3/9 Dimmu PMPS: 380. Still constipated. Help please.

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Hello everyone!

Dimmu's wounds finally stopped bleeding 11 days after his dental surgery, but he is still constipated, it started after the surgery. We have tried everything, olive oil, coconut oil, SEB, AVJ, egg yolk powder, raw egg yolks, Dulcosoft (Polyethylene glycol 4000, the best I could find here that's similar to Miralax) all the while waiting for the order of Miralax to arrive.... He couldn't poop everyday and even if he did, the amount was so tiny he stayed blocked and had to vomit a few times.

We went to the vet on Wednesday and were told that there's no obstruction. The vet prescribed Microlax enema and Lactulose which helped him pass 2 very hard but tiny stools Wednesday night and Thursday morning, and that was it. We gave him glycerin suppository last night and started him on Miralax (stopped giving him Lactulose), he made a bigger stool today. The vet said it's enough for now, and we should give him more Microlax enema to help him pass everything. We gave him the glycerin suppository instead, it didn't help much this time, he's only straining, the contractions are pretty violent, but nothing comes out. He's bloated and I could feel the log in his colon when I try to massage him. Is there anything more we can do to help?

Despite the poop drama, he had a pretty good cycle last night, all yellow for 12 hours for the first time, and of course he bounced today..... He's due for an increase again tomorrow, should I increase him to 6U tomorrow?

It's been quite a tough week for some of people here, hope things will start to look up soon. Have a great weekend, everybody.

 

Try pumpkin - Soulistic brand, sold in PetCo makes pureed pumpkin, 0% carbs, or you can buy fresh one, cut and steam or boil it down.
Another thing to try is to add extra water to his food. Massaging their belies often helps with going.

Opium based pain killers often cause constipation - have they given him anything like that after the surgery? One of the most common Rx is Tramadol (spel?) - most likely big time "constipator", although it'll take more than a dose, I think, to get symptoms.

 

oops, I see now that you are in the EU - the products I mentioned are for the US.
Try steaming & mashing some fresh pumpkin, and add a little with some water added to his food. Most cats don't object to pumpkin at all.
I also read some type of squash instead of pumpkin works, but cannot recall which one.

 

Miralax works by drawing water into the colon. It doesn't work immediately. Adding water to his food will help the process.

 

Butternut squash works, but I think almost any type of winter squash would do. It's the fiber you want. Have you seen the website http://felineconstipation.org/ ? The version of PEG you have is pretty close to Mirilax. In Canada ours is PEG 3350 and called Restoralax.

I would increase to 6.0 units. One thing we suggest to people whose cats get to 6 units, is to test for high dose conditions. The first I would try is the IGF-1 test for acromegaly. One in four diabetic cats has acromegaly. Your vet would draw the blood and sent it to Royal Veterinary College in London for testing. One of the symptoms that some acrocats get is called mega colon and causes difficulty with

Best of luck.

 

Thank you, guys for the help.

His meals has gone from stew-y to soupy in the past few days because of the laxative I gave him, so much that he almost doesn't drink from the water bowl anymore. He is still peeing alright and normal amount.

I gave him pumpkin before, but I am not sure if it helped. Do the pumpkin fibers bulk up the stool? He used to respond well to psyllium fiber, but his stools are so thick and packed these days, I don't think it's a good idea to keep giving him psyllium, it will only make it even bulkier and more difficult to pass, no?

 

Since he started insulin, I have been reading about high dose conditions because he is so difficult to regulate. I really hoped we wouldn't reach this point..... but it is what it is. I increased him to 6U this morning. Will see what happens.

As for the IGF-1 test, I remember you mentioned there's a chance of false positive if it's done within 73 days of starting insulin treatment, should we wait with that? I am not sure my vet has experience treating acrocats, but she seems like the type that enjoys learning. Will definitely start prepping her for the idea...

 

I am not sure I know how exactly pumpkin works but it is good, natural laxative. Its effect is short lived and it maybe the best to keep adding pumpkin+extra water consistently for some time and observe the effect. If in the past you gave him just a portion or two of pumpkin it may not have been enough to do the job. Ducia's poo is not bulkier with pumpkin than without and she eats food w/P almost every week. She is rarely constipated.
Another thing to try is to add clippings of fresh wheat grass to ea meal - about 1/4 teaspoon/portion. Wheat grass is a good source of fiber and in Ducia's case - helps with hairballs, too.
Use with caution because some cats had allergic reaction to it.

Sounds like a bit of dehydration here. Water and a little bit more water is the thing to try. By adding water to the meals you control the amount he drinks which is better then to rely on cat to drink enough. Ducia has up to 100 ml a day extra.
I hope the poo situation is resolved soon and Dimmu is feeling better!

 

Thank you @Tanya and Ducia , I boiled some pumpkin today and gave him 1tsp (Dimmu is a big guy, 25lbs).

We used to grow wheat grass in the house, but our civvie, Canna, was so crazy about it that she ate so much of it and threw up some blood with it. Then we tried portion controlling it, but she would "bark" to get grass if it's in her sight. Our current house has a garden, it's grass heaven for her and nightmare for us to control her. Dimmu is usually less interested in grass, but since he's blocked for such a long while, he seems to be looking for grass in the garden for relief. I will grow some wheat grass again, hopefully it helps with Dimmu's constipation.