Information and Insight on Megacolon Surgery

Hello, reading some of these past posts has been helpful as I have an 11 yr old Siamese suffering similarly. She is on a regimen of 5 - 6 ml of Lactulose daily, 3 x 2.5 mg pills of Cisapride and wet food. We are considering the surgery - but can anyone point me to a good source of information regarding it? I want to know more about the risks, complications, even a ballpark idea of the cost. Thank you, any info would be helpful.

Also, does anyone know a good source to buy Cisapride? From my vet it is costing me about $38 for 30 pills. My cat takes 3 daily now, which is expensive.

I also had her on very high fiber food for a while, and had tried adding fiber to the food, like Metamucil. I kept thinking it wasn't working for her, and now after switching to a low fiber, higher protein food, the situation seems better. Another q is, I'd like to test if the food switch alone is making her better, but dont want to risk her getting impacted again, if I reduce the meds. Any advice would be welcome! Thank you.

[Savas]

The cost is hard to predict as it depends on a number of factors. Ask your  vet for an honest appraisal based on no complications. Then get quotes from two other vets and see if the prices are reasonably similar.

Stopping the med's to check on the diet... well, it isn't a bad idea, but you have to be aware there is always a risk when you change the situation. I'd consider keeping a careful watch on her stool if you do.

A trick I've used is to give a cat KMR milk replacer supplement (solely) when stool gets too hard. It's a liquid protein diet and tends to cause diarrhea... which would be a desirable result in a cat that is getting impacted. :-)

[Leosmommy]

You can check compounding pharmacies or specialty pharmacies that do compounding.  I had put Leo on cisapride for a brief time, but don't recall what I paid.  I did a quick google search and a bunch came up, so you could do a search based on where you are.  I would think you could call them to get pricing to ballpark relative to your vet's.  If with shipping it's more, you could offer the option to your vet to match.  

There seems to be a difference of opinion regarding the fiber.  My vet even told me that some do recommend high fiber, where others recommend low fiber, low residue.  It may depend on your cat.  Personally I would always consult with my vet before changing meds, especially as some do require titration (gradual increases or decreases.)  Usually when I decide to monkey with Leo's diet or meds, I put a quick call in to my vet, who knows me quite well at this point.  I tell him what I'm thinking of trying and why, and ask for his thoughts.  

What my vet always says is basically to keep everything constant and try changing one thing.  Do it for a period of 4-6 weeks and then gauge the impact.  That way, you can really get a good feel if that one change is making a difference, without trying to weigh in multiple changes.  Leo has IBD as well, and we're in the process of ruling out allergens to determine if we can make his IBD better.  Of course, he's post-sub-total cholectomy, so it's tough to know which the diarrhea is resulting from, the surgery or his IBD.

Savas, it's funny you gave KMR.. I did find that when Leo drank milk, he got diarrhea.  So every now and then when he was having issues, I'd let him lick some of the milk from the bottom of my cereal bowl.  It worked often unless he was really bad.