Friend's 28lb cat severely constipated, any advice??

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Hendrick Cuddleclaw

Hendrick Cuddleclaw

Member Since 2022
Logan is in distress. He is 9 years old and this is what I know:

"Severe constipation. It's supposedly clogged in 3 spots, and he hasn't evacuated any of it yet. He's 9 y/o, vitals seem to be fine, and they said that at least the poop felt much softer from what they could feel from his abdomen. He's barely moving now, probably because of the meds (pain killers, laxatives, something to increase his apetite and 2 other things I can't remember). When he walks, it looks like his legs at the back are just sliding on the floor. He ate a lot last night (controlled portions) but he's not drinking enough water and hasn't eaten much, if at all, today." -- that is what I got via a discord message, they are in Quebec btw.

So he was at the vet 48 hours, got 3 enemas including a nasogastric tube and still no movement so they discharged him to see if when at home, he poops. But as you read above, no poop, not much movement, no food intake.

Of course I already gave the whole spiel on dry food, switch to raw/canned and taper that dry food out and also feed right amount of calories to drive his weight down.

But that is IF he survives this. Which, based on how today is going...honestly doesn't sound good to me.


Does anyone have any suggestions for Logan's human I can relay? Tagging a few of the super-knowledgable peeps @Bron and Sheba (GA) @Sue and Luci @FrostD @Diane Tyler's Mom @tiffmaxee
 
I can’t believe they were not able to unblock him. Is he getting fluids? Was this at a general vet or ER? I’d bd going to smother get as this sounds way too serious to handle at home. So sorry I can’t be of more help.
 
FrostD said:
I agree with Elise, this sounds too serious. Did they start on lactulose or miralax or anything? We also just had Mouse (@Kahluasmom ) with a similar issue but she thankfully went after a few stressful days.

@Suzanne & Darcy ?
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I knew I was forgetting someone ty! And yes laxatives given don't know what kind though. I told my friend that he and his girlfriend should post a thread here but they didn't get to it yet so I did it for them. So my apologies this is all 2nd hand info

far as fluids - doesn't sound like he is eating or drinking today, or moving much at all. Sounds like a dire situation to me tbh
 
I have to go to my 82-year-old mom's house now, won't be able to check this thread again for an hour or so. But I will! thanks in advance, and thanks @FrostD I already passed on that one thought you had -- try a different vet

apparently, the vet they did go to said "ok let's see how he does at home maybe more relaxed, and we get movement. If not, we'll need to operate"
 
Apparently that's a thing, they give enemas and send home. That's what happened with Mouse, she had a few (including at home ones) and was sent home to wait it out. I believe she also had an x-ray to see exactly what was going on.

I really don't know at what point you say ok operate...but several days without eating or pooping, all the pain and unable to walk....if it were my cat and I could afford it, I think I'd be saying operate today, or tomorrow at the latest. I don't know if feeding tube helps in these situations, but at least some lactated ringers solution?
 
Hello everyone!

Thanks again for making this thread for us.

Logan is our cat, so I'll try to answer some of the questions here. Thanks A LOT to all of you for trying to help by the way, as we're pretty overwhelmed by this situation, so we appreciate it :)

Oh and I'm a native French speaker so sorry in advance if I don't explain everything properly. Trying my best, but my medical vocabulary isn't great, and I won't know the English name of some of the meds.

We went to the ER as soon as we realized something was wrong on Sunday night. This is also the only pet hospital that we have in the city, so AFAIK it's our best local source of professionals. We brought him back home last night (Tuesday), so he stayed there a full 48 hours.

We had to choose between letting him stay for a 3rd night or bringing him home. The vet said that both options were fine, so we agreed to bring him here as he's always super anxious about everything and were hoping being safe at home would be what he needed. They've told us to give it a shot for 24-36 hours with the meds, new food, monitoring, etc., and to bring him back to the ER if he still hasn't pooped by then. We've had him for 18 hours now, and unless we missed it, I don't think he pooped (he did pee though). He's mostly been sleeping, and doesn't move around much. His breathing sounds normal, and he purrs a bit when I brush him, but he's clearly not as lively as he usually is.

As for the meds, he got :
  • Lactulose (laxative + prebiotic) 3ml every 8 hours, orally with a syringe
  • Cerenia (anti-nausea), 12mg once a day for the next 5 days
  • Lax-a-day (laxative) 1/4 teaspoon morning and evening in food
  • Cisapride 5mg orally every 12 hours for 14 days
  • Mirtazapine (apetite stimulant) 2mg once every 48 hours, as needed
  • Gabapentin (painkiller) 100mg orally once every 8-12 hours for 7-10 days
We also got some high fiber dry food that they recommended. Added tons of water bowls everywhere + cleaned our 3 water fountains. Added 2 other litter boxes in the house (we have 2 other cats, 5 litter boxes total now).

I think it covers everything!
 
Hi and welcome. Poor Logan,I’m sure he is feeling miserable.
How long since he has eaten? If it’s 24 hours I would definitely contact the vet as cats need to eat.
I also think he needs some IV fluids to keep him hydrated and to help move the constipation along.
In my opinion Gabapentin 100 mg every 8 hours is too much.. I would question that. I have seen a cat die from having that much gabapentin. Personally I would cut it back to 50 mg twice a day. That will be making him drowsy.
I would contact the vet now about moving forward with him.
 
There is such a wide range of dose for gabaentin, but Bron is right it often just makes them loopy/uncoordinated. He's a big boy, but I would try decreasing it and see if he's still ok on a lower dose.

As far as the food, fiber is great but you also need enough water to keep it wet and moving...or it makes things worse.

Will he let you syringe feed/water him?
 
Quick update about Logan. He had not pooped, wouldn't eat or drink, and was starting to drool + breathe heavily, so we decided to go back to the ER.

They'll do a few more enemas, will give him IV fluids, and do another X-ray to get a better understanding on what they're dealing with. They're not going to do the nasogastric tube thing again since they believe it could do more harm than good because he hasn't evacuated the previous treatment yet.

They also told us that they can't really do a lot more than that considering his weight, so if it doesn't work this time, we'll have to talk about an operation, and... I don't know what we'll do at that point because of the risks involved and his quality of life.

I really really hope they'll call us tomorrow with some good news...
 
I am glad you took him back to the ER. I hope they have success with the enemas.
As he’s only 9 years old I would have thought he should pull through the operation fairly well, providing they don’t leave it too late.
Please keep us updated. Sending best wishes.
 
man that really sucks Star I hope he turns a corner. Crossing my fingers and toes

You did the right thing taking him back in though based on what you described he was not going to recover at home. no way
 
I am surprised at the appetite stimulant. I would think a feline with an obstructed bowel should not eat more food, but then again I also know if a cat doesnt eat it can lead to all sort of other issues.
 
Hendrick's mom and dad said:
I am surprised at the appetite stimulant. I would think a feline with an obstructed bowel should not eat more food, but then again I also know if a cat doesnt eat it can lead to all sort of other issues.
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I think that would depend on whether they feel it's obstructed or impacted - did they mention an ultrasound?
 
I’m glad Logan is back at the ER. Constipation is nothing to mess with.and can become life threatening.

Tubby had an ongoing problem with constipation/obstipation and had to have surgery twice. Surgery saved his life—It was ridiculous the amount of stool they removed from him. He weighed around 26-28 lbs (acro). Eventually through trial and error we figured out how to mostly keep things under control but it took awhile.

I send my best wishes.
 
JL and Chip said:
I’m glad Logan is back at the ER. Constipation is nothing to mess with.and can become life threatening.

Tubby had an ongoing problem with constipation/obstipation and had to have surgery twice. Surgery saved his life—It was ridiculous the amount of stool they removed from him. He weighed around 26-28 lbs (acro). Eventually through trial and error we figured out how to mostly keep things under control but it took awhile.

I send my best wishes.
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how do they remove the stool? Make an incision, and then like squeeze it out of the intestinal tract? I am sure it is tough on the kitty but as you mention, it can save their very life. Glad it worked out for you and Tubby.
 
I got an update and it sucks

more enemas given, no bm

they think he may have developed megacolon (I need to google that, no clue)

so surgery is on the table, which will involve removal of his colon apparently. So not sure how that impacts the rest of his life exactly, or they will just make him comfortable and say farewell.

@#$% #$%^& :(:(

[edit] Update update: surgery is a go for tomorrow morning, they did some sort of scan to check if they could even go ahead and the results were good and he is a "good candidate"

In my thoughts even though I don't know this kittah. Wishing the best
 
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https://felineconstipation.org/whatgoeswrong.html

"There are conditions such as spinal cord injury or congenital malformation which can result in constipation that are beyond the scope of this discussion. Megacolon is also beyond the scope of this discussion but here is a word about the condition. There is a common misunderstanding that megacolon is like an old stretched-out pair of panty hose, that large stoolsmight somehow stretch the bowel out of shape. This is not how things work. Acquired megacolon (as opposed to congenital megacolon or spinal cord injury) can result from damage to the enteric nervous system, damage from neurotoxic by-products of pathogenic gut bacteria. If there is no nerve action, nothing will move even though the bowel muscle is intact. The problem is not the enlarged portion of the colon but the section which does not allow the stool to pass, does not receive the stool, is no longer dancing. This type of acquired megacolon could be considered a form of peripheral neuropathy."
 
Hendrick's mom and dad said:
I am surprised at the appetite stimulant. I would think a feline with an obstructed bowel should not eat more food, but then again I also know if a cat doesnt eat it can lead to all sort of other issues.
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I think the idea was that they had done everything that they could, but the last clog at the end could not be reached, and because of his weight, their options were very limited, so having him eat would also help pushing it all out.

And yes, the "some kind of scan" that they did was an ultrasound. Sorry, I didn't know what it was called in English.

I really think he's in good hands and we've agreed to every medical recommendations that they've given us. I'm not 100% sure what a megacolon is, and to be completely honest, I'm not in the best mood to read about it.

My wife just came home from seeing him one last time before his operation. We know it will be tomorrow morning (so in about 14 hours), and they'll give us a call before doing anything. I don't know how long it will take, and they didn't want to give us a % of success, only that he was a "good candidate" and that they're waiting for the morning to be sure that their best team will be there for the operation and (hopefully) to monitor his recovery after a successful operation. They'll be keeping him at least for the next 3 nights if all goes well. I'm really hoping it will, but it's been a succession of bad news so far :(

Oh and he's the big redhead in my avatar pic. The other one is called Pudding, our latest arrival. The 3 cats that we have used to be stray/feral cats, and they're all wonderful. We're doing everything that we can to keep Logan in our happy little family.
 
JL and Chip said:
I’m glad Logan is back at the ER. Constipation is nothing to mess with.and can become life threatening.

Tubby had an ongoing problem with constipation/obstipation and had to have surgery twice. Surgery saved his life—It was ridiculous the amount of stool they removed from him. He weighed around 26-28 lbs (acro). Eventually through trial and error we figured out how to mostly keep things under control but it took awhile.

I send my best wishes.
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Thanks for your reply. Yes, we went back to the ER as soon as things started to be worrying. They were surprised to see us coming back so quickly, and recommended at first that we bring him back home since we had all the meds they'd be giving him anyway, and he probably just needed a bit more time to get better. I'm so glad that we insisted to see the vet and have her check him again to be sure before leaving, otherwise he'd probably have died overnight.

How old was Tubby when he had his first surgery? Were they concerned about the procedure? Did it have long term effects on him?
 
Starforsaken said:
How old was Tubby when he had his first surgery? Were they concerned about the procedure? Did it have long term effects on him?
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Tubby was a rescue and we don’t know his history, so we never really knew Tubby’s age … best guess was maybe 8 or 9 years old at the time of surgery. I think there’s always concern for surgery of that type, but we really had no choice. Tubby was in significant distress, projectile vomiting, open mouth breathing, and so on. The vet was a general practitioner (not a specialist) but he was a skilled surgeon with years of real-life experience. I recall being told that the first few days after surgery were critical. Tubby came through very well with no apparent long-term negative effects. We DID, however, have to be mindful to track carefully his litter box habits and make sure things were still “moving.”

It took some time and experimentation to find what combination of food and medication worked for him.

I’ll be thinking if you tomorrow. Please post an update and let us know how the surgery goes.
 
Hendrick's mom and dad said:
@Starforsaken any updates?
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Yes! The surgery went fine! He rocked it like a champ, and woke up about 2 hours ago. His fever was down earlier this morning and he ate a bit, so this was a great day for us finally!

I don't have much details about the surgery because they called us while we were both in an important meeting, but we'll ask our questions tomorrow when they'll call to give an update.
 
Thanks for the kind words and the help everyone, I really appreciate it.

We just heard back from the vet. Logan doesn't have any fever anymore, there's no sign that there's any problem with the scar or his intestines, and he's not having problems breathing or drooling anymore.

The current concerns right now are that he still hasn't eaten yet (it's critical that he does), and doesn't want to walk. It would've been better if he did, but they're not that worried yet. They may have to feed him from the tube in his nose later today though. We also don't know if we'll still be able to see him tomorrow and bring him home, or if it'll have to wait until Monday.

Personally, I'd rather leave him there a bit longer with the professionals, but my wife would rather bring him home as soon as we get the greenlight. Opinions?

We also got more details about his condition. Basically, it was a megacolon, and it was a single clog spanning his whole colon. There was absolutely no way he would've been able to live without this surgery.

They've removed his colon, but fortunately, both of his "valves" were fine so they were able to leave them there and reattach them (?) (sorry, I get mild panic attacks when I hear about medical stuff like this, so I've only remembered/understood the most general stuff). Apparently this will help against diarrhea and incontinence, so that's a good news.

We'll also have to prepare a very specific diet for the next two months since he must not lose weight during that period, and then we'll move him to a weight loss program. We have to call "Hills" (food company?) who apparently have vets that will receive Logan's medical reports and will recommend the best diet for him. Anyone ever did that?

That's it for today's news. We're still happy and confident that he'll be here with us soon :)
 
Usually it is the vet that contacts Hills. Their sales reps do a lot of leg work with vets. Maybe because it is the weekend.

Apparently there is a Facebook megacolon support group for cats. They have developed a protocol. Click on the blue link.

Sending prayers for an easy recovery from Ontario.
 
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