8/27 Snuggie hanging in there

Jay Dee

Jay Dee

Member Since 2021
Gave his full dose last night based on PMPS; I’m hindsight I should have given him a reduced dose.

67 @ +8 fed HC (he ate prob about a tablespoon or more)
55 @ PM+9.5, fed HC (he ate a few tablespoons)
60 @ PM+10
No insulin given this am since he’s back at vet - He produced a few small poops overnight but nothing substantial, so we are trying 1-2 more enemas then we see what the options are. I’m not thrilled about sedation and am weighing the risks and benefits of a deobstipation procedure over how hard he’s fought for the last 6 months and all he already endures in a day, and if he’ll tolerate anything else added to his already rigorous daily treatment plan. I kind of feel like maybe this is our “one last thing” but don’t want to be selfish either.

EVENING EDIT: he pooped finally and is eating but not “well” - would like dose advice for this eve based on last nights experience

yesterday’s post - https://felinediabetes.com/FDMB/thr...le-no-insulin-despite-bg.252032/#post-2843804
 
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I haven't logged in for a while, so sorry to read about your and Snuggie's trials and tribulations this week. I hope you get some good poops out of him today. Will be thinking of you and looking forward to hearing good news - these are the days we don't want to be in your position but inevitably we are all there at some point. :bighug::bighug::bighug:. Come on Snuggie, poop for us!!
 
Poor Snuggie, and poor you. :bighug::bighug:

Megacolon is a possible side effect of acromegaly, if your vet doesn't know that already. Might be time for the big guns like lactulose. Paws crossed for enema success.
 
Thanks guys! We are home. He’s had a few successful but small BMs but things are soft and moving. If he continues to go, no more enemas needed. If he doesn’t go anymore tonight we may do one or two more tomorrow. But so far deobstipation is avoided - whew!

Lactulose is in play - we have a plan for now, then once things are moving normally.

would you suggest we stay with lactulose rather than miralax going forward?
 
Hang in there Jill and Snuggie! Good to hear that there is promise on the poop front! Have you ever considered also adding in sub q fluids with everything else? That has been successful for me and Pearl and the constipation struggle.
 
Margaret (and Pearl) said:
Hang in there Jill and Snuggie! Good to hear that there is promise on the poop front! Have you ever considered also adding in sub q fluids with everything else? That has been successful for me and Pearl and the constipation struggle.
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Thank you!! Yes we had been doing 50mL daily but increased it to 100 now that we realized he likes LRS better than normosol - thank god we figured that out right when we needed to start giving him more!
 
UPDATE: HE POOPED! We are out of the woods! Yay!!

@Suzanne & Darcy id prefer miralax just because I can mix into food rather than another syringe thing - he was traumatized by gabapentin via syringe in the past and I’m happy we can give his cab via syringe. I’m going to work with the vet for a higher concentration liquid of cab next refill so we don’t have to give as much liquid but any time I can avoid syringe administration I try! But if lactulose is better we can prob put the cab in his food. He loves bacon marshmallow! Yes please PM away
 
Jay Dee said:
would you suggest we stay with lactulose rather than miralax going forward?
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Yes to the lactulose, it is more effective. It is insoluble sugar, so shouldn’t affect BGs.

Hydration is key, so the subq fluids should help alongside the lactulose to help things get moving, then you can create a maintenance plan moving forward.

Some poop is a good thing! Better than no poop :)
 
Miralax requires a lot of water, other wise it can create more problems and it takes longer to work (a few days). 2 tbsps of water to 1/4 tsp Miralax. Mix it, then put it on the food. I’m not a big fan of it, but understand that others may find it work just fine. I read a research study that it can affect potassium levels over time.

Lactulose can be put on the food or just on a dish. Cosmo has seemed to tolerate that well.
 
Thank you @thebigfuzz !! I add water to his wet food and we give fluids but maybe with the phos binder and everything else it’s not the best option. I’ll try mixing it in food and see how it goes. Right now he’s not eating his usual amount altho I’m sure now that he’s pooped the big one his appetite may return soon. He’s getting 3mL 2x a day today and tomorrow (that’s a lot for food lol) then we will taper down to a maintenance dose. So we will see how it goes.

speaking of not eating well just yet- @Wendy&Neko @Suzanne & Darcy id love some dosing advice for tonight based on last PM cycle hitting 55 at +10. I’m not sure if I should give full dose or a reduced dose?
 
I've been steadily increasing her dose of Lactulose to 2 mls from .5 mls and adding it into Ruby's food twice a day and she doesn't notice. I'm also giving subQs but not every day. I was giving Miralax every day for a long time as her oncologist suggested it was easier to administer because it doesn't have any taste but it didn't work. It was either no poop or diarrhea.
 
PerfumedCatMom said:
I've been steadily increasing her dose of Lactulose to 2 mls from .5 mls and adding it into Ruby's food twice a day and she doesn't notice. I'm also giving subQs but not every day. I was giving Miralax every day for a long time as her oncologist suggested it was easier to administer because it doesn't have any taste but it didn't work. It was either no poop or diarrhea.
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Ahh good to know. I’m basically sold on lactulose after all this!
 
Sorry to be late on the dose tag for tonight. With the skip both yesterday morning and today, the depot will be even more depleted tonight. 9 units will be fine, but I'm hoping you'll have less drama tonight.
 
Wendy&Neko said:
Sorry to be late on the dose tag for tonight. With the skip both yesterday morning and today, the depot will be even more depleted tonight. 9 units will be fine, but I'm hoping you'll have less drama tonight.
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Less drama will be wonderful - we are all tired!!
 
Jay Dee said:
UPDATE: HE POOPED! We are out of the woods! Yay!!

@Suzanne & Darcy id prefer miralax just because I can mix into food rather than another syringe thing - he was traumatized by gabapentin via syringe in the past and I’m happy we can give his cab via syringe. I’m going to work with the vet for a higher concentration liquid of cab next refill so we don’t have to give as much liquid but any time I can avoid syringe administration I try! But if lactulose is better we can prob put the cab in his food. He loves bacon marshmallow! Yes please PM away
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Most cats don’t seem to mind Lactulose in food. Does he eat baby food? You can mix it in there. How much did he poop? If it’s still small hard balls then that’s a problem.
 
:cat::cat:Thanks everyone for all the support and good vibes! All is good: he’s still a little out of sorts after 6 enemas but things are flowing and he’s eating. We did a reduced dose the one night then went back up to his usual, but he’s had a few cycles where he hit mid-50s (even with a normal appetite and usual amount of food on board) so I’m reducing tonight. Sorry I didn’t update yesterday - we were all tired!

oh - the bacon marshmallow is his cabergoline for acromegaly. :-)

Thanks again everyone!
 
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