Senior Diabetic Constipated and Not Ready To Give Up

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bonnie972

bonnie972

Member Since 2019
Hello,
I am new here and just discovered this site because my dear 17 year old Himalayan has just been diagnosed with diabetes. He recently dropped 4lbs, lost his appetite, vomiting clear fluids every other day and more recently battling with constipation. I haven’t been able to give him his 2x daily dose of insulin because he hasn’t been eating and now he is straining to pass his poop. Vet said his only option is surgery to remove impaction but said his chances are slim due to age, poor heart, and diabetes. He is on day 2 lactulose now. I’m running out of time :( Is anyone else having the same problems with elderly cat ? I’m not ready to give up on him yet. :arghh:
 
I am so sorry he is so ill. I do not have experience with a compaction. Someone will come by who does though and will be able to help you better, as I am still rather new to this.

Can you tell us more about him? What kind of insulin has he been prescribed, and at what dose?

This website is a lifesaver and I am glad you and kitty have found us.

Has your vet checked for ketones? I would be concerned about that with the weight loss, vomiting, lack of appetite, and him not being able to get his insulin. :( These factors together can lead to diabetic ketoacidosis, which can be very dangerous.

Hang in there and know that with proper treatment, it can often get better. Cats can actually sometimes go into remission from their diabetes and no longer be insulin dependent! I’ll see if I can find more info for you.

Hugs to you and chin scratches for kitty.
 
Thanks Cassandra! My baby was prescribed Lantus .5 (half) unit every 12 hours. I don’t believe they checked for ketones. He was hospitalized a few days ago to confirm his diabetes and to find his dosage. We brought him back in yesterday because he still hasn’t pooped yet and doesn’t feel comfortable. I checked his glucose and it was high at 570 after his meal and lactulose. He started acting like himself again shortly after until I tried to massage his colon. He passed some gas and then started growling again. He’s trying really hard to defecate. I can tell he doesn’t want to give up either. :( I should ask about ketones though. Thank you again!
 
You don't say what you're feeding but have you tried adding water to his food? My civie, who has never drunk water, had issues with constipation a few weeks ago and I was on the verge of taking her to the vet when I started adding water to her food - it really helped so I've continued with that and she's been fine since. It doesn't have to be plain water - a light broth made from poaching chicken is just as good if not better... cool it and keep it in the fridge for a few days.

Good luck, I hope you get this sorted.
 
Hello! My baby has been prescribed with Royal Canin glycobalance. I add beef bone broth to it and he has been eating all the sauce from the food and the broth as well. He seems ok sometimes, then sleeps most of the day. His vomiting had stopped since he’s been back and now on insulin. He also gained back a bit of weight. Half a pound :) I’m just worried his constipation is going to cause more problems if he doesn’t pass them out soon . Thanks
 
Diana&Tom said:
You don't say what you're feeding but have you tried adding water to his food? My civie, who has never drunk water, had issues with constipation a few weeks ago and I was on the verge of taking her to the vet when I started adding water to her food - it really helped so I've continued with that and she's been fine since. It doesn't have to be plain water - a light broth made from poaching chicken is just as good if not better... cool it and keep it in the fridge for a few days.

Good luck, I hope you get this sorted.
Click to expand...

What a great thing to think of suggesting for this! :)
 
Does eating all the gravy and bone broth be considered a meal? Would giving insulin after be ok? Vet said that the lactulose shouldn’t spike glucose levels but 570 has been highest I’ve seen. It’s been at 330-350 since the last two checks.
 
bonnie972 said:
Hello! My baby has been prescribed with Royal Canin glycobalance. I add beef bone broth to it and he has been eating all the sauce from the food and the broth as well. He seems ok sometimes, then sleeps most of the day. His vomiting had stopped since he’s been back and now on insulin. He also gained back a bit of weight. Half a pound :) I’m just worried his constipation is going to cause more problems if he doesn’t pass them out soon . Thanks
Click to expand...

A quick bit of google brings me back to FDMB to a post regarding carbs in the Glycobalance - 14%, which is considered too high for a diabetic cat.
http://www.felinediabetes.com/FDMB/threads/carbs-in-royal-canin-glycobalance.196766/
 
bonnie972 said:
Does eating all the gravy and bone broth be considered a meal? Would giving insulin after be ok? Vet said that the lactulose shouldn’t spike glucose levels but 570 has been highest I’ve seen. It’s been at 330-350 since the last two checks.
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The gravy has a lot of sugar. I cannot say personally for certain that it would be enough, because every cat is different and I have not tried that.
Chances are the sugar in the gravy will have a faster effect and then wear off more quickly, and I imagine the broth itself does not have enough in it.

I see 0.5u Lantus 2x/day is prescribed.
What is his healthy weight and what is his current weight?

Lantus has maximum effect typically between approximately 5-7 hours after dosing, so that is when blood sugar could be most likely to drop, and if it drops too much you could have a hypoglycemia emergency.
 
AliceMeowliss&Cassandra said:
The gravy has a lot of sugar. I cannot say personally for certain that it would be enough, because every cat is different and I have not tried that.
Chances are the sugar in the gravy will have a faster effect and then wear off more quickly, and I imagine the broth itself does not have enough in it.

I see 0.5u Lantus 2x/day is prescribed.
What is his healthy weight and what is his current weight?

Lantus has maximum effect typically between approximately 5-7 hours after dosing, so that is when blood sugar could be most likely to drop, and if it drops too much you could have a hypoglycemia emergency.
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Thanks! He is currently 11.8lbs. He has been around 15 pounds as his normal weight. He was 11.5lbs when we brought him to the vet last week. Thanks for the information . I been running on little sleep and still learning how to give shots and glyco testing. I just hope he gets better soon.
 
Lisa and Witn (GA) said:
For the constipation you can add Miralax or canned pumpkin to his food. Add extra water or broth to it also. If you use pumpkin, make sure it is only pumpkin and not pumpkin pie filling.
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Thanks! I’ve tried pumpkin in the past she he just didn’t care for it. I have been adding more liquid to his food. Hope he passes poop soon !
 
He just ate his morning meal. Again just ate all the gravy and the bone broth. I tested his glucose before he ate and it was at 116. I retested after his liquid meal and it is at 152 so I think I may have to skip his insulin. I think he also had vomited half of it out as well. I spoke too soon.
 
I don't have constipation problem with my Ti-Mousse, but I use Miralax for my little 17 yo little girl who has the problem occasionally! She's very fussy and as Miralax is tasteless, I just sprinkle it on her food and she eats it!

Also did a little search on the Forum and found suggestions from two experienced and well-known members (Marje and Bobbie):

(Marje)
- giving him some raw egg yolk? It’s really good for that kind of thing. I’d start with about 1/8 of a raw egg yolk and see if it helps. If not, give him a little more but don’t go overboard. As a more long-term solution, you might want to try FoodFurLife’s raw egg yolk powder.

(Bobbie)
- I give egg yolk powder that I get from www.foodfurlife.com twice a day. You start off small and then work you way up to 1/2 tsp twice a day. It also helps with hairballs.
- I also give miralax daily. Start with 1/4 tsp of miralax twice daily and see how that goes. You might have to tweak it.

Hope this helps your little guy !!
 
Try adding Miralax to the food. Since it dissolve well in water and does not have a taste, he shouldn't have any problems ingesting it. If he's very constipated that may also be part of the reason he's throwing up food and and the broth.
 
Ti-Mousse said:
I don't have constipation problem with my Ti-Mousse, but I use Miralax for my little 17 yo little girl who has the problem occasionally! She's very fussy and as Miralax is tasteless, I just sprinkle it on her food and she eats it!

Also did a little search on the Forum and found suggestions from two experienced and well-known members (Marje and Bobbie):

(Marje)
- giving him some raw egg yolk? It’s really good for that kind of thing. I’d start with about 1/8 of a raw egg yolk and see if it helps. If not, give him a little more but don’t go overboard. As a more long-term solution, you might want to try FoodFurLife’s raw egg yolk powder.

(Bobbie)
- I give egg yolk powder that I get from www.foodfurlife.com twice a day. You start off small and then work you way up to 1/2 tsp twice a day. It also helps with hairballs.
- I also give miralax daily. Start with 1/4 tsp of miralax twice daily and see how that goes. You might have to tweak it.

Hope this helps your little guy !!
Click to expand...

Thank you for you suggestions. I will try anything at this point. The vets pretty much only gave me one option and that will not be something we will make him go through at his point in life. I just have to keep reminding myself that he had a good 17 years. Heartbreaking to see him suffer and that we could not do more. :(
 
Lisa and Witn (GA) said:
Try adding Miralax to the food. Since it dissolve well in water and does not have a taste, he shouldn't have any problems ingesting it. If he's very constipated that may also be part of the reason he's throwing up food and and the broth.
Click to expand...
He is currently on Lactulose (day 2). Is it ok to combine Miralax since he is already taking Lactulose? Don't want him to get too dehydrated. His glucose is currently stable and he hasn't eaten much either. Thank you!!
 
My welcome will be mostly useful links, as you're already giving insulin and home testing! You're ahead and seem to know many things!

When you have a minute, there are two things that need to be done:
- Set up your signature: we all have a signature below our posts giving brief info on our kitty; here is the link to set it up signature
- Set up your spreadsheet: we have a spreadsheet where we enter our kitty's testing numbers; that way when you need help, experienced members can give you advices. How to set up spreadsheet

Info links:
- Food: Low Carb wet food is suggested; most of us refer to Dr. Pierson's food chart list which gives the % of carb for most of cat food;
- Home testing: As you know already, testing should always be done before each shot to make sure kitty is in a safe range to get his insulin! Here’s a link with some very helpful info on testing and how to make it easier!
- Ketone testing: You can home test for ketones using Ketostix or another brand! It's easy and takes a minute!
- How to use the Forum: here is another link FDMB

Your next posts should be done on the Lantus forum, as it's the insulin you're using! At the top of the Forum you have yellow Stickies giving valuable information regarding that type of insulin!

If there are any things that you can't do or are not familiar with, post for help! Don't be shy, ask as many questions as you need, we're there to help you!

Hope constipation problem gets solved! Welcome again with us! :)
 
I'm really concerned that the vet's given you lactulose which is a laxative. A stool softener such as Miralax will help draw water into the colon wetting old stuff as much as possible but it's still not going to come out easily. Rather than a laxative, a motility drug such as Cisapride (Reglan if Cisapride isn't available) would help strengthen contractions. That helps move things through. With any partial obstruction, giving a laxative can cause bowel perforation due to hard feces being pushed against the outside of the colon by soft, somewhat 'explosive' stuff behind it. That old stuff has to come out for the newer stuff to not stack behind it. I would also add a greasy hairball remedy or about 1 - 1.5cc's of petroleum jelly (vaseline) twice a day. That's the main ingredient in the hairball remedies, the rest are for 'flavor'. That will help coat the lining of the colon AND the hard stuff helping it move through easier.
 
Squeaky and KT (GA) said:
I'm really concerned that the vet's given you lactulose which is a laxative. A stool softener such as Miralax will help draw water into the colon wetting old stuff as much as possible but it's still not going to come out easily. Rather than a laxative, a motility drug such as Cisapride (Reglan if Cisapride isn't available) would help strengthen contractions. That helps move things through. With any partial obstruction, giving a laxative can cause bowel perforation due to hard feces being pushed against the outside of the colon by soft, somewhat 'explosive' stuff behind it. That old stuff has to come out for the newer stuff to not stack behind it. I would also add a greasy hairball remedy or about 1 - 1.5cc's of petroleum jelly (vaseline) twice a day. That's the main ingredient in the hairball remedies, the rest are for 'flavor'. That will help coat the lining of the colon AND the hard stuff helping it move through easier.
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Thank you so much! Can I get Miralax at any pharmacy? I am running out the door now. I had asked for Cisapride but the vet said something about him being diabetic?
I just gave him his second dose of Lactulose. I will have to wait until tomorrow for the Miralax. He still has not pooped. Spoke to the vet today and she had mentioned (again) that his only route is to put him under anesthesia and manually take the poop out. However, he only has a 50/50 survival because his heart is not strong enough due to age.
 
bonnie972 said:
He is currently on Lactulose (day 2). Is it ok to combine Miralax since he is already taking Lactulose? Don't want him to get too dehydrated. His glucose is currently stable and he hasn't eaten much either. Thank you!!
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First of all welcome!!

I wouldn't mix lactulose and Miralax is more like one of the other, also you should know that lactulose can sometimes raise his blood glucose numbers.

Has your vet told you why does he think there is no other option than surgery?
 
Veronica & Babu-chiri said:
lactulose can sometimes raise his blood glucose
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The sugars in Lactulose aren't digestible. Dakota actually went lower when I gave him a dose of lactulose for his CKD and the ammonia absorption side.

The vet may have been meaning 'sedate' him rather than 'anesthetize' him. There's a big difference in the 2. He may have to have an enema but that would be if what you're doing just isn't working and it's getting worse. They are hard on a cat...

Some of the sugars in cisapride are also non-digestible but it's the corn starch that gets you there. If you have a compounding pharmacy nearby, they may be able to compound Reglan into something without sugar.

Hugs and prayers...
 
You should be able to find Miralax at your pharmacy or the health section of the grocery store where the laxatives are. Depending on what country you live in it may have a different name. The active ingredient is Polyethylene Glycol. I usually give my cats a healthy teaspoon once a day when they need it.
 
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