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.

[gravel489]

Read your post about the problem with Cisapride. My cat will not take anything thru the mouth. Nothing. She was a wild cat for 9 years and I have had her for 9 years. She showed up in my lumber yard and stayed until I closed it and brought her home. She didn't like that for a few months either. No one else can touch her but me.
She is not a people cat. She is in the vets office once a month. I have tried everything.
I got Cisapride compounded with chicken flavor. this is the only thing she will take in her food. Problem is it cost.
hope you have luck...

[lisa8899]

my sister's cat had severe megacolon
the only thing that helped after years of tests,vets
latalose, kristolose and various medications.....

try miralax.....

[lillithsmom]

I am sooo glad I found this site.  My Lillith has had a megacolon for about a year. She is also hypothyroid - after a radiation treatment which totally destroyed her thyroid.  

I have been having trouble with her deciding that our (actually my husband's) couch and our bed (on my husband's side) were much better places to defecate.  At first I just thought she was mad at my husband - a bit of humor).  I now put plastic over our bed all day and at night the couch and spray them both with pet block as an additional deterrent.  I don't like doing this but is works pretty good.

I have decided to stop giving her dry food at all even though she LOVES it.  She has no trouble with the pumpkin.  I have been giving her 1ml of Lactulose and 1ml of Cisapride. I am glad to see that others give a lot more of the Lactulose and think I am going to start giving her more.  

One thing I have been doing which seems to help temporarily is Vitamin E on her rear which is often very red.  

Again, thank you to all of you for your comments and suggestions.

[bdsteed]

Hi this is Brenda with my cat Fritzy who is 13 1/2 yrs. old. I went through pretty much all that you described in the above articles.  I gave Fritzy the medacolon operation after great consideration and though about 2 mos and a consultation with my vet. .  It cost almost $3,000.00 but it was worth it.  Fritzy is my buddy and I love him to death.

I was shocked to see that cisapride can cause heart problems but we didn't try that too long.  Fritzy was very good afterwards, his stitches healed nicely the only problem I do have after wards and for the past two years is a sore potty which I am giving him anti-inflammatory and antibiotic.

Apparently, because the colon is virtually removed then they bring the small intestines over and sew it up with the 2 in. of colon left, the poop does not have the same juices or process it goes through if he had his colon.  So he attends to his potty which I deter him by saying, "Fritzy don't touch your potty." because it just makes it sore.  He listens to Mamma.   I have tried vaseline and several creams for relief but other than that he is a happy kitty and because he is older he sleeps more but enjoys watching TV with mummie in the evening and he comes to cuddle before bedtime and in the morning he comes and cuddles.  I also bought him a tree which he enjoys looking out the window to see the birds and any other activity outside that is going on and I have the window open a bit so he can hear the birds.  Seems to work for us.  Animals give unconditional love and are company for any animal lover.  I know the operation is expensive but I had the best vet surgeon in southern CA.  You could shop around for reputation and a better price.  Good luck to all and thanks for sharing your experiences on this thread. Brenda and Fritzy ....

[megacolonmom]

We adopted a cat from a shelter about 5 years ago & they estimated he was 4-6 years old. Within a couple weeks, we started noticing his trouble to go to the bathroom. After 2 years of working with vets to find a good routine to prevent his needing enemas (cisapride, lactulose, prescription foods, etc.), it all stopped working & we took him in for the partial colectomy. This completely fixed him & turned him into a brand new cat for about a year, before we wound up back at the vet for another enema. At this point, he is on a strict diet of Science Diet i/d (gastrointestinal health) wet food + 1/4 teaspoon of Miralax laxative every day & this has kept him regular (& sometimes a little more than regular) for about a year now.

[brenda711]

Re your cat.  I have a male 12 year cat who had megacolon.  I treated hims for 2 years with cizapride, colace, and lacsatone and all that but the bottom line is cat's die from this eventually.  I decided instead to pay 2,500.00 for surgery.  They removed most of the colon (large intestine and then used the small intestine to be attached to the 2" colon left.  With this operation they have dog pile after while poops.
Their anus is sore for several weeks and so is his insides where he is in pain while he has a bowel movement.  This is where I am at right now.
I called the Vet and he said he may have some colitus in the little bit of the colon that is left.  So he has given me a prescription to hopefully clear this up and his pain goes away.  If that is the case, we will be home free.  It was a hard decision to have the operation, but really you have two choices either you put you cat to sleep after so many months of having mega colon or you can choose the operation but they told me the success rate is 90% for the surgery but you can ask the doctor.  It is a hard decision but you have to address it one way or the other to try your best to fix the problem

Hope this helps

Brenda