# CRF cat constipation



## VictorKilo (May 11, 2015)

Just joined. My CRF cat has severe constipation. Already been flushed twcice. Any one has similar experience and advice?


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## 10cats2dogs (Jun 16, 2013)

Welcome aboard Victor!
Use our 'Search' function on the forum...there are a lot of threads dealing with "Constipation"...
Your poor baby...
Hopefully other's will jump in here, with more/better ideas!
Sharon


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## maggie23 (Mar 10, 2012)

if your crf cat is taking epakitin (phosphorus binder), i believe one of the side effects can be constipation. that might just be one small thing contributing to the problem. but i give my Angel miralax as well as squash (baby food) with her meals to keep things moving through her system. maybe you've already read lot of other tips with that "Search" function, but this might help, too. 

good luck!


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## NebraskaCat (Jan 15, 2013)

Here's the Tanya's website page on constipation...

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Constipation


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## VictorKilo (May 11, 2015)

yes she is on Ipikitine. If I stop it her phosphrous count will jump high. What do I do?


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## spirite (Jul 31, 2012)

I'm sorry about your kitty's health issues. My cat isn't CRF but she does suffer from constipation. Like maggie23, I give Miralax daily: 1/4 tsp. dissolved in a little warm water and mixed into wet food. It has no taste and no smell. 

However, Miralax should be used to prevent constipation. If your kitty is already constipated, then maybe a hairball remedy (one of those tubes of gel) would help her to pass the stool. Once she has, then you can give the Miralax every day to try to prevent further issues. 

Mixing a bit more water into her wet food should help as well. 

I hope your poor girl feels better soon!


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## laurief (Jun 22, 2008)

If Miralax is not available in your local pharmacies, ask your vet about it or Lactulose. They are both osmotic laxatives with similar preventative action, though Miralax is easier to administer. As noted by spirite, Miralax is a tasteless powder that is easily mixed into canned food. Lactulose is a very sweet and sticky liquid that cats don't particularly enjoy, but it is effective if you can't get Miralax. Either one of these should be administered every day to prevent constipation.

Both of these are dose-to-effect drugs, meaning that you can adjust the dose until your cat's stool consistency is firm enough to hold shape but soft enough to pass easily. Start with 1/8 tsp and see how that affects your cat's stool. If it is still too hard, increase the dose a little. If it's too soft, decrease the dose a little. 

These meds both work by holding water in the GI tract to moisten and soften the stool, so they are only effective in properly hydrated animals. Since your cat is CKD, she is already prone to chronic dehydration which is causing her constipation. If you are not already administering subQ fluids at home to keep your girl hydrated, this is another thing you should be discussing with your vet. In the meantime, mix plenty of warm water into canned food for her daily to increase her water intake. Also put multiple bowls of water around your house for her, and perhaps add a pet water fountain if she likes to drink moving water.

Laurie


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## VictorKilo (May 11, 2015)

Thanks for all your help. Yes my cat is on subQ daily. I am now using Forlax, the equivalent thing in France but unfortunately it has a bit of citric acid does not taste so nice for her. She had two manual enemas already one on 1st April and another on 27 April and I fear she can take no more. She has been drinking a lot more lately as vet suggested putting a bit of sugar in the water and that cause a small hafd poop to happen today. On top of CRF she had fibrosacorma and was operated on lst July, had radiotheorapy and immunotherapy which triggered her CRF last Oct. She has been through a lot, but her spirits are still high and cuddly. She is 17 an old lady but so full of life and especially picked up a lot on the new a/d diet that the vet recommendated with a half tbsp of cannolla oil. She has been on Epikitine phosphorus binder for over six months now and I am concerned that it is also the side effects of this. Her blood works is however very good, phos normal with creatine and urea just above normal. **** we are going to fight this she is not giving up so why should we. Can some one tell me the pros and cons of slippery elm bark. we have been using laxatone but its awful and tends to just leave her ina half diarrhea hald blocked miserable state. I am hoping to get my vet to agree to using slippery elm bark instead.


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## 10cats2dogs (Jun 16, 2013)

Hi Victor, 
I can't help with the Slippery Elm question, I haven't had to use it yet, hope someone who has, can fill you in on it's uses!
Your cat sounds like a love...♡♡♡♡
I'm glad you're not giving up on her...
(((HUGS))) and Prayers, 
Sharon


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## laurief (Jun 22, 2008)

I've used Slippery Elm Bark (SEB) on cats, dogs, and horses. It's certainly worth a try on your old girl, assuming she isn't hypercalcaemic (high calcium). If you haven't read it yet, here is a link to info on SEB on Tanya's site:

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Holistic Treatments

SEB is an herbal remedy, so I assume it doesn't require a veterinary prescription in France. You should be able to acquire and use it without your vet's prescription.

SEB is a demulcent. It coats the entire GI tract with a soothing, slippery slime. It also contains a certain amount of fibre. That slime and fibre can help keep stool moving through the tract. The only caution regarding the use of SEB (aside from the fact that it contains some calcium) is to give it at least 2 hrs before or after any other med or supplement, since it can inhibit absorption through the gut. I've seen SEB have nearly miraculous effects on some cats, and very little on others. In any event, it's certainly worth a try.

If the French version of Miralax contains citric acid, see if your vet can prescribe Lactulose (it may even be available over the counter in France). It has much the same effect as Miralax, and your cat may find its very sweet taste less objectionable than citrus. If neither of those options work for your girl, try giving her a little heavy cream daily. Dairy can produce the same stool-loosening effect as Miralax and Lactulose in cats who aren't used to eating dairy regularly. Dairy is high in phosphorus, however, so you may need to mix a little Ipakitin into the cream to compensate. Of course, the same caution about calcium in dairy applies if your girl is hypercalcaemic.

The most important aspect of constipation management is hydration. How much fluid are you giving her daily? If it's less than 100 ml, and assuming her heart is healthy, you may want to bump her up to 100 ml daily. If she's already getting 100 ml daily, I wouldn't increase her subQ fluids above that.

Laurie


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## Mochas Mommy (Dec 9, 2013)

I just sprinkled it on my cats food when they weren't feeling well. I recall someone telling me not to use it long term....have to go back in my notes to see if I can remember why....

It really helped them want to eat again when their tummies weren't happy.

Website advocate for both sprinkling and making a liquid.

http://www.littlebigcat.com/health/slippery-elm/

http://www.felinecrf.org/holistic_treatments.htm


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## Mochas Mommy (Dec 9, 2013)

Just found a note from something Laurief posted...."you separate it from any other meds or supplements by 2 hrs, since it can interfere with absorption."


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## VictorKilo (May 11, 2015)

Thanks Laurie: She is on Sub-Q 40ml per day. Yes I will talk to the vet to see if we should increase this at least over the dry summer months. Will talk to her about sippery elm but I doubt if she knows anything about this in France. It looks like she might need another manual enema next week if things don't improve.

https://www.dropbox.com/s/gyq9k9pqiwg0mbm/IMG_20150305_154954.jpg?dl=0

She is a doll and it grieves me terribly that she should suffer. Still jumped onto her mummy's bed this morning at dawn to wake her up. I have another vet who is more holistics, giving her massage and acupuncture treatment that seemed to have done some good as her spirits are certainly up after all she had been through last year.


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## laurief (Jun 22, 2008)

What a pretty little torbie girl. 

Don't worry. You can get this constipation issue under control. The first thing I'd do is ask the vet if there's any medical reason why you could not safely increase her fluids to 100ml daily. That's a standard fluid dose for many CKD cats, and it will help address her constipation problem. 40ml really isn't much fluid for a CKD cat, esp. when dealing with chronic constipation. It may also be why the Forlax hasn't been successful for her. If Forlax is the same as Miralax, its effectiveness is dependent on proper hydration. So address the hydration issue ASAP.

Have you checked herbal suppliers in France to see is SEB is available? If it is, I'd definitely recommend buying it and giving it a try with your girl. It probably won't solve the constipation problem on its own, but it may help to add it to her daily protocol.

Have you tried adding some fiber to her diet, like plain canned pumpkin or mashed peas? If you have a health food store or some other resource where you can buy unflavored, powdered psyllium husk, that's a great fiber source, too. You can read about the use of these fibers at the link to Tanya's site that NebraskaCat provided above.

Here's another link to a site with comprehensive information about feline constipation. It'll teach you more about kitty constipation that you've ever been likely to want to know:

Feline Constipation Home Page

Laurie


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## VictorKilo (May 11, 2015)

Thanks Laurie. Yes I have been using pumpkin. However during the last bout I have been using too much and that made the problem worse so I am reluctant to try it again. She is on Hill's a/d and it helps a lot to keep her weight stable compared to before when she was on k/d. I have a friend send me some SEB capsules 400mg capsules and have some powder ordered from Amazon. They should be coming soon and will advise the vet on that. I am at my wits end at the moment and am waiting my vet to call to see when it is safe to flush her again if at all possible.


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## maggie23 (Mar 10, 2012)

sorry for the delayed response about the epakitin question. you were wondering about stopping it because it might be contributing to the constipation.

DON'T stop it. she does need it to keep the phosphorus in control. just concentrate more on getting more water into her system. i agree 40 ml/day of subQ doesn't sounds like a lot. my angel is 10.5 lbs and she started 2 1/2 yrs ago with 100/ml 3X/week, but i ended up gradually increasing that to 100/ml per day. she's been getting that for the whole past year without any problems with her heart. 

i also make sure she gets LOTS of water with her meals. it's kinda funny, but her meals are always basically soup, but she still loves it and eats it all up thank goodness. she is 14 yrs old now and gets 4 meals a day with nearly 1 oz of water added to each meal. her fur used to be all pristine white, but now her chin is permanently stained brown from the soup. ha ha!

so in case i didn't give details before, Angel gets 1/8 t miralax plus 1/4 - 1/3 t of baby food winter squash (i used to do pumpkin, but she actually likes the taste of the squash much better) with each of her 4 daily meals. along with that extra 1 oz of WARM water, of course.

in regard to the miralax, it really is great because there is no flavor and dissolves quickly. could you maybe order some on Amazon.com or something over there? then you wouldn't even have to worry about trying to get her to eat something that tastes yucky or syringing something into her mouth or making sure she gets the SEB 2 hours before other medications or anything. miralax is so much easier.

Oh! and one other thing i thought i'd mention even though you didn't mention anything about your girl not liking the subQ sessions. Angel was very sensitive to the needles, but i switched to the terumo ultra thin wall needles and it changed my life. 99% of the time she doesn't even feel the needle going in AND she lies down and naps or grooms during the whole thing. it's almost like a little spa session for her now and there is absolutely no stress. just an FYI if your girl becomes sensitive to the needle pokes.


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## maggie23 (Mar 10, 2012)

more water! more water! more water!

i am so sorry to hear your girl may need another enema soon. :-( i just know if you can get more water into her system it might do the trick and get her regular again. we had a 15 year old that suffered through at least 3 or 4 enemas in a year at the rescue and another enema soonafter we adopted her as well until we were able to get things under control. we did the miralax, pumpkin and very soupy meals for her and she became very regular with a gorgeous poop everyday. she did not have kidney issues. it was just constipation before. we were able to completely discontinue the lactulose the rescue had her on as well by doing this. she hated getting that squirted into her mouth and i was not very good at administering it either, so that was a relief.

sending you all my well wishes!!!


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## VictorKilo (May 11, 2015)

Thanks everyone. My girl was 4.5 kils but she has dropped to 3.6 kilos now sad sad. She was on 40ml subQ for abotu 6 months. I am going to talk to my vet to up that as you guys suggested. But is increasing subQ the same is trying to get her to drink more which is tough. My vet suggested putting some sugar in the water and that seems to work but her drinking is not enough. She keeps peeing it out too. She is on Nelio, 1/2 tablet that dilates her kidneys. She does eem to have a megacolon issue since childhood and I must insist on an Xray if she gets her enema again and perhaps a poo test? She keeps scratching int he garden and I am note sure how much she did if at all. I thought I could feel stuff in her colon, but its not easy.


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## VictorKilo (May 11, 2015)

Just been authroised by vet to up her sub-Q to 80ml. SEB has just arrived, will talk to her about using it too this week. Still no sign of poooo.... hghh...


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## maggie23 (Mar 10, 2012)

poor girl. i feel for you both. i definitely do as I've been thru it myself with the 15 year old i mentioned. alhto the vet never specifically said it was megacolon for her, she did say that there was a bit of a "pouch" right at her anus where the tissue obviously had been stretched and was weak and susceptible to having poop get trapped there if things weren't working smoothly. then it would just build up over time because it didn't have a clear path to the "exit". i ended up massaging her bum many times to try to get the stuff back on track a bit. don't know if that helped, but definitely the daily miralax and pumpkin and soupy food helped a ton! i swear our girl went a whole year without getting constipated at all once she got on that regular schedule.

as for the incresae in SubQ fluids, someone else can probably explain how it works, but i do know that my Angel did start peeing more once we started fluids. i imagine just being more hydrated overall allows the fluid to be absorbed by her whole body including the digestive tract, which may allow more moisture into the poop as it makes it way thru, which then makes it easier to get rid of. easier to get rid of soft moist poop versus hard dry stuff for sure.


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## VictorKilo (May 11, 2015)

Ya that colon, anus problem does occur to me, so I shall definitely ask for an X ray and also poop test if we are going ahead with another enema, this Thursday's appointment, thanks Maggie.

My bottle of SEB says it also contains Calcium hydrogen phosphate, Malodextrin, hydroxypropyl, cellulose magnesium sterate, colloidal anhydrous silica, cinnamon oil, clove oil and peppermint oil - yuk. Oh no, they are not capsules but tablets. No way I am going to use this.


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## laurief (Jun 22, 2008)

Oh no, no, no! Do NOT use those tablets. You should purchase loose, pure, powdered SEB with nothing else added. I go a step further and buy organic loose, pure, powdered SEB online. Here's a link to a reputable brand that I buy for my own animals:

Amazon.com: Starwest Botanicals Organic Slippery Elm Bark Powder, 1-pound Bag: Health & Personal Care

Laurie


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## VictorKilo (May 11, 2015)

OO la la. Just been back from her homopathetic vet who gave her acupuncture and massage. She thinks her stools have hardened too much. Must have manual enema tomorrow or latest by Friday. She seems still dehydrated as of this morning. My wife is against going ahead as she has been under so much stress already two enemas in less than two months. Just ordered SEB via courier but takes a long time to come from US. Is this stuff any good? Dorwest Tree Barks Powder - Pet Drugs Online

It says it contains SEB plus white poplar bark. I can get that from the UK in a few days.


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## VictorKilo (May 11, 2015)

Just found this stuff Peridale Capsules - Pet Drugs Online, seems to do the same thing as SEB. 
Will order it anyway can get here by next week.


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## maggie23 (Mar 10, 2012)

Darn about the enema!

Once she's "cleaned out" again, though, I really hope you can get her to eat more soupy food along with the miralax. If you can't get it over there, i would definitely recommend ordering it ASAP from the US. her stools will just continue to be a problem if you can't get them softened up right away.


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## VictorKilo (May 11, 2015)

She is already on "soupy" food. I have to syringe feed her 3 times a day with Hills a/d mixed with water and a little oil as recommended by the vet. I have been using Forlax which is the equivalent of Miralax here, yes it has a little citric acid for kids but she is ok with it. Dehydration is most likely the problem as whatever stool she was able to pass out last week was rock solid and dark black like chalk.


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## spirite (Jul 31, 2012)

Oh your poor girl.  

You said the vet told you to give 1/2 tbsp. canola oil regularly. How long has she been getting the oil? I've read conflicting things about whether giving a little oil can be helpful or not. I don't remember the specifics, but there was a reason that I decided not to give any oil to my kitty. 

Maybe laurie or maggie or someone else will have some more information on this? 

I'm glad you're going to have x-rays done. Please let us know how things go. I'm keeping my fingers crossed for you and your girl.


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## maggie23 (Mar 10, 2012)

i've never tried canola oil actually. but i do put @10-15 drops of salmon oil in angel's food twice a day. i do it mainly for her coat and maybe keep her cholesterol in check (i don't know if this works for cats the way it does for humans, but oh well!), but i'm also just assuming it does help to coat her intestines a little to help things slide down easier. and she doesn't mind the smell of it, so i just keep doing it. don't THINK it's harming her at least.


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## VictorKilo (May 11, 2015)

Only using the oil for a month or two. I did press her and questoin her on this due to all kinds of report. I use organic canola oil, 3% to her a/d Hill's diet. She swear by it as she has been to a course in Paris recommended by a cat dietician. Who am I to question that.


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## VictorKilo (May 11, 2015)

I have got good news and bad. She did some poop this morning after I increased her hydration, not a lot, watery but dark. Her bowels seem to be moving. Been to the vet who said her stools are a lot still but softening, and asked that I continue the Forlx/Miralax. I showed her my notes on SEB and she said its a good idea. She is not keen to do another manual enema unless its an emergency as she already had two. She authorised me to increase subQ to 100ml per day and continue with Forlax. Next appointment is Tuesday next week as it is a long long holiday weekend here, fingers crossed for more poo action tommorrow! SEB arriving from US via express.


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## laurief (Jun 22, 2008)

Dark brown stool is fine, but black stool should be checked by your vet for blood.

Increasing subQ to 100ml daily is great. So is continuing with the Forlax. Did your vet explain to you that Miralax/Forlax is a dose-to-effect drug, meaning that you can adjust the dose until your cat achieves optimal stool consistency? If she's still having hard stools, you should increase her daily Forlax dose a little. If the stools get too soft or loose, you can cut back on the Forlax dose a little. It's not a one-dose-fits-all drug. You have to adjust the dose according to your cat's specific needs.

Digestible oils like canola and salmon are fine for improving coat quality and adding calories to the diet, but they aren't that useful for managing constipation because they ARE digested and don't travel through the GI tract intact. Lubricant laxatives like petroleum-based hairball remedies are much more useful because they are not digested and do lubricate the length of the GI tract. 

Miralax works by holding water in the gut, which uses that extra water for softer stool production. Unfortunately, though, hard, constipated stool already formed in the GI tract is water-resistant, so the extra water made available by Miralax can take days to soften constipated stool enough for it to pass. In other words, Miralax is a LOT more effective as a preventative than it is as a cure. Petroleum-based hairball remedies and SEB syrup are more effective at dealing with acute fecal impactions, so keep giving her the Laxatone.

That little bit of watery stool you saw this morning was probably stool that had been liquified by the Forlax and was trapped behind the constipated stool impaction. When enough pressure builds up behind an impaction, some of that liquified stool can leak out around the impaction, esp. when the cat strains to pass it. Unfortunately, that doesn't necessarily mean that the constipation has or is resolving. The "plug" is likely still there, unless you're seeing hard, formed balls along with the watery stuff. You may need to be prepared to take her to an emergency vet during this holiday weekend if she doesn't manage to pass any of the impacted stool very soon.

In my long experience with CKD cats, there is very little that can make them feel sicker, more painful, or kill the appetite more quickly than constipation. It's certainly not a condition that you want to try to wait out. There was a cat within the last few years on this forum or one of the other pet forums I frequent who suffered a horrible constipation impaction that went on for so long that they ended up having to euthanize her. It was horribly tragic, and her death could almost certainly have been avoided with more proactive treatment.

Laurie


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## maggie23 (Mar 10, 2012)

laurief said:


> Digestible oils like canola and salmon are fine for improving coat quality and adding calories to the diet, but they aren't that useful for managing constipation because they ARE digested and don't travel through the GI tract intact. Lubricant laxatives like petroleum-based hairball remedies are much more useful because they are not digested and do lubricate the length of the GI tract.
> 
> There was a cat within the last few years on this forum or one of the other pet forums I frequent who suffered a horrible constipation impaction that went on for so long that they ended up having to euthanize her. It was horribly tragic, and her death could almost certainly have been avoided with more proactive treatment.
> 
> Laurie


good to know about the digestible oils. Thx again Laurie for the continuing education all the time! 

And that is so sad about the cat who had to be euthanized. so terrible. :sad:


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## VictorKilo (May 11, 2015)

Just got my SEB. I administered 1/4 tsp mixed with water into a slimmy paste fills about 10ml of water in a syringe. My littel girl took it ok with no problems. Last weekend I tried laxatone on her and she vomiitted everything out. Also the Forlax which the vet did warn me about as it contains citrus, so had to order some Miralax from Amazon to come. Vet does not want to do another manual enema, she feels the stools are softenning, in fact she has signs of brown stool now leaking out in the morning. She thinks that another anathesia and she might not wake up again as she already had two done over the last two months. Now I suddenly read the warning label on the package which says that SEB must be administered with 250ml of water, oh my God, how do I get that in her? What can I do now?


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## laurief (Jun 22, 2008)

If she got that large dose of SEB down without choking, she'll be fine on the 100ml of fluids you're giving her subQ every day. However, I would NOT give her that large a dose of SEB at one time again. Instead, I recommend making the SEB syrup using the water:SEB proportion directed at the following link and dosing per that link's instructions. BTW, you really don't have to boil the syrup as that link instructs. The easiest and fastest way to make it is to put hot tap water and SEB into a bowl, use some kitchen utensil to push the SEB down into the water to dampen it, then use an eggbeater or hand mixer to beat until thoroughly blended and thickened:

http://felinecrf.org/holistic_treatments.htm#SEB1

Laurie

P.S. Assuming you didn't buy some "cats only" version of SEB (if there even is such a thing), the instructions on the packaging probably relate to its use in humans.


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## laurief (Jun 22, 2008)

Oh, and you should still be giving her a big dose of Laxatone every single day until she passes all of that constipated stool. She's vomiting because that big plug of stool is still in her system. Hopefully between the increased fluids, the SEB, and the Laxatone, she'll be able to pass that stool soon. But if she keeps vomiting and can't keep anything down, you need to ask your vet about an actual stool softener ... and/or about administering an enema without anesthesia (which can be done without undue discomfort to the cat).

Laurie


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## 10cats2dogs (Jun 16, 2013)

Victor,
(((HUGS))) and Prayers for your girl.
Sharon


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## VictorKilo (May 11, 2015)

Good news. The SEB seems to have worked. She passed out some stool yesterday, a long strip about 3 to 4cm of dark brown soft stool not black. She also seems much happier and seems to be relieved. She might have done more in the garden during the course of the day and her colon seems to be soft and relaxed - will see her vet tomorrow to seek confirmation. Thanks folks will give her Miralax tomorrow when it comes. Do I use SEB daily or only a few times a week?


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## laurief (Jun 22, 2008)

That’s not good news, Victor. That’s FANTASTIC NEWS!!! Your girl and you must feel such relief today! Heck, I’m even feeling relief for you both! WELL DONE!!!

Once you have the Miralax in hand, swap out the Forlax for Miralax. Continue SEB daily for 7-10 days to help her GI tract heal from all of its recent trauma, then stop the SEB entirely. Since SEB can potentially interfere with absorption of other meds, supplements, and possibly even nutrients from food, it’s not something you want to give any more often than necessary. If you’re giving sufficient fluids and Miralax, you should be able to prevent future constipation with those alone. You can and should, of course, give SEB again if she demonstrates GI discomfort at any point.

How much Forlax were you giving her and how frequently? Obviously, she wasn’t getting enough to prevent constipation, so you’re going to need to increase that dose. When you get the Miralax, you’re also going to have to compare the amounts of polyethelene glycol in both products to help you determine an equivalent dose of Miralax. If you can’t make a direct comparison, start Miralax at a heaping 1/8 tsp (or slightly more) daily and see how she does. If her stool remains too hard, increase the dose slightly. If it gets too soft, decrease it slightly. Remember that Miralax is a dose-to-effect drug, so don’t hesitate to adjust the dose to find what works best for her. 

You’re an excellent caretaker, and you’ve pulled your girl back from the edge. Congratulations!

Laurie


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## laurief (Jun 22, 2008)

Oh, and continue to give her a larger than usual dose of Forlax each day until the Miralax shows up.

Laurie


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## VictorKilo (May 11, 2015)

Can't do, she vomits on taking Forlax as it contains citrus and lots of other stuff that upsets her, same with Laxatone. SEB seems ok. I am expecting my Miralax tomorrow. Thanks.


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## laurief (Jun 22, 2008)

VictorKilo said:


> Can't do, she vomits on taking Forlax as it contains citrus and lots of other stuff that upsets her, same with Laxatone.


It's important for you to understand that vomiting is a common symptom in constipated cats, regardless of what they are ingesting. If they're plugged, anything they take in orally has nowhere to go but back up the way it went in. Her vomiting may not have had anything at all to do with the ingredients in either Forlax or Laxatone.



> SEB seems ok.


Again, this may not have anything to do with the fact that the ingredient in SEB was not upsetting her stomach. It more likely has to do with the fact that her constipated stool has been gradually softening over the last week with the increased fluid admins, so she was finally able to pass some stool and allow the SEB to follow the full oral track.



> I am expecting my Miralax tomorrow. Thanks.


I'd still recommend a dose of Forlax each day until the Miralax shows up, now that she is passing some stool again. In potential vomit vs. potential constipation, vomit seems the lesser of two evils ... for now, anyway.

Laurie


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## VictorKilo (May 11, 2015)

I know, but vomit makes administering anything a waste of time as it comes right out again. Anyway Miralax has just arrived and will start her today on 1/4 tsp. Vet saw her this morning and said her colon is good, seems constipation is under control. Will start Miralax this evening with her meal. Unfortunately vet found a tiny tumour on her belly. May have to do a scan next week in case it is cancerous or a relapse of her fibrosarcoma treated on last year. Haghhaaaa!


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## laurief (Jun 22, 2008)

That's excellent news about the resolution of her constipation, and great that you now have Miralax on hand to give her daily. I'm sorry to read of the tumour on her belly. If it's by a teat, and if she is unspayed or was spayed after her first heat cycle, it may be mammary cancer. My Somer (RIP) developed mammary cancer several years ago. The average age for mammary cancer to appear is 10-12 yrs of age, though it can occur earlier or later than that. Calicos and torties (Somer was calico) also seem slightly more prone to developing mammary cancer than cats with other coat colors. But the biggest risk factor is the number of heat cycles the cat experienced before being spayed.

If your girl's tumour is on a teat, I wouldn't waste either the time or money on a scan. I'd strongly recommend having it surgically removed immediately and sent for pathology. Mammary cancer can spread quickly.

I wish you and your girl the best possible outcome.

Laurie


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## maggie23 (Mar 10, 2012)

so relieved for you about the constipation issue. that was quite a long ordeal for you and your girl. thank goodness things are getting back to normal down there. at last!

and sorry to hear about the tumor. hope you get that taken care of right away, though, per lauiref's recommendations.it's about time you and your little girl caught a break!


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## VictorKilo (May 11, 2015)

We are experiencing a heat wave here. Vet told me the max for a cat is 200ml a day. I am just worried if it gets up to 36 or 38C next week if i should increase her infusion. I know Laurie does not think one should go beyond 100ml per day, is there any special reason to limit at that amount?


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## laurief (Jun 22, 2008)

Yes, there is. It is possible to overhydrate a cat and internally drown her. I know. I've done it (and I was following a vet's prescribed fluid dosage at the time). It is NOT fun to watch your cat drowning before your eyes, gasping for air.

One way to monitor your cat's fluid intake, though not a terribly accurate way, is to weigh her immediately before and after a fluid admin. Then don't admin any more fluid until her weight has returned to its previous pre-admin weight. Also, never admin additional fluids if there is still a palpable or visible fluid pocket that has not been fully absorbed from the previous admin.

If you're having a heat wave, it's best to keep your cat inside out of direct sun during the hottest part of the day. If she does seem to be suffering from the heat, just don't warm her fluids before her daily admin. Giving her room temp fluids will help cool her down. But I would strongly advise against giving more than 100 ml of fluids daily unless she is demonstrating signs of obvious dehydration.

Trust me. You won't EVER want to see your girl gasping for air because you gave her too much fluid, and if you ever do witness that, you'd better be prepared to drop everything and get her to the vet immediately to try to save her life.

Laurie


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## VictorKilo (May 11, 2015)

OK Laurie, thanks for the tip. Vet has authorised me to to give up to 200ml if she needs it as the coming weeks is going to be a heat wave, but will follow your advice on weighing her. Bad news is her stools are hardening again as the Miralax does not seem to be working, dehydration? I stopped SEB yesterday as she was looking rather tired and I was concerned it was inteferring with her nutrient absorption, but will start it again today. Her tumour or lump was checked again today and her vet who did the surgery last year said it is not fibrasarcorma and is tiny and could be fat tissues. They don't recommend doing anything yet and will just keep monitoring her in case they need to take it out later.


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## laurief (Jun 22, 2008)

VictorKilo said:


> OK Laurie, thanks for the tip. Vet has authorised me to to give up to 200ml if she needs it as the coming weeks is going to be a heat wave, but will follow your advice on weighing her.


Well, if you insist on giving her 200ml of fluids daily, keep a VERY CLOSE eye on her breathing, and get her to the vet IMMEDIATELY if she starts open-mouth or very rapid breathing. Her life will depend on how quickly you can get her to the vet if and when she goes into respiratory distress. Also, before you start giving her such large fluid doses, I recommend having a cardiac ultrasound done by a veterinary radiologist or cardiologist to check her heart function. Also, if you give her more than 100 ml daily, it would be safer to split the dose and give half at 12 hr intervals.



> Bad news is her stools are hardening again as the Miralax does not seem to be working, dehydration?


Maybe dehydration, but more likely you're just not giving her enough Miralax. As I keep noting, Miralax is a dose-to-effect drug. If her current dose is not adequately softening her stool, increase the dose.



> I stopped SEB yesterday as she was looking rather tired and I was concerned it was inteferring with her nutrient absorption, but will start it again today.


Make sure you give the SEB at least 2 hrs separated from any other drug or supplement, including Miralax, as the SEB can interfere with their absorption.



> Her tumour or lump was checked again today and her vet who did the surgery last year said it is not fibrasarcorma and is tiny and could be fat tissues. They don't recommend doing anything yet and will just keep monitoring her in case they need to take it out later.


Is the tumor on or directly adjacent to one of her teats?

Laurie


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## VictorKilo (May 11, 2015)

OK Laurie, vet has just given her 100ml today. I will check her tonight and see if she looks dehydrated and weigh her first as she has been weighed this morning. Will increase dose on Miralax to 1/2 tsp and see for today. Vet is unsure if its a tumour or bit of fat but its not hard like a tumour so she will see again next week. Perhaps she might need another cat scan but that means putting her under anasthetic not good.


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## laurief (Jun 22, 2008)

I don't understand why the vet would even consider anesthetizing her for another cat scan instead of just removing the growth. That makes no sense to me. When my Somer developed a small growth by one of her teats, I started researching and was absolutely certain it was mammary cancer. My highly skilled and widely respected veterinary surgeon, who also fancies himself well educated in oncology, was certain it was NOT cancer. The pathology report identified it as cancer. Even highly skilled and experienced vets are sometimes wrong, and when that happens, the animal patient pays the price.

Statistically speaking, feline mammary cancer more often occurs first in proximity to one of the teats closest to the hind legs, though it can start anywhere along the mammary channels. And as I stated earlier, cats who were spayed after their first heat are at much higher risk of developing mammary cancer later in life than those who were spayed before their first heat.

BTW, that Miralax increase may take a couple of days to show its effect on her stool.

Laurie


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## maggie23 (Mar 10, 2012)

hi viktorkilo,
just a reminder that i've been giving my 14 year old 1/8 teaspoon miralax 3X/day with her meals so it's almost 1/2 teaspoon per day. she eats all wet food that i make very soupy for her as well. are you giving the miralax to her all at once in one meal? if you feed her more than once a day, maybe you could instead give her some at each meal so it helps throughout the day. 
it will probably take a little while to figure out the right dosage for her as every cat will be different. i'm constantly adjusting myself depending on the situation.
just a thought. Good luck once again!


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## VictorKilo (May 11, 2015)

Got her up to 140 ml yesterday with no ill effects, vet did 100ml in the morning and I did 40ml at night. **** dman, she is scratching this morning and passed out nothing. yes Miralax is up to 1/2 teaspoon over meals. Can someone tell me what the does for SEB is. On Tanya's website it says 1/4 tsp per day but on the syrup formula much less.


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## laurief (Jun 22, 2008)

SEB syrup has been reported to be more effective at soothing GI issues than giving it dry, so I recommend making up a little batch of the syrup at the SEB:water proportion recommended on Tanya's site. As I believe I posted here earlier, you really don't need to cook the syrup. It's VERY EASY to make by just putting the SEB and water into a small bowl and blending until smooth and thickened with an eggbeater or hand blender.

You misread the dosing information. When using syrup, you can give a little MORE than when using dry powder. I'd give 2-2.5 cc of the syrup a day, when necessary, either mixed into canned food or given orally with a syringe. Dosing with SEB doesn't have to be exact. It has a very wide margin of safety, unless your cat has high blood calcium.

Laurie


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## VictorKilo (May 11, 2015)

Today my little girl had diarrhea as I started on on 1/2 tsp of Miralax yesterday. So I am going to back off to 1/4 tsp again day. Gave her some SEB, 1/4 tsp mixed with water into a paste with some honey and water to fill a 20ml syringe. She has just been fed and now gone to bed. I also started her on Astro fish oil two days ago. It seems to give her a much better appetite and even came to the table to ask for tit bits while we were having dinner something she has not done before for months. Well a few shreds of chicken which she loves is not going to hurt her phosphorous level will it?


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## laurief (Jun 22, 2008)

That's good news. Now you know that Miralax works for her. You just have to tweak the dose to achieve optimal stool consistency. It can take a little time to get it right.

Why are you mixing honey with the SEB? Is that just an attempt to get more calories into her system?

It's great that her appetite is improving. Hopefully it will stay improved once you get that Miralax dose regulated properly. She must feel sooooo much better not being plugged up with constipated stool.


A few shreds of chicken shouldn't make her phos go too wonky, but I trust you have having her phos checked regularly. If it starts to rise, you can just give her a bit more Epikitin to compensate for her improved appetite.

Laurie


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## 10cats2dogs (Jun 16, 2013)

Hi Victor, 
I've been following all along on this journey, you and your girl are on...
Keep listening to Laurie, she knows what she's talking about!

Sending (((HUGS))) and Prayers for both of you♡♡♡♡♡
Sharon


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## maggie23 (Mar 10, 2012)

that's great news that the miralax is working! although you've probably already cut back to the 1/4 tsp, i'd suggest 3/8 tsp instead. if i remember correctly, when you gave her 1/4 tsp, she became constipated again. might be better to taper off slowly from the 1/2 tsp instead of cutting it in half right off the bat. would hate for her to go back and forth from diarrhea to really hard, dry stools right away. better to adjust the dosage more gradually i think.


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## VictorKilo (May 11, 2015)

My little darling is now regular on 1g Miralax and 1/4 tsp SEB daily. SQ Infusion is kept to 100 ml per day unless it is a really hot and dry day, then I will give her a bit more in the evenings to bring it to 120 or 150ml (max). I am seeing moderately soft stool once every three to four days now. Thanks to all, especially Laurie.


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## 10cats2dogs (Jun 16, 2013)

Victor,
That is Great news! So glad she's doing so much better!
Sharon


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## laurief (Jun 22, 2008)

What a relief for you and your girl that you have her stool regulated and are keeping her properly hydrated. She must feel sooooo much better now. Well done!

Laurie


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## spirite (Jul 31, 2012)

This is great news! Every 3-4 days is already somewhat regular; hopefully it will soon be every 2-3 days, then 1-2 days. I'm so glad that you've found the right combination of things to help her!


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## VictorKilo (May 11, 2015)

Second blood tests showed creatine level has dropped. But phos level still climbing, above normal. I tried increasing her ipikitine a little last month but not helpful. Does anyone have any suggestions? Good news is her constipation is under control.


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## laurief (Jun 22, 2008)

Everything you need to know about phos binders and dietary control can be found at these links:

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease -All About Phosphorus Binders
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - The Importance of Phosphorus Control

Read them in their entirety.

Laurie


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## VictorKilo (May 11, 2015)

Hi everyone. My little sweetie is doing well. Constipation fixed and creatine level coming down after starting CRF Nitrogen scrub. Also phosphorus improving with low phos diet. However she has plagued on her teeth. The vet said she has to put her under anaesthetic to clean her teeth but this is dangerous as she has CRF. If it builds up further, she may not be able to eat. What can I do?


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## 10cats2dogs (Jun 16, 2013)

Hi Victor! 
Age isn't necessarily a disease, as far as a Dental goes!
IF she's in good general health now...AND...she will be constantly monitored by an anesthesiologist...
You need to find that out first! 
I think she should be put on a fluid drip as well...if I remember correctly...
I hope someone with knowledge of senior kitties and their health issues weighs in here...
Sharon


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## VictorKilo (May 11, 2015)

Sharon: She is in good health apart from her Kidney problems now. I am just worried if we can put her through anaesthesia, Gas I believe to put her to sleep for ten minutes of more to clean her teeth as her gums are plagued and she might have difficulty eating soon due to pain. Anyone with CRF cats in this situation who can help?


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## 10cats2dogs (Jun 16, 2013)

Victor,
I just found a Thread you can check out!
Pay close attention to what LaurieF has to say!
And follow the link she included to Tanya's site!
Sharon

http://www.catforum.com/forum/showthread.php?t=322602


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## VictorKilo (May 11, 2015)

Bad bad news. A lump was found on her side close to the spine the goes through the lumbar muscle. Doctor can't put her on anaesthetic to do a scan due to her kidneys and even if so there is not enough margin to operate to cut the tumour. She had fibrosarcoma treated a year ago. It looks quite aggressive. Chemo is out of the question due to her kidneys. One suggested thrying palladia but not sure if it is suitable for cats. Any one with any info much appreciated.


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## 10cats2dogs (Jun 16, 2013)

Victor, 
I'm so sorry to hear this...
It just seems like it's one thing after another, she's having to deal with...
I hope someone has some ideas, and advice for you soon...
(((HUGS))) and Prayers for your girl...
Sharon


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## NebraskaCat (Jan 15, 2013)

I'm very sorry for this discovery. Sometimes the best treatment when there are so many converging serious medical issues is lots of loving attention.

 It looks as though Palladia has only been cleared for use in dogs at this point in time.


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## VictorKilo (May 11, 2015)

Yes indeed. We are giving her the best of quality of life at the moment. Her CRF situation is stable, in fact putting on weight and eating and drinking more so its a blessing already. The tumour is growing. Sadly I made the wrong decision to let the vet try a needle to do a biopsy which failed. Now it looks like her wound would not heal and will likely cause her lots of aggro in due course. I fear the end is near. However she is still strong and active, enjoing the sun and making the most. Every day is a blessing for us now. I already started feeling the pain of losing her yet I know I must save my grief till after and concentrate on how to give her the best that we can afford.


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## VictorKilo (May 11, 2015)

Sadly my little girl died last Sunday night in her sleep. She did not suffer and I could not have asked for more. God was kind to her and she has lived a full life. Thanks you all for your support especially Laurie who saved her from severe constipation earlier in 2015.


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## 10cats2dogs (Jun 16, 2013)

Victor, 
I am so sorry...:'(
You and her waged a long battle, she is at peace now, and she passed over in her sleep, at home, she didn't have to endure any final traumas...
HUGS,
Sharon


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## maggie23 (Mar 10, 2012)

:heartvictor, my thoughts are with you and your baby who has gone to the rainbow bridge. you showed her so much love and care and you were both rewarded with her peaceful passing in the very end. that is the best gift in the world in my eyes. I think we can all relate to how you feel right now, but you are in good company here. wishing you peace and comfort and only smiles very soon whenever you think of your little girl.


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## eldercat (Jul 3, 2015)

You gave her a well loved lifetime. She was a good cat. What more can anyone ask, really? Glad to read she went out peacefully.


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## VictorKilo (May 11, 2015)

Many thanks everybody. yes my little one is over the bridge. My wife and I thank you all for your support. We have donated her monthly food bill to cat rescue and for the feeding of strays and abused cats in Singapore. Much love and do take care of your little ones. Ours was indeed blessed and so were we. I have always prayed for God's Merci to not let her suffer in the end. xxx


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## spirite (Jul 31, 2012)

Oh my goodness, I had missed this earlier. I am so, so sorry.  She was a lucky girl to have had you and your wife caring for her. You did so much for her, and I know she brought you so much joy as well. Perhaps, in time, you will feel ready to help another kitty. In the meantime, what a wonderful way to show your love and a wonderful tribute that so many other cats will benefit from her passing. Sending you many hugs and sharing your grief.


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