help with megacolon

[Clary]

Hello!  I've an 11-year old long-haired feline who has megacolon.  We move around quite a bit, and I have had to shuffle him between vets, and am about to shuffle him again.   Four years ago, just a few months before we were about to move overseas, he developed a constipation problem.  His American vet gave him an enema and put him on stool softeners to be used only occasionally.  Once we moved overseas, he had several enemas before his vet put him on liquid paraffin every day.  I used to take him for a check every two weeks too make sure that the paraffin was working, and for the most part, it did, like a charm; only very occasionally, the vet would determine that he also needed a micro-lax (which I gather is like a glycerin suppository), and that would sort out any problems--this regime worked for several years.  Still, periodically my vet would mention the prospect of a colonectomy--apparently, from x-rays, he did not absolutely have megacolon at the time, but it was arguable that the colon was at least a bit stretched. This vet had performed many colon-ectomies and assured me that there were few side effects and that it would instantly solve the problem.  I debated this possibility for a long time, and then eventually I needed to move back to the states. Unfortunately, when I moved back, I had to leave my cat for six weeks with my mother.  She says she gave him his paraffin every day (I am sure she did), but when I got home there was an obvious and critical problem.  I immediately called a family vet (literally, a family member who is actually a very well-respected vet).  This vet argued that a colon-ectomy could have serious side-effects, and that I should try to regulate the problem by other means if I could.  This made sense, since I rarely got a negative report during my cat's fortnightly checks overseas; I probably could get the problem under control.  Anyway, I brought my cat in to this vet's hospital, where an x-ray was performed. This time, the diagnosis was definately megacolon. They gave my cat an enema, and tried him on lactulose, since paraffin is not commonly prescribed in this country. This was about six months ago.  Since that time, I have had to switch back to paraffin (I order it from overseas), because the lactulose did not seem to work at all.  I have to say that he seems worse.  He struggles obviously and often in the litterbox, and at first, I thought it was just a stumbling block, getting used to a new place and regime.  My current vet told me that I could give my cat liquid glycerin suppositories to sort out any immediate problems, which I have to do about once a week or ten days.  I take him in for a check every few weeks or so, but lately (I suspect because the weather has been hot) I have been noticing that he dehydrates rapidly, and the problem arises more frequently--he barely ever goes to the litterbox without a liquid glycerin suppository.  I know his urinating is normal, because I am frequently monitoring his trips to the litterbox.  The last two times I have taken him in for checks, they have given him sub-cutaneous fluids and an enema.  They also suggested that I give him pedia-lyte, which I have been doing, though I confess only occasionally, when his flesh 'feels' a bit dehydrated.  My vet seems to think that it is probably the hot weather, but I wonder.  Tonight, for example, he strained four or five times in the box, so I gave him a liquid glycerin suppository.  He feels a bit dehydrated again. He produced a bit of stool, but then resorted to squatting several times outside the box, in several different places, leaking out drops of liquid feces, and he was also vomiting foam.  He did this last time (about a week ago) as well.  OK, so it has usually been an effect of the liquid glycerin suppository that he vomits afterward--it is not always foam, and the vet said that this was normal.  Tonight, his feces has had a strong odor that he does not normally have--normally (at least for the past six months) his feces has had almost no odor.  I would dearly love to order a full blood work-up, but at the moment I don't feel like I can ask for something that my vet does not suggest.  In a few weeks, however, I will be moving a few hours away for a new job that will last a year.  I will continue to see my current vet periodically (I am likely to be a nomad for at least a few more years, and this vet is fairly close to my parents' home), but I will also find one who is close to where we will be living at my new job.  In a sense, I will be glad to have some fresh tests/diagnosis, but it is also difficult to keep moving between vets. Before I make the switch to another vet, I'd love to have an outside opinion of the matter. I know I will be directed a certain way--but is there something I should suggest--any tests, for example? I worry so much about this problem--I keep thinking that something dreadful is going to happen in-between visits to the vet, perhaps even overnight or something, if I am not astute in my observations.  I also wonder if there is something else wrong with him, maybe contributing to the constipation or else happening as a result of it--I really think that I notice changes in his symptoms, but it is hard to present that case--for example, who cares if his feces has a stronger odor all of a sudden?  Maybe it was something he ate!  I realize that I cannot insist upon having him seen and checked every few days, but the 'system' we have going at the moment just does not seem to be working like when we were overseas--everything just seemed so much more consistent then, and I wonder if that last bout of extreme constipation (when he was with my mother) actually changed the problem or created a new one.  There is just something not quite right. Oh, and I should mention that every vet my cat has seen has tried to teach me to 'feel' for constipation--I am hopeless at this.  Further, I should say that the summer here is much hotter than any my cat has experienced over the past four years, when we were overseas. Thanks in advance for any opinions you may have to offer.

[lastietia]

A cat I saved has mega colon we give him metoclopramide and lactulose through our vet it works lasts a year than have to  go back to renew it ,anyway also can try real unsweeted pumpin  to help soften stool just mix it in their food my cats love it .if you have any questions let me know via my email address it is ***@**** and all the best you sound like a wonderful parent for you cat. mrs Wynne

[opus88]

sorry almost missed your post, you have posted on a very OLD thread and asked a question to velvet who only posted back 2 or 3 years ago...so unfortunately I doubt you'll get a reply from her.

Please follow the recommendations of your Vet with any medications, do NOT go by what someone mentions on this or any forum...RANITIDINE should never be used as a laxative!!!!!!

using lactulose is regarded as safe, it is a stool softner....my Vet has prescribed 2mls mixed with 3mls of water 2x a day. I wouldn't use more than that as it could cause cramping. it won't work overnight and sometimes isn't effective but worth a try.
for megacolon its best to use insoluable fibers that soften the stools and promote faster evacuation so the stool doesn't sit in the colon and become hard and large.
other insoluable fibers are pumpkin,wheat bran, zucchini, celery, sweet potatoes. so you can also try adding one of these to his food...just start slow.
good luck, post again if we can help.

[getts2]

We've just joined the group of megacolon cats with our 11 yr old male British Shorthair.  I've read your comment about the Ranitidine and gathered that you are giving it to your cat with success.  But how did you calculate the dosage?  Our cat weighs 30 pounds (he's lost 6 since the onset of illness).  His Cisapride dosage is 10 mg - if that gives you an idea on weight/dosage ratio. The Cisapride does not seem to be doing much for him though he has become resigned to having a capsule tossed down his throat.  We found the small liquid glycerin suppositores and those work really well.  
I've also read pros and cons regarding low density foods and high fiber foods.  How are you feeding your cat?  

Thanks so much!  Your post was the best collection of information I've found so far.  

[opus88]

yes stool softners work great, but the one to use for cats is called LACTULOSE....ratiopharm 667mg/ml. I use it for one of mine who also has issues..
its avail thru our human pharmacies. its a sticky liquid that you need to add water with. I safely use 2mls Lactulose (.40 of a tsp) plus 2mls water(.40 tsp)
once a day...twice if really constipated. judge this on an as needed basis, and when starting anything start will less than whats recommended just to see how its going to effect gravel...don't want it to give him the poops.
so I recommend you start the first day with 1ml (less than 1/4tsp) if he doesn't have a poop the next day do the 2mls, if this still isn't enough do the 2mls 2x a day...and believe me that WILL work....
This can be used daily to keep him regular or on an 'as needed basis'

[gravel489]

Thanks for your comment. I think I'm using the last of the cisapride. It cost $60 a lick. Last about 6 wks. didn't seem to work that well.
Just got Gravel home a few minutes ago.
I'm going to try a stool softner that I found. Megalax. Since gravel will not even get close to any meds i think this will work.
It is tasteless and odorless. Vet said this would be okay. Have to guess at the right amount.....

[opus88]

hi and welcome to our forum. good for you for taking this kitty into your home and caring for her....
I am wondering if your kitty is on a canned diet? kibble diets are already so dehydrated they lead to constipation issues. proper hydration alone can correct this chronic problem.
You can also add some pumpkin(plain NO spices) 1-4Tbsp per meal and wheat bran 1-2Tbsp per meal into the wet diet this adds good fiber. kitty must be getting alot of fluids in the diet when supplementing with fiber to minimize the impaction.
Probiotics are also another good addition.

I'm not sure about using cisapride especially long term. it has been removed from the market for humans b/c of possible heart arrhythmias and heart attacks....I know Vets still use it however I question the safety.