Constipation

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Sandy and Brie

Member Since 2012
Hi my name is Sandy and my diabetic kitty is Brie and he is a he. I adopted him when he was 10 years old and never changed his name. He is 15 now and has been diabetic since he was 11. Prior to the last few months he was getting 1 unit of Lantus twice a day and was rock solid stable with his sugars. He now has CKD and probable large cell lymphoma. I say probable large cell because I never had biopsies done. He's had a few US done in the last few months and the radiologist first thought mast cell vs lymphoma after his October US. He found a mass on his liver but the followup US showed no change in the liver but the gastric lymph nodes had gotten bigger and he also started showing some gastric thickening thus now the radiologist thought large cell lymphoma. There was no intestinal involvement at that time and that was in the beginning of November. Brie eats only ff classics. He was started on pred in the beginning of November so his sugars have gone up but we've been managing. I've been giving him subq fluids as well for his CKD. Today he was acting funny in the litter box. I took him to the vet and he was constipated. He got an enema with good results. I've never had this problem with him before and I'm afraid that it may happen again. Does anyone have any suggestions as to what I can do to prevent constipation? My vet said I could give him either metamucil or benefiber 1/4 tsp twice a day. I just wanted to see if I could get some feedback. I believe that these fiber additives could effect his BG as well. Yes I do home test and I'm glad I do. He threw up after the enema and it was breakfast. Of course he got his regular dose of insulin today after breakfast and before we knew anything was wrong. BG was 50 at 4pm and 112 at 8pm. No insulin tonight.

Thanks Sandy
 
Most people here use Miralax for consitpated cats. The dose is 1/4 teaspoon to 1/2 teaspoon. You can give it up to twice daily, I think. Dissolve the Miralax in water first and then mix it into canned food.

Canned pumpkin is another alternative. Look for regular canned pumpkin with no suar or spices. You do not want canned pumpkin pie filling.

I've used Benefiber for a civie but I don't know if it would affect bgs levels for a diabetic cat.
 
what food are you feeding? Most people feed a wet food and just mix in the miralax but be sure to add more water than usual to the food. I put 1/4 tsp into a small amount of my cat's am and pm meals with extra water, then when it's eaten, I add the rest of those 2 meals onto the plates.

My cat has megacolon so he also gets lactulose BID 3ml, cisapride TID .5ml, and 1 Senokot tab a few times a week... all in addition to his miralax in 2 meals a day. He also gets 100ml subQ fluids every 2nd day.

The miralax and lots of extra water in the food as well as his fluids should be enough to keep him regular once he starts movements after the enema.
 
I give him ff classics mostly salmon since it is lowest in carbs. Adding water to the food is a good idea. I worry since he has CKD and that the miralax may dehydrate him. He does get 100 ml of subq fluids every other day.

Sandy
 
traubboo said:
I give him ff classics mostly salmon since it is lowest in carbs. Adding water to the food is a good idea. I worry since he has CKD and that the miralax may dehydrate him. He does get 100 ml of subq fluids every other day.

Sandy

when you add water at the start, do it gradually as some cats need to get used to the change.
And yes, for sure, you need to add more liquid into the cat with the miralax as it draws moisture from the cat's body into the bowels to soften the stool for 'exit'.

For the fluids, you can always give the same amount of fluids only give every day, yes? It may be easier on your cat to give 50ml a day.... just a suggestion in case your have one of those cats who will sit for the first part but get antsy after passing the 50/75ml point.
 
Thanks for your replies. I'm going to look into the pumpkin. I have the miralax at home. I don't know about doing the fluids every day. We did them every day for 3 months from July through September. He was not happy. I just ordered some 19 and 20 G terumos and I'll see if that makes a difference. I'm hesitant about the miralax but I know I probably have to do it.

Sandy
 
traubboo said:
Thanks for your replies. I'm going to look into the pumpkin. I have the miralax at home. I don't know about doing the fluids every day. We did them every day for 3 months from July through September. He was not happy. I just ordered some 19 and 20 G terumos and I'll see if that makes a difference. I'm hesitant about the miralax but I know I probably have to do it.

Sandy
I would go with the miralax because if you have already needed to give your cat an enema, you could be heading to a chronic problem.... the miralax and the water will help to keep the stool soft and passable.

what did you mean about the 19 and 20 needles making a difference? What size needles are you using now for fluids? The numbers are just needle size and will just result in slower input of the fluids.
At the vet, they often are using 18s because they are big and get the fluids into the animal fast, but they are uncomfortable for some cats, plus you have to use the wheel to adjust the fluids flow.... fast flow seems to upset some cats .... my two did NOT like the 18s, and I made sure that the biggest I used were 20s, but my Shadoe liked the 22s because they were much smaller and the flow took longer but she was willing to sit still for 100 or 150ml.
 
My cat, Jibber (my avatar picture with the blue scarf) has always had constipation troubles, but once I started him on the Miralax, about one eighth to one quarter of a teaspoon, twice a day, he has been going a lot more easily.

I also add water to his wet food, and I really believe that has helped him the most. The vet had him on the lactulose, but that did not help.

Best wishes,

Jean and Charcoal (GA) cat_pet_icon
 
Thanks everyone. I gave my first dose of miralax with dinner. I also added water to the wet food and Brie ate it right up. I just hope to see some poo. Generally how long does it take to start working?

Sandy
 
Tess gets a daily dose of Miralax to keep her regular, mixed right in the food w/ extra water, 1/8 tsp in the evening and another in the morning if there has not been a poo. Even plain pumpkin will add carbs to the food.

Do you fee FF because that is all he will eat? Most of the Classics are pretty high in Phosphorus for a CKD cat. Dr. Lisa has updated the food lists and shows Phos levels as well. You want something under 250mg/100 kcal or less than 1% on a Dry Matter basis. I have a condensed list in a tab on Tess's SS of foods I can use for Tess.
 
traubboo said:
Thanks everyone. I gave my first dose of miralax with dinner. I also added water to the wet food and Brie ate it right up. I just hope to see some poo. Generally how long does it take to start working?

Sandy

How long it will take will depend on the 'condition' of the stool inside the cat..... the secret to know is that the miralax is drawing water from the body, so you are upping the intake by adding lots of water to the food, plus you are already giving fluids which should be enough to get some sort of 'movement' in a couple days.

Watch for trips to the box and if any attempts but no deposits, then if you see some very loose stuff at the start, it does NOT mean diarrhea, but rather the start of working out some previously too hard to pass stool.

My Oliver often is a bit touchy on his sides when the bowels are in the process of preparing the next output.

Just watch him closely for changes in his habits; if he drinks all the water out of his food bowl you can add more if you like.... Oliver almost likes the watery food better than the food left after he laps out all the liquid.
 
Hi Blue
Yes when I mentioned the needles I was talking about the size. I've been using 18 G needles. Brie is the one that is more difficult to give fluids to. My other boy Vandow is really good about them. I like the 18 because it goes so fast. I ordered the terumo needles mainly for Brie. I'm hoping a smaller and possibly sharper will make things go smoother. I haven't opened the boxes yet. I'm still waiting on a poo. I think I'll take him in tomorrow for a possible enema. I've had him isolated a few times but nothing. I think he may have had a few nuggets last night but with four cats I can't be sure. I think they were his though. Thanks Ann about mentioning the phosphorus in ff. Brie is not a picky eater so I will take a look. I've been thinking about the phosphorus in ff for a while now but have done nothing about it. I really wish my boy would just poo. All kinds of things are going through my mind now. I'm worried that his cancer may have spread more now. I really need to take a deep breath. Besides this new issue of constipation with Brie I'm also dealing with my boy Vandow who has not been doing well.

Sandy
 
traubboo said:
Hi Blue
Yes when I mentioned the needles I was talking about the size. I've been using 18 G needles. Brie is the one that is more difficult to give fluids to. My other boy Vandow is really good about them. I like the 18 because it goes so fast. I ordered the terumo needles mainly for Brie. I'm hoping a smaller and possibly sharper will make things go smoother. I haven't opened the boxes yet. I'm still waiting on a poo. I think I'll take him in tomorrow for a possible enema. I've had him isolated a few times but nothing. I think he may have had a few nuggets last night but with four cats I can't be sure. I think they were his though. Thanks Ann about mentioning the phosphorus in ff. Brie is not a picky eater so I will take a look. I've been thinking about the phosphorus in ff for a while now but have done nothing about it. I really wish my boy would just poo. All kinds of things are going through my mind now. I'm worried that his cancer may have spread more now. I really need to take a deep breath. Besides this new issue of constipation with Brie I'm also dealing with my boy Vandow who has not been doing well.

Sandy

When you are at the vet, ask about lactulose, cisapride, senokot and other helpers for the constipation if it's extreme.

For fluids, the 18s may be fast but I don't think they feel good at all. Both of my cats squirmed with 18s and Oliver does not even like 19s, but is OK with 20s. My Shadoe HATED all of them but she was content to sit longer when I used 22s. I know they are slower but if it eliminates the discomfort, it's worth it.
What if you can get a couple of the smaller sizes from your vet just to try; you may be surprised that the smaller takes longer, but is more to the cat's liking.
 
Hi Blue
My vet did mention cisapride or something like that on Saturday. She wanted to wait and see how he did. If I would start cisapride is that something that Brie would need every day. I guess what I'm wondering is if he will become dependent on it to have a bowel movement. When I was there I asked about adding benefiber or metamucil and she said I could do that. I never mentioned miralax. After doing some reading it kind of scared me to add fiber. After posting here it seems like miralax is what most people use. I also joined the yahoo megacolon group yesterday. Not much activity on that group yesterday or today. I'm guessing the holiday. I hope my vet doesn't get upset with me for starting the miralax. What are your feelings about fiber additives. I tried the 19 G on Brie tonight for his fluids. The jury is still out there. I think his next session I'll try the 20 G. I think the fluid itself is bothering him more then the needle stick. I'm happy he lets me do it.

Sandy
 
Hi,
Nice post.Constipation occurs when bowel movements become difficult or less frequent. There are numerous reasons and causes of constipation:
Consumption of quick foods and foods that lack several fibers
Inadequate fluid intake.
Eat several Fibers.
Thanks.
Colon constipation
 
Re: Constipation - Metamucil??

Has anyone had luck using Metamucil? I have an older cat, recently diagnosed diabetic. Lantus did not control her blood sugar at all - was like using water. Now she's on ProZinc and hoping this works for her. When I switched her to Purina Diabetes Management she got very constipated. Don't use this food - I later found out it's high in fat and has corn meal in it - UGH! What's Purina thinking? Also, it's VERY expensive at almost $3/can. I switched her to Weruva - there are certain flavors that are very low in carbs and fats - like the fish and chicken varieties. I then tried psyllium fiber - which actually made my cat's constipation worse, because it draws water from the colon. It actually caused a blockage. Then I tried Miralax, which the vet said be careful because the polyethyl glycol can cause anemia. I now am trying Metamucil (inulin) - give her about 1/2 to 3/4 teaspoon per day mixed with food and water. This is only about day 2 and so far no results. I'm wondering why the vet hasn't given me a prescription for something to relieve the constipation as I have taken her in about 3 -4 times in the past 2 months for enemas. Any suggestions?
 
I'm pretty sure that metamucil is a psyllium fiber. If that is the case you may want to stop it. You could also join the yahoo feline megacolon group. There are a lot of poop watchers over there. They are very helpful. Most people in that group are not big fiber fans. Fiber can increase the bulk of the stool but the cat may not be able to push it out. As the stool becomes bulkier the colon may expand distally especially if the cat can't push it out. I can see why a blockage may occur. Brie has anemia due to CKD and I do give him the miralax twice a day. It helps him. I also add water to his wet food. If you do add miralax to the food you should always add water. Miralax only really works on newer stool. I've never heard that about polyethyl gycol. I am thinking I've heard that anti freeze can cause anemia and kidney failure. I can't remember the chemical compound name for it. I'm wondering if your vet is a little confused. I may be confused too. Brie had a few enemas initially and was started on the miralax. Originally my vet suggested a little metamucil. I did research on my own and found the megacolon group. After joining that group I decided to go with miralax instead. When I went back to my vet I told her what I did she was fine with it. She went on her VIN network and saw that more and more vets are recommending miralax now. I also had Brie on cisapride for a few days as well. I'm sorry your kitty is having constipation issues. I know how worrisome it is because if they get blocked it could be an emergency. I will definitely look into the possible side effect of anemia.

Sandy
 
Hi - thanks for the info. I didn't think the Metamucil added fiber like the psyllium did - it dissolves instantly in water without any bulk, so I thought it wouldn't block her. But since she's not going, maybe it already has (?)

How much Miralax do you give your cat daily? I still have it, but it didn't really work for her before.

Thinking the best for now is the cisapride until I can figure out a regular fiber or stool softener. I tried Ducolax liquid and gel pills - no luck there because the liquid has to be diluted in almost a cup of milk (no good for diabetics) and I couldn't get the gel caps into her.
 
I give 1/4 tsp twice a day. I've seen where people have given more and less. It can take a few days to start working. If your kitty has a lot of stool inside your kitty may need and enema or two a few days apart. When Brie had his first enema he had good results. A few days later he seemed to be uncomfortable so I took him back in and had my vet do an xray. I was surprised at how much stool he still had in his distal colon. My vet felt that the stool in the proximal colon looked better and that was probably due to taking the miralax but the stool at the end of the colon was the older stool that wasn't passing. The second enema did the job. Boy did it do the job. I started the cisapride after his second enema along with the miralax. After both his enemas his BG levels pre pm shot were a lot lower than his normal readings. I had to adjust his insulin for the numbers. That was just my personal experience. I just thought I would put that out there. I think Blue one of the fdmb members has a lot of experience with constipation. I have never used ducolax. I was not aware that it could be used in cats.
 
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