, however, understand the conflicted feelings you might have about this because many of us were the same - I was one, and I like my vet a lot. I feel completely different now since I've taken control of my cat's care and have learned SO much more about what's going on with him and how to respond.

I suggest you take some time to look at some of the informational "Stickies", read some of the conversational threads, etc. There's a lot here and it will feel overwhelming so go slow. Ask any questions you want. No concern is too small and there are no silly questions. :)
 
Here is an excellent, reputable website with information on feline constipation and treatment for same.

www.felineconstipation.org

Plain canned pumpkin (NOT the pie filling!) can help. Psyllium husk is another option. You'll find info on both at the above website (look at the section on probiotics and fibre). If you do try adding a little fibre to Zazu's diet it's important to start very, very slowly so that you can make sure it agrees with him.

Another thing that can help retain moisture in the stool without adding bulk is Miralax. It's OK for short term use but other members may be able to advise you whether it can be used longer term. Your vet may be able to advise you about this. Again, if you and your vet agree that this is a good treatment option start slowly. (Info about Miralax is also available at the link above.)

Diabetics can have problems with gut motility because the disease can affect the nervous system. B12 methylcobalamin helps with diabetic neuropathy when cats have problems with leg weakness. It may be worth asking your vet whether B12 supplementation may help with gut motility issues.


Mogs
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tiffmaxee said:
Miralax can be used long term. A good site on this topic is felineconstipation.org.
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Ever since I started Hannah on MiraLAX about a month ago, we've had good luck using it. She gets an 1/8 tsp. twice a day and she is no longer constipated. I mix it with about a tsp. of water, let it dissolve, and pour it over her meal. She actually likes the stuff and thinks it's gravy. Woot! However, I've had the question in the back of my mind as to whether it's okay to use long term. Your response has answered that for me. Thank you. Just for the record, we tried pumpkin prior to the MiraLAX but found it ineffective for constipation. Others have used it with success. I guess my little sugar girl just has to be different. We've also used pumpkin for diarrhea and it worked wonders for that purpose.

Kris & Teasel said:
The vet must be thinking that Zazu has a condition called "megacolon" in which the colon walls lose their ability to propel poop and the colon weakens and stretches out too large. I would certainly recommend trying other measures like wet food, etc. before taking a drastic step like this excision surgery!
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I agree. It might be a good idea to try a few other options before taking such a drastic measure. Is MiraLAX readily available in your area? How about plain, canned pumpkin? If so, it's certainly worth giving them a try. Best of luck and keep posting here as you need advice, help, or support. The folks here are a wonderful resource.
 
Zazu is looking good. Vet suspects it may be megacolon. The stool from his colon was aparently not dried out or big and had lots of hair in. He has been loosing alot of hair the past month. I guesed it was due to the stress of going to the vet every 10 days. They suspect his colon may not work as well as it should and is recommending possible removal. I decided to see how it goes first, as I don't think we will go through the colon removal. It is amazing how well he takes all of what he's been through. Vet also noted that I should test him before injections and if his BG is below 10 to not inject. Yesterday morning his BG was above 10 for the first time in 2-3 days at 14.4.
Thanks for all the information. Will do some reading today.
 
Thanks for the update, Mari. I think you are wise to try other options and see if they work, putting off the removal of Zazu's colon. Also, so glad that you will be testing before giving insulin. Excellent!
 
Mari said:
Zazu is looking good. Vet suspects it may be megacolon. The stool from his colon was aparently not dried out or big and had lots of hair in. He has been loosing alot of hair the past month. I guesed it was due to the stress of going to the vet every 10 days. They suspect his colon may not work as well as it should and is recommending possible removal. I decided to see how it goes first, as I don't think we will go through the colon removal. It is amazing how well he takes all of what he's been through. Vet also noted that I should test him before injections and if his BG is below 10 to not inject. Yesterday morning his BG was above 10 for the first time in 2-3 days at 14.4.
Thanks for all the information. Will do some reading today.
Click to expand...

I like your vet's advice to test before giving insulin and not to inject if BG is below 10. It's a good idea to see how Zazu manages before going the route of megacolon surgery. My brother's cat had megacolon and underwent that surgery. She did very well for years after it and passed away at the ripe old age of 19. If I recall, the only problem they had was occasional loose poop. She was a long haired kitty so needed a bit of cleaning up and fur trimming from time to time.
 
Critter Mom said:
Here is an excellent, reputable website with information on feline constipation and treatment for same.

www.felineconstipation.org

Plain canned pumpkin (NOT the pie filling!) can help. Psyllium husk is another option. You'll find info on both at the above website (look at the section on probiotics and fibre). If you do try adding a little fibre to Zazu's diet it's important to start very, very slowly so that you can make sure it agrees with him.

Another thing that can help retain moisture in the stool without adding bulk is Miralax. It's OK for short term use but other members may be able to advise you whether it can be used longer term. Your vet may be able to advise you about this. Again, if you and your vet agree that this is a good treatment option start slowly. (Info about Miralax is also available at the link above.)

Diabetics can have problems with gut motility because the disease can affect the nervous system. B12 methylcobalamin helps with diabetic neuropathy when cats have problems with leg weakness. It may be worth asking your vet whether B12 supplementation may help with gut motility issues.


Mogs
.
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Great website! Thank you! Poor Fred has only pooped a little nugget today and yesterday. Pumpkin didn't really help. Maybe I was too cautious with it. We will try a stool softener after talking to vet. He is tasting his canned food with a bit of water. No nausea. Peeing in his litter. Sitting in window talking to birds. Hope you're doing ok.
 
Jamye and Fred said:
Great website! Thank you! Poor Fred has only pooped a little nugget today and yesterday. Pumpkin didn't really help. Maybe I was too cautious with it. We will try a stool softener after talking to vet. He is tasting his canned food with a bit of water. No nausea. Peeing in his litter. Sitting in window talking to birds. Hope you're doing ok.
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You're seeing some good signs of improvement! :)
 
Mari said:
Zazu pooped!!! And properly. Am I jumping the gun on being exited about this? It must mean that his colon is still working!?
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WOO HOO!! We love to hear poop stories!!!!

I don't think you're jumping the gun at all....another thing that hasn't been mentioned is that if you've switched to a canned food diet, it's not unusual for their to be "less poop" since their bodies are able to use the nutrition in the food better....Dry has all those fillers in it that a cats body can't process so it has nowhere else to go but "out".

It can take several days for pumpkin to work....it's not a laxative....it just adds fiber to the stool. If he eats it OK, I'd continue to try it for awhile. It's also fine to add the Miralax (generic name is polyethylene glycol ).....it acts by pulling water into the stool so it's easier to pass.

I definitely wouldn't even consider such a drastic surgery like removing his colon at this point!! There's all kinds of things to try before going to that degree!!

Its also not unusual for their to be a lot of hair in the poop....when you improve the nutrition as well as start to get better control of the BG, the cat's coat can almost completely "drop out" and grow back in again....and it'll be much softer and thicker than ever! You might want to start brushing him every day to remove some of that dead hair so it doesn't go down his throat and out the other end ;)
 
Excellent news about Zazu's .... bathroom habits! ;) Yes, his colon is still working. Chris & China gave you good advice above.
 
Glad y'all are doing ok! Fred pooped again today! I had given stool softener yesterday and today and a bit of pumpkin in his food. He still has issues with not having an appetite, but no nausea. He's purring again.
 
Can you send poo vibes to Sky? She hasn't been to the loo since Monday that I know of (she did go outside for about 30 minutes on Monday night but doesn't usually go to the loo outside!).....she's eating and playing and seems perfectly fine, just no poo. Doesn't seem in any discomfort or anything. She usually goes once every 24-36 hours so beginning to get a little concerned.....
 
Sootyca said:
Can you send poo vibes to Sky? She hasn't been to the loo since Monday that I know of (she did go outside for about 30 minutes on Monday night but doesn't usually go to the loo outside!).....she's eating and playing and seems perfectly fine, just no poo. Doesn't seem in any discomfort or anything. She usually goes once every 24-36 hours so beginning to get a little concerned.....
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Okay, sending "poo vibes" to Sky. Go, Sky... literally!
 
;) Sending poo vibes from Texas! Fred left me another little poo today. I gave him 1/2 tsp Pedia Lax ( docusate sodium) stool softener diluted in 6 cc water again today and 1/2 tsp pure pumpkin in his feeding. (E tube) Still not much of an appetite and need to get his strength up and then cut back on feedings so he'll be hungry hopefully.
 
Poo vibes always work :) Maybe I should have specified I didn't want them to work just as I had finished preparing my food ! At least she has been without any assistance needed.
 
Yay doing the poop dance!

Miralax works well for us. Sockeye salmon - just a drop or two a day - is also helpful. Another route that is more intensive but very good is bone marrow broth. If you are feeling ambitious, simmer bones in water for hours in a slow cooker. The resulting gelatin is not only very healthy but also has gentle laxative effect.
 
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