Help with megacolon treatment

[hkeough]

I have a 13 year old neutered male cat with megacolon, chronic renal failure, and a narrow pelvis.  My vet prescribed 0.5 ml of cisapride twice a day, 3 ml of lactulose twice a day, and a 1.5 inch strip of lax'aire twice a day to treat my cat's chronic constipation.  Unfortunately, the medicine is not working.  He still requires frequent trips to the vet to get enemas and is losing weight due to a loss of appetite.  In addition, he is now taking 1 tablet of cyproheptadine Hcl 4mg once daily to encourage him to eat.  My vet asked me to consult with other doctors to find other potential treatment options as my cat's case appears to be getting worse.  Do you have any suggestions?  

[caliesmom]

After suffering for several years with megacolon symptoms my cat Casey found immediate relief when our vet changed his diet to Royal Canin Veterinary Diet - Gastro Intestinal Fiber Response for felines.  It has been 3 weeks so far and no symptoms have returned.  He likes the food (it is dry) and my other cat eats it also with no problem.  I considered surgery but was told that Casey was not a good candidate.  I was desperate for help and did not know how much longer I could watch him suffer.  Please talk with your veterinarian about changing to this food.  (I have no affiliation with the company that makes this product.)
Casey's Mom

[IshasMom]

I think you misunderstood the other person's posting about dosage, as .5 ml's is half a milagram.  2.5 ml's is way beyond the max. dose usually recommended, which happens to be .5 ml's.  I believe you meant to write .25 ml's.  Which is the typical first dose perscribed.

[Savas]

Thanks for a great post, Christine. Definitely helpful for anyone with this issue!

[Christine5550]

I suggest you do find another vet.  The max. dose for Cisapride is 2.5 mg, 3x/day...which is what my cat, Jax, takes (he also has a narrow pelvis, complicating the megacolon).  Jax also takes 1.5 ml Lactulose once every other day.

Hydration:  Jax drinks bottled water from a pet fountain.  The oxygenated water encourages drinking because it tastes fresh.

Comfort:  Heating pad in place for the days when Lactulose makes the kitty crampy, or the tummy just hurts.

Food:  Wet food only, preferrably watery wet food.

No appetite:  Beechnut baby food always gets mine to eat again when his stomach is upset.

Exercise:  Any pen laser action will do.

End result:  Jax has not required a trip to the vet in a year.  His previous vet referred him to a surgeon, who said he was nowhere near needing surgery yet.  He has a new vet now.

GOOD LUCK!!

[Savas]

Just for a little background information; what does your cat's diet consist of, past and present?