# Constipated Cat - How long does it take to regulate stool?



## Kattt

As I've posted in another thread, my 7 year old female cat has been having some constipation issues. 

I took her to the vet Tuesday night to find the cause. They did xrays, bloodwork and a full thorough exam and said shes extremely healthy. All organs are in very good shape, colon is fine, anal glands are fine, no tumors and no diabetes. Basically said there is nothing medically wrong causing her constipation. 

They did however say it was her poor diet causing the issues. She was eating Fancy Feast wet twice a day, but only licking the gravy, eating none of the meat. And eating Fancy Feast Gold dry throughout the day. Yuck, I know. Now that I'm educated on cat nutrition and what a poor diet can do, I immediately got my cats on better food. They are now eating Wellness Healthy Indulgence Pouches for breakfast and Blue Buffalo Healthy Gourmet wet for dinner, and they do at least eat a very small portion of the meat now, vs eating no meat on Fancy Feast. They're not big canned food eaters, so they only eat a little bit of it. And they're huge cats - 16lbs & 21lbs, so I still have to give them a little dry in between feedings so they don't starve. They eat about 1-2 ounces of dry food daily between the 2 of them, which I have just switched to Innova Evo dry. And they both drink lots of water throughout the day.

The vet gave her an enema Tuesday night, which made all of the stool come flooding out as soon as we got home. The vet advised me to put pumpkin in her food for now, which I have been doing - about 1/2 a teaspoon twice a day, since she only eats a small portion of wet, I don't want to overwhelm it with pumpkin. And also said to give her Laxatone, which I have been about twice a day - she licks it, but only a very small amount.. probably about 2-4 licks a day. The straining has stopped, and she is getting poo out, however its small amounts. She is only poo'ing small, round hard stool - which are the signs of still being constipated. But she's only been on the new food/pumpkin/laxatone for 3 days. Does anyone know how long it will take for the new food/pumpkin to regulate her stool?


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## laurief

Improving your cat's diet should help a lot. So should the addition of pumpkin into her canned meals. One of the most helpful management strategies in terms of stool consistency is to increase your girl's fluid intake (thus the importance of canned food vs dry). Hopefully your cats will develop more of a taste for canned food over time, but even if they don't, you can increase their water intake by mixing warm water into their canned food to turn it into "canned food soup". You may even find that they prefer and will eat more of it that way. It'd also be a good idea to put more water bowls around your house and maybe even consider buying a pet water fountain (some cats love to drink "flowing" water from a fountain). The more water she takes in every day, the less likely she'll be to constipate.

If your girl won't eat the pumpkin-laced food, you can substitute 1/8 tsp of unflavored Metamucil, instead. It's a fiber supplement that serves the same digestive purpose as pumpkin.

Laxatone is useful for helping pass constipated stool (it lubricates the digestive tract to make passing stool easier), but it won't affect stool consistency, and it shouldn't be used long term because it can interfere with the absorbtion of nutrients from her food. Instead, ask your vet about giving your girl Miralax. Miralax is an osmotic laxative that is available OTC, and it DOES soften the stool consistency as it is forming in your girl's system. It does this by holding water in the digestive tract. This extra water is then absorbed by the newly forming stool, making it softer. Miralax is a dose-to-effect drug, meaning that you can adjust the dose up or down to achieve optimal stool consistency. And Miralax doesn't interfere with nutrient absorbtion. Miralax is also very easy to administer because it's a tasteless powder that can be mixed directly into canned food or mixed into a little water and administered via oral syringe.

Laurie


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## Kattt

Thanks for the advice Laurie!  

My cats are normally extremely picky eaters, so I was very fortunate that they took so well to the new healthy foods. My female cat even gobbles it up with the pumpkin in it. I am still giving a little bit of the old, so their stomaches don't get upset from the rapid diet change, but they actually prefer the healthy food over the old (If I leave both side by side, they choose to eat the new healthy food), which was good to see. They are definitely both eating a bit more of the canned food now, than they did with the old FF brand.. so hopefully they'll gradually eat more and more. I've been giving them a variety of flavors, some they enjoy more than others.

They absolutely love water - drinking in it, playing in it and such. So they do drink lots of water throughout the day. I have 3 different water bowls in various places for them, which I refresh multiple times a day to keep it fresh for them (Drives me nuts to see lil cat hairs in the water from my boy cat dipping his paws in it, so I'm constantly giving fresh). They also enjoy drinking from the bathroom faucet (My male cat has an obsession with playing in water and drinking it with his paws). But oddly, wanted nothing to do with a pet fountain when I bought one, go figure.

They've been on the unhealthy Fancy Feast food for 7 years (Which I felt bad about after learning about nutrition - I had no idea it was bad for them). So I wasn't sure how long it would take for the new food to regulate the stool. I would imagine at least a week, or maybe even 2-4 weeks? 

I'll call the vet and ask about the Miralax. Should that be added in addition to the pumpkin, or should I substitute the pumpkin for the Miralax?


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## laurief

Kattt said:


> Thanks for the advice Laurie!


You're welcome.



> My cats are normally extremely picky eaters, so I was very fortunate that they took so well to the new healthy foods.


You are fortunate. My cats love canned FF (it's considered "kitty crack" by many because their cats are so addicted to it), but they're just so-so about premium canned brands.



> My female cat even gobbles it up with the pumpkin in it.


That's great news. The pumpkin should help bulk up her stool so that it's easier for her to pass.



> They are definitely both eating a bit more of the canned food now


That's great. Canned food will help hydrate them, whereas kibble is dehydrating (it absorbs fluid out of the digestive tract, which exacerbates constipation problems), so the more canned and the less kibble they eat, the better.



> They absolutely love water


It's likely that some or most of their water consumption has been triggered by the dehydration caused by eating kibble. You may find that as they eat less kibble, they also drink less water.



> They've been on the unhealthy Fancy Feast food for 7 years (Which I felt bad about


Hey, now that you know better, you're doing better. That's all any of us can do. I spent the first five decades of my life feeding garbagy foods to my animals. Now that I know better, I'm doing better, too. 



> I wasn't sure how long it would take for the new food to regulate the stool. I would imagine at least a week, or maybe even 2-4 weeks?


If you add water to her canned food and increase her hydration, that should help gets things moving more quickly. But if you add Miralax, that should soften her stool in just a day or two.



> Should that be added in addition to the pumpkin, or should I substitute the pumpkin for the Miralax?


Pumpkin and Miralax work in two entirely different ways, so they can be used together. Just don't overdo either one, or you'll cause more problems than you cure. 1 tsp of pumpkin and 1/8 tsp of Miralax daily is a good place to start.

Laurie


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## Kattt

Thanks again for the suggestions! 

The vets is already closed, since its saturday. But I left a message with their answering service, and they said they'll have the vet call me back sometime by this evening to let me know if I can give her the Miralax. 

I can't believe the rapid change with them eating healthy food. My cats were shedding hair extremely bad, I would literally have a handful of hair when petting them. But after only 3.5 days on the new food, they are hardly shedding much hair now and their fur is already softer and shinier. I figured eating healthier would make their appearance better overall, just didn't expect it that fast. Now, if only it will fix her constipation issue, we'll be golden!


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## doodlebug

Just to give you some perspective on water intake...

Cats are "designed" to get all their water from their prey...they're desert animals with very little thirst drive.
Prey is made up of ~70% water
Wet food is ~70% water
Dry food is 10% water (majority of brands)

A cat eating dry food needs to consume 1.25 cups of water for every cup of dry food consumed to make up for the missing 60%. Typically a cat eating dry doesn't even consume half of that amount. Yours may be different, but knowing how much they need to consume will help you assess whether they're really getting enough.


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## Kattt

Thanks for the info Doodlebug.

Yea, I don't think theres any way my cats drink 1.25 cups of water a day. They have quite frequent trips to the water bowl througout the day and night.. but probably no way they drink a whole bowls worth (I refresh their water quite often throughout the day, so no way to tell how much they actually consume. I guess I should try to measure it).

I'm trying to get them more on the wet food. But not sure that will ever be possible. They eat no where near enough for it to be their sole diet. I split a 3oz can between the 2 of them twice a day, and neither of them eat it all of that even, theres still quite a bit left in the bowl when they're done. They both seem to mostly just lick it until its dry, and eat very little of the actual meat. So not sure how much that is helping their diet, if any?! 

As for the Miralax, my vet was not keen on that. He said he would have to check into it some more, but didn't want me giving it to my cat until he did more research. He said he didn't like the ingredients in it, and felt pumpkin and Metamucil was a better route. He suggested that I use both pumpkin AND Metamucil to get her going regularly again, so she doesn't end up with Megacolon. However, I have read on this forum that both should not be used together?! :? 

I think because she doesn't eat all of the wet food I am mixing her pumpkin in, she is probably not getting the correct dosage that she should (Per the vet - 2 tsps per day until stool is normal). So I’m going to have to try some more creative ways to get her to absorb the full 2 tsps of pumpkin I guess.


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## doodlebug

I don't remember if you've said...are you leaving dry food out for free feeding? If so, you'll never get them to eat enough wet if they prefer dry. They'll just fill up on dry and nibble on the wet, or just lick the gravy because they like it. Take away the dry and let them get good and hungry before giving them wet. Also enticements for wet food toppers...tuna juice, parmesan cheese, crumbled dehydrated chicken treats (Whole Life or similar), a few kibbles stuck in the wet food (really smushed in there so they have to get wet to get it out), some cooked chicken or other plain meat as a topper...again smush in. 

If the vet has suggested pumpkin and metamucil and given you the amounts to use, then go ahead and follow his recommendation. People here generally say don't use them both because you can overdo it. I think you said she likes the pumpkin...you can try giving it straight. Sometimes hand feeding is more likely to get them to eat something. If you have to...try dipping a kibble in pumpkin, get a blob on it and hand feeding it like a treat.


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## laurief

I recommend you print out the information at the following links and give them to your vet for review. They cover all of the constipation remedies in popular use, including pumpkin, Metamucil, Miralax, and many others. These should answer any concerns your vet has about the use of Miralax or any other constipation treatment or prevention:

http://www.felinecrf.org/treatments.htm#constipation
http://www.felineconstipation.org/acutetreatment.html
http://www.felineconstipation.org/prevention.html

I personally would be hesitant to use both pumpkin and Metamucil, since too much fiber can make constipation worse instead of better. I suppose if you used very small doses of both, it would be equivalent to a larger dose of just one of them.

I agree with Doodlebug about restricting the amount of dry food to inspire your cats to eat more canned. That's how I converted my kibbleheads to eating adequate amounts of canned food (later converting from canned to raw). Originally, my cats were free fed kibble. Then I switched to 3 meals a day - 2 kibble and 1 canned. Then I reduced to 2 meals - 1 kibble, 1 canned. Then I swapped the canned meal for raw so they were getting 1 kibble and 1 raw. That's what I still feed most of them today. They each receive 1/8 c. of kibble (EVO) daily in addition to the raw meal. It took about a year for them to really relish their canned food (before switching to raw), but they did eventually develop a strong taste for it.

Laurie


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## Kattt

Thanks again to you both.

Yes, I was free feeding. They really don't eat much - maybe an ounce or 2 of dry between the two of them daily, so I didn't think it was bad, but with her bathroom issues right now.. I realize it isn't good for her. 

So I tried your suggestions last night, I picked up the dry food, then this morning I fed them the wet. And my female (the one that really needs it because of her constipation issues), did actually eat most of it this time (I split a 3oz can, so she ate about about 1 - 1.5oz). So she finally got some of the meat into her along with most of the pumpkin, when prior to this she would only lick it which wasn't getting much pumpkin (and no meat) into her system. My male cat however, took one bite and walked away. Hes always been alot pickier than her. So he'll require alot more work. But for now, my focus is on my female trying to get her stool regulated, because I fear megacolon if her constipation turns into a chronic issue.

I've been trying to get her to be more active by making sure she plays for at least a half hour a day, because I heard that also helps get their stool moving. The vet also suggested that I feed her the wet food with pumpkin maybe 4 times a day, since she doesnt eat it all in one sitting - she'll get more into her system feeding her multiple times. So I'll try that as well.

My girl is an extremely high anxiety cat.. shes scared of everything and everyone, but me. Follows me room to room upstairs (She won't leave the upstairs level of the house, eats upstairs, litterbox and toys are all upstairs for her). If I go downstairs she lays on the top landing hanging over the edge peeking downstairs waiting for me to come back up. I work at home, upstairs.. so she lays on an extra office chair that I set up right next to my desk, with a comforter on it for her. So shes extremely attached to me (I pamper her - Shes very spoiled since comfort her all day so she stays calm). 

And just recently, I've noticed when she has to go to the bathroom (urinate). She will sit and look up at me meowing, until I get up and walk into the litterbox room with her, she'll hop in and pee, then hop out and go about her business. The vet did a thorough exam tuesday, and checked her for urinary issues as well, and she had none. So I think she just wants me with her at all times. Which I am for the bigger part of the day and night, but obviously I can't be 24/7. So I don't know if her anxiety is possibly contributing to her constipation issues, or not. Like shes afraid to leave my side, and holds in it until shes constipated. Nor do I know how to stop her from needing me to "hold her hand" so to speak. The vet said she doesn’t like to prescribe prozac or xanax to cats, unless its an extreme case, because its not really good to get them hooked on it. So I don't know. For now I will continue getting some pumpkin into her, and hope that gets things moving easier for her.


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## razzle

Hi my cats are on Metamucil 1/4 tsp. twice a day for constipation due to chronic renal failure (CRF). CRF cats can't drink enough water to keep up with the kidneys and the urination so they become constipated.

I'm woory your cat is too dependent on you. I think you are enabling her. She needs to go to the bathroom by herself. She needs to go to the bathroom without you there. My friend Deb has a cat that won't eat unless she is in the same room. So the cat eats fast because she knows Deb will leave the room. This became a problem when Deb ended up in the hospital for a week. The cat hardly ate. Her son had to stay in the room with her but she still didn't eat much. The cat lost 1 or 2 lbs. 

I have heard of some people getting good results when their cats were put on Prozac. I think you should give it a try. See how your cat does on it for a while. It might take 2 to 4 weeks to start to see results (at least in people this happens). You might want to consult a cat behaviorist. Maybe you could bring her down a few of the stairs, hold her (for a few minutes) then give her a treat before she has a chance to run back up. Do this till she is calm (for a few minutes) then do a few more steps and treats, etc. If you can get her to the bottom of the stairs then try the same technique in a room moving further and further as she become comfy. I think doing this while she in on Prozac will greatly enhance the process.

Kathy


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## Kattt

Thanks for the suggestions Razzle. Sorry to hear your cats have CRF. I hope they are doing well.

I do try to coax her downstairs daily, and she'll go down for maybe 5-10 minutes at a time. But she tiptoes around like shes terrified (And we've lived in the same house since I got her as a 6 week old kitten 7 years ago. I got both of my cats from an in-home foster shelter named "Dumpster Cats". I suspect she may have been abused prior to arriving at the shelter). I can even get her to go out on the screened in porch from time to time, but the minute a car rides by, or she sees someone walking past the house.. she shoots back inside and darts back up the stairs. As long as shes upstairs, she feels safe and she's generally low on stress, unless its thundering (she'll cringe and hide under the bed), or if she sees my male cat or an unfamiliar face up there, then she gets real stressed out. I did discuss her dependancy and anxiety issues with the vet, who suggested I try Feliway as a first resort to calm her stress. I haven't gotten it yet, so I have no idea how effective that stuff is for stressed cats?! So I guess I will give it a try, and see what happens. 

But on a much happier note, she finally had a healthy bowel movement tonight. I've never been so excited to see her poo :lol: I feared we were in for another vet visit tomorrow. Because she was straining yesterday, and only small hard stool came out. Same thing earlier today, one small hard piece. So I increased her wet food to 4 times today per the vets suggestion (she only eats 1 - 1.5ozs each sitting, so shes not overeating), added 2 tsps of water each time, plus gave her 2 tsps of pumpkin throughout the day.. and finally, it came out healthy looking. So I'm hoping now that she got past the hard part, getting the dry stool out.. and has had a healthy movement, we're on the road to recovery and no more constipation. I'm going to continue to feed her 4 times a day with extra water and pumpkin for a bit to be safe (Decreasing the pumpkin down to 1 tsp now that she had a healthy movement). I surely don't wanna go through that again, and I'm certain my poor kitty doesn't either.

Thank you all who gave advice. This forum has been extremely helpful.


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## laurief

It's fantastic that she finally passed a normal looking stool, but don't rush to rely solely on her new diet to keep things moving smoothly. If she were my cat, I'd keep adding extra water and pumpkin to her meals as long as she's still eating any kibble at all. If you can manage to wean her off of kibble entirely, then it might be safe to eliminate the pumpkin, though there's really no reason not to keep giving it to her indefinitely.

Laurie


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## Kattt

I agree. I am definitely going to continue adding water and pumpkin to her food since it seems to have worked, and she seems to really like it that way (She gobbled it up more once I started adding water). And also continue feeding her 4 times a day until I can increase her wet food intake to get her to eat bigger portions, hopefully 3oz twice a day someday. I have mostly taken her dry food away from her. I give her just a few kibble a day now (I didn't want to take it all away from her at once, making her think she was being punished or something for her constipation issues).

My boy cat however, is going to be the bigger challenge. Hes quite stubborn when it comes to food. He would literally let himself starve if he doesnt like the food. He won't eat much of the wet, 2-3 tiny bites tops and thats only if its a fishy flavor (Tuna or Salmon).. then walks away. Put chicken, turkey or beef in front of him, he won't touch it at all. And from what I've read on this forum, fish based products can cause urinary issues. So we're working on testing different healthy brand flavors, to hopefully find something he'll like.


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## laurief

Kattt said:


> (She gobbled it up more once I started adding water).


Many cats prefer canned food soup. Makes perfect sense if you think about it. What's the first thing cats eat when offered canned food that's chunks in gravy? The gravy, of course, and then they leave the chunks behind. By adding water to pate-style (NOT chunks in gravy) canned food, you're essentially turning the meal into a bowl of gravy that they like to lap up. If you offer your boy cat canned food soup, too, you may find that he's more willing to eat it.



> I give her just a few kibble a day now (I didn't want to take it all away from her at once, making her think she was being punished or something for her constipation issues).


There's no way your girl would ever make a connection between having constipation and being "punished" by not getting kibble. Cats just don't think like that.



> we're working on testing different healthy brand flavors, to hopefully find something he'll like.


If he won't eat any of the healthy brands, go ahead and try the cheapo brands (FF, Friskies, etc.) with him. Even those lower quality canned food brands are healthier for him than the most premium kibble, and the lower quality canned foods tend to be more appetizing to many cats. I'm not sure what the cheap foods are flavored with, but my cats will always choose cheap canned foods over premium ones if offered the option. Do, however, use pate-style foods instead of chunks in gravy. The gravy in "... in gravy" type canned foods is typically made with wheat gluten, and that's best avoided in the feline diet.

If you can get your boy eating cheap, tasty canned foods, you can always try to convert him to healthier brands later by gradually mixing tiny amounts of the better food with the junk food.

Laurie


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## Kattt

Laurie - Thanks again for all of your suggestions. While my girl is going a bit better now, she is not fully back on track yet, and still having some issues with some hard stool.

So I spoke to my vet again, and she finally agreed to give her the Miralax, as long as I make sure she gets plenty of extra water in her wet food. So I am going to start her on that today, to see if we can hopefully resolve these issues once and for all. The vet said her colon is healthy, no sign of megacolon, so hopefully the Miralax will get her fully back on track.

I should have asked the vet this, but it slipped my mind. Do you know how much water intake a cat should get daily? My female is 16lbs, I want to make sure I get plenty of water into her while shes on the Miralax.


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## laurief

I'm glad that you'll be adding Miralax to her treatment regimen. It sure did the trick for Billy's chronic constipation. Do be careful, though, not to overdose, or you'll end up with the opposite problem (diarrhea). Start with 1/8 tsp. once daily and see how that effects her stool consistency over the next 48 hrs. If her stool is still too hard in a couple of days, increase it to 1/8 tsp twice daily. If her stool becomes too soft, decrease the Miralax a little.

In terms of water intake, here is a quote from the following website:

http://www.vetinfo.com/catroutine.html

"Most animals require approximately the same amount of water intake as calorie intake on a daily basis. To determine the necessary calorie intake for a cat, the formula is 1.2 x the resting energy requirement (RER), which is roughly 1.2 x 70 calories/kg of body weight. Using this formula, an 11 lb cat (5kg) would need 420 calories per day and therefore about 420ml of water. Some water is obtained through the food and the amount varies by composition of the food (canned food might be 80% water and dry food 5% water, for instance). The variability in water need based on diet can be very large and is a source of confusion. Cats being fed dry food are reported to require approximately 2.5 x the volume of dry food for water intake. So if the cat is eating 1cup of dry food per day it requires approximately 2.5 cups of water per day. Cats being fed canned food can sometimes nearly meet their water intake requirements from the food alone."


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## Kattt

You've been such a huge help through this, thanks again! 

The vet I spoke to on Saturday, which was the head of the practice (older guy), wasn't keen on Miralax and pretty much told me not to give it to her, until he researches it. So I called back today, and asked for the vet that actually examined her last Tuesday, and she gave the ok (much younger vet). I think older vets/doctors are sometimes stuck in their ways, and don't like to try new things, which is why I asked for the one that actually did the exam on my cat. She said she read up about Miralax, and was fine with giving it to her as long as I make sure she gets plenty of water, and monitor her by checking her gums for dehydration.

She said to start her with 1/8 tsp twice daily. But per your suggestion, I think I'll just start with once daily, and see how she does first. Since shes SO picky and stubborn, I had to squeeze some of the gravy out of the pouch with no meat.. mixed in the Miralax along with 2 tsps of water to make sure she absorbed it all, and luckily she licked the bowl dry. Then I gave her the rest of the package, which of course she again just licked the meat and the rest of the gravy, and was done. 

She did say it was ok to continue giving her the pumpkin too, but I don't know if thats overkill?! I would hate to cause the opposite effect, and constipate her more.

I really hope this stuff works this time! I hate seeing my babygirl uncomfortable. I also plugged in a Feliway Diffuser per the vets recommendation, to try to alleviate some of her stress since shes a high anxiety cat. Never used them before, so I have no idea how effective that will be either.


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## laurief

Go ahead and keep giving her the pumpkin, too. It is a fiber source. Miralax is not. They work entirely differently, so they're fine to give together. If your girl's stool does get too soft or loose, however, just dial back the Miralax a little. You're likely to have to experiment with dosages to get her stool consistency just right. I monitored Billy's stool and tweaked his Miralax dose for more than two years. Stool consistency depends on many factors, one of the most important of which is daily fluid intake.

Laurie


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## Kattt

Will do, thanks.

Prior to getting the 2 I've had for the past 7 years, I had to put my female cat down for constipation issues. She couldnt pass her stool, because her bowels literally shut down on her. It was so heartbreaking. But that cat was 19, so age played the biggest part in it. I would hope at 7 years old, that is not the case. The vet said my girl is healthy, and showed no signs of megacolon or anything else. But of course I have that fear in the back of my mind, thinking its that situation all over again, but I sure hope not.

As for their food - Since my cats both go for the gravy only, and avoid the meat... The vet did also suggest blending up their wet food in a blender so its entirely all soup, like you have suggested many times (I think you even said to blend it too). Which seems gross to me :? But I suppose I will try that, and see how it goes.


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## laurief

Kattt said:


> Prior to getting the 2 I've had for the past 7 years, I had to put my female cat down for constipation issues.


Well, I can certainly understand how your current situation must be causing you a tremendous amount of concern. But I'm sure your girl will be fine once you fine tune her management and diet.



> As for their food - Since my cats both go for the gravy only, and avoid the meat... The vet did also suggest blending up their wet food in a blender so its entirely all soup, like you have suggested many times (I think you even said to blend it too). Which seems gross to me :?.


LOL! Gross for you, delicious for your kitty kids. The blender will essentially turn their entire meal into a tasty "gravy" for them to lap up. They'll love it, I'll bet!

Laurie


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## Kattt

Well you were right, Miralax certainly does work. It sure flushed out her system. I gave her 1/8 tsp last night, and another 1/8 this morning. At first this morning she was still straining (Miralax probably hadn't kicked in yet). Then about an hour later she had a normal bowel movement. And by this afternoon, she had alot more come out. The afternoon stool was really soft, and had some semi-diarrhea, so I'll cut back her Miralax dosage now. But what a relief, finally having something that works and seeing her get that out of her system without requiring another vet visit for an enema. And she feels much better too, alot more relaxed now.

The vet didn't actually say how long I should continue giving the Miralax to her. I don't think shes out of the woods just yet, because I think she's possibly had a bit of a constipation problem longer than I've actually realized, but because she was actually getting stool out, I didn't notice until I saw her straining and there was hardly anything coming out at all (Poor thing). So for now, I'm going to continue giving her the Miralax. Maybe a downsized dosage every 2-3 days to see if I can get her regulated with a lesser dosage. I'm hoping I don't have to permanently give it to her, because I've read that it can cause damage to the colon if its given daily, not sure how true that is? I would hate to create more problems by using it. 

As for the blended food, it was a no go with my picky eaters, they both turned their noses up. But I think I have finally mastered a perfect blend of the Blue Buffalo chicken with water and pumpkin that my female is finally happy with. She finally actually ate the chicken meat twice today, about 1 oz each time, not much.. but its huge progress for her. My boy though, forget it. He's stubborn and will require so much more work. I really want to get him on wet, because aside from the fact that its healthier, but if I ever have these kind of issues with him, I'll have a real problem giving him meds if he only eats dry food.


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## laurief

Kattt said:


> Well you were right, Miralax certainly does work.


It's amazing what 1/8 tsp of the right stuff can do, isn't it? I'm so glad Miralax helped clear all of that poo out of her system and has made her more comfortable.



> for now, I'm going to continue giving her the Miralax. Maybe a downsized dosage every 2-3 days to see if I can get her regulated with a lesser dosage.


That sounds like a reasonable strategy to me. Maybe give 1/8 tsp once daily for the next few days, then reduce to 1/8 tsp once every other day and see how she does for a week. If all goes smoothly, reduce to 1/8 tsp once every 3 days for another week, and so on.



> I'm hoping I don't have to permanently give it to her, because I've read that it can cause damage to the colon if its given daily


Where did you read that? I'd like to check out that source myself. I haven't read anything about colon damage associated with Miralax, and I gave it to Billy twice daily for over two years.



> As for the blended food, it was a no go with my picky eaters, they both turned their noses up.


That's too bad. You never know what those picky eaters might like (or not) until you try it. 



> But I think I have finally mastered a perfect blend of the Blue Buffalo chicken with water and pumpkin that my female is finally happy with.


That's a step in the right direction, for sure.



> My boy though, forget it. He's stubborn and will require so much more work.


Have you tried him with the tasty junk food canned foods like Fancy Feast and Friskies? Have you tried both pate style and chunks in gravy style? There's bound to be something out there that will appeal to even his picky palate.

Laurie


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## Kattt

I can't find that article again. I've probably read every constipation article on the net over the course of the past couple of weeks she's been having issues, so lord knows where I saw it. Now that I think back, it didn't say Miralax specifically, it said laxatives in general.. and it wasn't a credible source, it was just articles I've read that people wrote themselves on how they resolved their own constipation isuses. So probably nothing to worry about.

But I did read when I googled Miralax side effects, that it should not be used for prolonged use (no longer than 2 weeks), because it can cause dependancy and stop working. But if you've been giving it to your Billy for 2 years, I hope it will continue to work for my girl too... because I'm sure she will probably need it longer than 2 weeks. 

Do you give it to Billy daily, and how many times a day? Mine is still only poo'ing every 3 days. I think her main problem is, she holds it.. until it builds up into a very large stool, so large that its hard for her to pass. So it takes her several straining tries to get it out (Which obviously isn't healthy for her colon, to contiuously having to strain to get her poo out). She just did that today, it took her nearly 5 tries.. I felt so bad. And I swear it was nearly human size LOL, which is why she had so much trouble getting it out of her tiny body. It was normal texture, not hard or dry.. looked healthy, no blood or anything unusual.. just extremely large.

Maybe my fault, I probably didn't give her enough Miralax. I only gave her 1/8 tsp of Miralax the past couple of days (instead of twice daily like the vet said to do, because it caused semi-diarrhea the first day, so I cut it back to once). Plus yesterday I sprinkled it on top of her wet food, because I figured since she licks it, she would lick that all up first... but maybe she didn't take it all in (She never eats all of her food). So today I went back to my normal routine and mixed it up in a lil tiny bit of gravy, which ensures that she gets the full 1/8 dosage into her. I'll give her another 1/8 dosage again tonight, and continue twice a day until she hopefully stops waiting 3 days causing herself to strain so much. What a crazy ride this has been! 

As for my stubborn boy.. I have tried the junk food brands too.. Friskies, Fancy Feast, etc. They have been on Fancy Feast canned for the past several years, but he's only ever licked the gravy out of it. Pate styles, neither of my cats will even attempt to lick or try. However, I am finally starting to make a bit of progress with him the past 2 days. He's finally decided he likes the Blue Buffalo Tuna flavor (only flavor he'll even go near). He only eats a very, very tiny bit.. but its a start, that hes actually eating a little of the meat now. So I'm going to stick with the flavor he enjoys for now to try to get him eating more wet food, and hopefully he'll eat a bit more each day. I know tuna flavor isn't great for cats to have, but its all he'll eat.


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## laurief

Kattt said:


> Now that I think back, it didn't say Miralax specifically, it said laxatives in general.. and it wasn't a credible source, it was just articles I've read that people wrote themselves on how they resolved their own constipation isuses. So probably nothing to worry about.


There are different types of laxatives that work in entirely different ways, so cautions that apply to one type of laxative aren't likely to apply to others. I wouldn't be at all concerned about generalized, anecdotal statements made by unreliable sources.



> But I did read when I googled Miralax side effects, that it should not be used for prolonged use (no longer than 2 weeks), because it can cause dependancy and stop working.


That definitely was not my experience with Billy. Miralax never lost effectiveness with him.



> Do you give it to Billy daily, and how many times a day?


Billy passed on several weeks ago, but his condition was considerably more complicated than your girl's. Billy was 20+ yrs old with chronic renal failure, hyperthyroidism, hyperparathyroidism, and skin cancer. You can't make comparisons between what his body required to maintain reasonable function and what your girl's does. But to answer your question, Billy received a heaping 1/8 tsp of Miralax twice daily, every day.



> Mine is still only poo'ing every 3 days. I think her main problem is, she holds it.. until it builds up into a very large stool, so large that its hard for her to pass.


I suppose that's possible - that she's holding it because she anticipates so much pain when she tries to pass it. But hopefully she'll stop holding it once you get it properly regulated and she realizes that she can pass it without discomfort.



> She just did that today, it took her nearly 5 tries.. I felt so bad. And I swear it was nearly human size LOL, which is why she had so much trouble getting it out of her tiny body. It was normal texture, not hard or dry.. looked healthy, no blood or anything unusual.. just extremely large


It sounds to me like you may be giving her too much pumpkin and bulking up her stool too much. If you're giving her more than 1 tsp of pumpkin daily, I recommend you reduce it to 1 tsp only.



> I only gave her 1/8 tsp of Miralax the past couple of days (instead of twice daily like the vet said to do, because it caused semi-diarrhea the first day, so I cut it back to once).


Reduce the pumpkin first, if you're giving her more than 1 tsp daily, and maybe increase the Miralax to a heaping 1/8 tsp once daily. Then wait a couple of days and see what effect that has on her stool consistency and frequency.



> Pate styles, neither of my cats will even attempt to lick or try.


Have you tried pate style mixed into a gruel with warm water? They both might be a lot more inclined to eat it if they can lap it up. Also, warm it in the microwave for a few seconds - just long enough to make it REALLY smelly. Do NOT, however, make it so warm that they reject it because of the heat.



> He's finally decided he likes the Blue Buffalo Tuna flavor


As you know, not the best option, but it's definitely a good start toward eating canned food.

Laurie


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## Kattt

Aww I'm so sorry to hear about your Billy passing. But wow, 20 years.. nice long life for him. All of your knowledge with his medical issues most likely expanded his years.

As for the pumpkin, I've only been giving her 1 tsp per day (1/2 tsp split between 2 feedings). Which means, since she doesn't eat all of her food, she wasn't even taking in the entire tsp. So maybe I should cut the pumpkin out all together if that’s whats bulking up her stool and making it that large. The vet told me that the pumpkin would help her push her stool out, but that doesn't seem to be the case since she's still straining. 

You're most likely right about her associating having a bowel movement with pain, so that’s whats causing her to hold it... and in turn, causing her to be constipated. She can hold it for a long time too.. believe me. Even after the vet gave her an enema, which should have released it nearly immediately, my girl held it in for well over an hour and a half after receiving the enema until we got home. So shes a pro at holding her stool in. 

And for the food. I have tried mixing water in both pate and non-pate wet food. My boy will not touch the wet food if I put any water in it, at all. Which is odd, because he loves water.. so I figured he'd like it more, but nope. I've also tried warming it a few seconds in the microwave too, and no go. The only way he'll eat it is fresh out of the can.. with nothing at all added or heated. I did ask my also ask my vet about him only eating tuna flavors, if it was going to create issues for him. She said as long as I'm feeding a high quality brand (which I am now), and hes had no urinary issues, he should be fine. So I hope shes right, because that is seriously all that boy will eat. I've tried a ton of brands, flavors, tricks, etc.. with no luck, aside from the tuna flavor. I'll keep trying, because if he ever does have a urinary issue, he won't have a choice. So I'd rather gradually conquer the problem ahead of time, just incase.

Thanks again for all of your help. You've been great!


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## laurief

I think I'd keep giving the 1 tsp of pumpkin, because bulking up the stool does make it easier to pass. Maybe it'll just take a bit of time for her digestive tract to adjust to the changes.

I remembered something today that you might want to add to your girl's regimen, esp. since it might allow you to wean her off of Miralax more quickly. It isn't the first option that comes to my mind because it isn't suitable for CRF cats (too high in phosphorus for CRF cats), but it might work beautifully for your girl. It's milk! Milk can act like an osmotic laxative (same as Lactulose and Miralax) for adult cats. It's possible that giving your girl a small amount of whole milk every day might soften her stool enough to eliminate the need for Miralax. It's worth a try, anyway. I'm not at all sure about the amount, though. You might try a tbs or two of milk on the days that you don't give any Miralax and see what happens to her stool.

Now, milk might not do anything for her if you're already giving her any dairy as treats (milk, cream, cheese, yogurt, etc.), but if her body isn't accustomed to digesting dairy, then it might do the trick to soften her stool.

Laurie


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## Kattt

I've never given her anything dairy before, so her body isn't accustomed to it. However, when this constipation issue first started, I did try giving her both whole milk and cats milk, and she wouldn't touch either. Took one lick of each, and walked away. What cats don't like milk?! Only my 2. So picky, I swear. And it seems milk might give her an upset stomach if mixed in wet food like chicken or something.

She did poo again today, so thats 2 days in a row. First time in years she's done that. Its always been every 2 days as her norm, and every 3-4 days once her constipation issues started. (Prior to these issues, I had no idea cats were supposed to go daily, I thought every 2 days was normal :? ). 

So I'm hoping, emphasis on HOPING, that I can continue to give her the Miralax for a couple of weeks, and possibly get her into the routine of going daily, so she can re-train her brain that its ok, and it won't hurt if she goes daily. Then she can hopefully start going on her own soon again with pumpkin only, and no Miralax. I really think a huge part of it is mind over matter with her thinking its going to hurt, since the vet says shes healthy otherwise.

I'd hate to have to give Miralax daily forever. If she was in her teens, I wouldn't mind so much. But 7 years old seems way too young to keep her on it forever, and probably would create dependancy issues and stop working eventually if used for years on end, 3-5+ or more. So I can only keep my fingers crossed at this point.


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## laurief

Don't give up on the dairy yet. Buy a small container of whipping cream and warm up a tbs or two in the microwave for a few seconds. See if she'll go for it once the chill is taken off. Also, don't stand there watching to see if she'll drink it. Treat it like it's something she's not supposed to get into, and let her "steal" it. 

In the last few weeks with Billy, he ate very little on his own, so I tried to tempt him with milk just to get something into his system. He wouldn't drink it out of a small bowl that I offered to him directly, but he WOULD drink it out of my own cereal bowl as I sat on the couch eating breakfast. I suppose he figured if I was eating it, it must be worth stealing.

A little reverse psychology can sometimes work wonders on a picky eater.

Laurie


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## Kattt

So I tried some Cool Whipped Cream with her, warmed it up just a bit to take the chill off, and put it in a bowl that she see's me eat out of, since she always tries to get to it while I'm eating. And the little brat wouldn't touch it, go figure LOL. I'm going to try her a few more times with it since she didn't even attempt to try it, maybe if she eventually tastes it.. she'll like it. Is the Kraft cool whipped brand ok for her, if it has to turn into a daily dose thing to replace the Miralax?

I finally found a food that she'll eat the entire 3ozs, licks the bowl dry... meat and all - Wellness Healthy Indulgence. Down side, its the tuna flavor (of course). But its the only flavor she'll actually eat all of though. And given she eats it all, its been a huge help with making sure she absorbs all of her pumpkin and Miralax into her system. I also mix in 2-3 tsps of water, and its definitely helping. Shes been poo'ing every 1-2 days now, and today she actually went on the first try, with no straining. 

So I'm hoping now that she's almost fully transitioned to wet food, along with the extra water and pumpkin that I mix in, I can possibly ween her off of the Miralax soon. I don't want to rock the boat just yet though, since she's just barely starting to get back to normal. I may keep her on it for at least 3-4 weeks, so her brain is re-trained that she can go without it hurting, and then hopefully she won't require anything extra, aside from the pumpkin.


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## laurief

Kattt said:


> Is the Kraft cool whipped brand ok for her, if it has to turn into a daily dose thing to replace the Miralax?


LOL! No, no, no, Cool Whip is NOT whipping cream. In fact, I'm not sure Cool Whip even has any dairy in it. Do NOT give Cool Whip to your girl. Buy real whipping cream (or half & half, or even just whole milk). You'll find it in the dairy section with the milk and half & half. You're not looking for cream that's already been whipped. You're looking for real cream in its natural, liquid form.

Here's the thing about dairy. Nursing kittens have an enzyme called lactase that can metabolise the lactose in milk so that it is digestible, but this lactase enzyme decreases in a mature feline if the cat stops drinking milk. If enough milk is consumed by and adult cat to exceed the capacity of the lactase present, the milk acts like an osmotic laxative, similar in action to Miralax. The only thing I'm not sure about is whether the adult cat might start manufacturing more lactase enzyme again if she starts drinking dairy regularly.



> I finally found a food that she'll eat the entire 3ozs, licks the bowl dry... meat and all - Wellness Healthy Indulgence. Down side, its the tuna flavor (of course).


Hopefully it'll help her palate eventually enjoy other canned foods, as well.



> Shes been poo'ing every 1-2 days now, and today she actually went on the first try, with no straining.


That's terrific. She must be feeling much better these days. 



> So I'm hoping now that she's almost fully transitioned to wet food, along with the extra water and pumpkin that I mix in, I can possibly ween her off of the Miralax soon. I don't want to rock the boat just yet though, since she's just barely starting to get back to normal.


Sounds like a good plan to me. I hope she continues to do well and can keep things moving smoothly without Miralax once you wean her off of it. But now you'll know what to do for her if she should start to bind up again. I'm so glad she's over the hump.

Laurie


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## Kattt

Shows how much I know about whats good, and whats not for cats. Good thing she didn't eat it LOL!

Well, hopefully I won't need it. I'll go with my plan of weaning her off the Miralax in a couple of weeks, and see how that goes first. If she still needs something extra afterwards, I'll try some whipping cream. 

And yes, definitely glad I know I have the Miralax on hand that works for when she does get bound up again. Saves on expensive vet bills. I'm hoping the healthy diet and additional water intake will get her back on track again.

Shes actually poo'ing in the litterbox again too. Which she hasn't done in YEARS. She's always pee'd in the litterbox, and poo'd on the floor. I got rid of all carpets and had hardwood floors installed because of her. Friends would always tell me they'd get rid of that cat. No way! She's my baby.. my cats are like my kids. No matter what her issues, I could never give my cats away. I know alot of people that get rid of pets for going on the floor though, its sad. I tell her all the time she's lucky she ended up with me, no one else would put up with her poo'ing habits and bad attitude on top of it LOL 

So I'm guessing these issues have been going on for way longer than I actually realized, which was causing her to go on the floor. But the vet always gave her a clean bill of health, and said there was no medical reason for it aside from her being a high anxiety cat.


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## laurief

Kattt said:


> And yes, definitely glad I know I have the Miralax on hand that works for when she does get bound up again.


If she does get bound up again, remember that Miralax will not soften constipated stool already formed in her system. It will only soften newly forming stool. So if she does become badly constipated again, she still may require manual extraction or enema to get her cleaned out before the Miralax can do its job of prevention.



> Shes actually poo'ing in the litterbox again too.


Amazing how we, and sometimes even vets, make mis-assumptions about the causes of some behaviors. I think you're right; I think she's probably had constipation problems for a long time.



> I know alot of people that get rid of pets for going on the floor though, its sad.


Sad, indeed, and disgraceful how disposable animals are when they don't fit perfectly into a selfish human's lifestyle. I agree completely with you about the animals being my family. I would never dream of tossing one out of the family just because they didn't follow my human rules.

Laurie


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## Kattt

So I haven't updated here in a few.

She is poo'ing every 2 days now. I know they say cats should go daily, but she has never gone daily.. its always been every 2 days. So I'm not sure if I should consider that normal or not, since its been HER norm. But she is using the litterbox now, which has not been normal for her for years. So the fact that shes using the litterbox again, I can only hope thats a sign that shes feeling better about having a bowel movement.

But my 2 main concerns are, even though she's going every 2 days, it still sometimes seems a bit on the dry side. Its not small, or round like it was when she was fully constipated... its usually normal size, but looks a bit dry. But its not always dry. Sometimes it looks normal, while other times dry. So maybe I'm just paranoid at this point after everything, and that’s not anything to worry about. But what does bother me.. is she also seems to get worrisome when she has to go. Like I can usually tell when she has to have a bowel movement by the way shes laying (on her belly with all 4 paws tucked under her) and by the look on her face. Then once she goes, shes all relaxed again. Then rinse, repeat in 2 days. Maybe its her stress causing this? I've read that stress can cause constipation issues. I have no idea. I tried a Feliway plug-in, but that did absolutley nothing to relieve her anxiety. I'm more concerned by the fact that she feels the need to worry when she has to poo, but I don't know how to change that. 

I'm still giving her pumpkin - 1 tsp daily. I split the tsp up into 2 meals - half mixed in her morning meal, and half in her evening meal. I'm also still giving her 1/8 tsp of Miralax each morning. I feed her wet food 3 times a day (Because she's still only eating about 1-1.5ozs per sitting), and I mix 3 tsps of water into each feeding, to give her extra water intake. 

She definitely gets the full amount of Miralax into her system, because I mix that separately into a tiny bit of gravy, and give her that first to ensure she gets it all into her system.. once she licks it up, I give her the rest of her food which has the pumpkin and water in it. She never eats all of her food, she does however lick it until its dry though. I have noticed she drinks way less out of her water bowl now, since I started putting water in her food. I have read on this forum that its normal that they drink less water when they're on wet food though. 

So any suggestions on what I can change to make her stool less dry? And make her feel less stressed when she has to go? I know the pumpkin is supposed to bulk up her stool, but do you think because shes not eating all of her food, and possibly not getting all of her pumpkin, that could cause it to be dry? (I'm not sure what pumpkin does texture wise to the stool, aside from bulk it up). This morning I gave her the pumpkin in the lil bit of gravy that I mix the Miralax in, so I know she got both the full dosage of pumpkin and Miralax today. So I guess I will continue trying that as well. And maybe I should be adding more water than 3 tsps? I'm going to give the vet another call Monday too, and update her and see what she thinks as well. Given she checked out health wise, I can only think this is all somehow stress related.


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## laurief

Kattt said:


> She is poo'ing every 2 days now ... So the fact that shes using the litterbox again, I can only hope thats a sign that shes feeling better about having a bowel movement.


I wouldn't worry about the every 2 day thing as long as her stool size and consistency are good.



> it still sometimes seems a bit on the dry side. Its not small, or round like it was when she was fully constipated... its usually normal size, but looks a bit dry.


This is a little concerning. Dry stool means that there's not enough water in her gut to soften the stool, so it'd be a good idea to increase the amount of water that you mix into her canned food meals. If that's not enough to consistently moisten her stool, increase the Miralax to a heaping 1/8 tsp once a day.



> she also seems to get worrisome when she has to go.


Maybe that's because the dry stool is still uncomfortable for her to pass. Hopefully when her stool is consistenty moist, her worry will dissipate.



> I have noticed she drinks way less out of her water bowl now, since I started putting water in her food. I have read on this forum that its normal that they drink less water when they're on wet food though.


Water is water. It doesn't matter whether it enters her body through food or through drink. 



> I know the pumpkin is supposed to bulk up her stool, but do you think because shes not eating all of her food, and possibly not getting all of her pumpkin, that could cause it to be dry?


No, I don't think that's an issue with stool dryness. You just need to get more water into her.

Given she checked out health wise, I can only think this is all somehow stress related.[/quote]

You may be right about that. I'm just not sure. Have you tried Rescue Remedy? I've also read that Feliway spray sometimes works even if the plug-in doesn't, because the spray can be applied to her coat so that it stays with her no matter how far away she is from the plug-in.

Laurie


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## Kattt

So.. back from another stressful vet visit, with yet another enema... well, 2 enemas actually. She wouldn't poo from the first one, so they gave a second one. She still refused to go, until I got her home. She really is a pro at holding her stool in. 

While she was passing stool every 2 days, she was straining LOTS to get it out.. and she didn't go at all today, which was day 2. I thought her fur felt fine this morning, but as the day went on.. it started looking a bit off which made me suspect dehydration. So my gut told me it was time for another vet visit, and I took her in right away. And I'm glad I went with my gut instincts. She had quite a bit of stool backed up in her again, more so then last time.. and she was slightly dehydrated.

They said she still shows no signs of megacolon, and can't give me an answer as to why she's getting constipated. But said it was time for stronger treatment given the circumstances, to hopefully prevent this issue from happening again. 

Here's the part you won't like.. they put her on Lactulose, mixed with Cisapride. YES, I do know that Cisapride was pulled from the US market for humans, and of course that raised serious concerns that I questioned. The vet claims that it has been deemed safe for cats, and used safely and effectively for years to treat constipated cats, with never any side effects. She assured me that its safe for her, and that its the best option for her right now. I have read throughout this forum that many others use it as well. 

While I'm not happy to know that it was pulled from human usage, I'm also desperate to fix this problem. So do I trust my vets judgement?! 

Oh, and because of the slight dehydration issue and the importance of water while on Lactulose, and me expressing that I'm finding it quite stressful to get 300 ML's of water into her daily (She was losing interest in all of the water I was giving her, no matter how creative I got), so she also gave me SubQ Fluids to administer every 2 days. 

This issue is crazy. Aside from unexplanable constipation, shes healthy, and even acts happy and healthy. She's never lethargic, all tests check out healthwise.. she eats normal, plays normal... so I don't get it, and the vet can't explain it either... and claims that sometimes they never figure out why cats get constipated. But says constipation is treatable and she can live a long, happy life once we find the right balance that works for her. I hope she's right. And I hope these new meds work. It's been quite stressful and frustrating for us both to say the least.


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## laurief

Kattt said:


> back from another stressful vet visit, with yet another enema.


It sounds like it would be a good idea to have your vet teach you how to administer an enema at home so as to keep your girl's stress to a minimum, should another enema become necessary.



> they put her on Lactulose, mixed with Cisapride. YES, I do know that Cisapride was pulled from the US market for humans, and of course that raised serious concerns that I questioned. The vet claims that it has been deemed safe for cats, and used safely and effectively for years to treat constipated cats, with never any side effects.


I have no problem with the vet switching her from Miralax to Lactulose, because Lactulose may just work better for her, and it may have some effect on improving gut motility as well as retaining fluid in the stool. I DO, however, have a problem with any vet who uses the word "never" relative to medication side effects - esp. a med with as serious side effects as cisapride has had in human patients. It's also well documented that cisapride can cause diarrhea and stomach cramping in some cats. So do keep a close eye out for these side effects that "never" happen.



> do I trust my vets judgement?!


Listen to your vet's advice, ask your vet all necessary questions, do your own research, and then trust your own judgement.



> she also gave me SubQ Fluids to administer every 2 days.


How much fluid did she prescribe at each admin? If your girl really requires subQ fluids, it would be preferable to give them daily to maintain a more even hydration level in her body. Otherwise her body will constantly cycle between dehydration and rehydration , since fluid is not retained in the body for 48 hrs. after an admin. If your vet recommended 100 ml every other day, for instance, your cat would reap greater benefit from 50 ml daily.

If you want advice on administering subQs and on obtaining subQ supplies inexpensively, let me know.

BTW, have you started her on methylcobalamin and folic acid yet? If not, you should do so, in addition to B-Complex. The B vits are quickly washed out of the system in urine, and subQ fluids produce lots of extra urine.

Laurie


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## Kattt

Thanks Laurie.

I definitely plan on asking them to teach me how to give her enemas, and to provide me with some enemas to have on hand if this happens again. The vet visits are way too stressful on her, as with any cat. So anything I can do for her at home, I will do it.

I did spend lots of time researching Cisapride for hours last night in both humans and cats, along with some packet information my vet gave me as well. And from what I read, I felt safe attempting it with Pepper. Supposedly alot of the side effects in humans were due to it having adverse effects when mixed with other medications, and the FDA felt it was too risky due to humans often seeing multiple doctors and being on multiple medications that can interfere with Cisapride. And as my vet said, given she's only visiting one vet.. and we know she's on no other medications, those particular risks aren't there. I did read as you stated though, that it can cause cramping and diarrhea. Which my vet did advise me of that as well, and said to monitor her closely.. and contact her immediately if I notice signs, and we can scale back on her dosage, or seek alternative options. Although I'm not sure how to tell if a cat has cramping, given cats often hide their pain. But I'd imagine she'd probably hunch over, or at the very least show signs of discomfort.

She's had 2 doses so far (One last night, and one this morning). And so far she seems fine, she doesn't appear to have any cramping or anything and she appears happy and relieved. And she did again poo this morning on the first try, with no straining, about 8 hours after her first dosage. The stool was solid and normal size.. on the soft side, but not diarrhea. I'm not sure if that was the medication working, or she was still poo'ing out stool leftover from her enemas last night. So the jury is still out on if this medication works or not. Got my fingers crossed.

The vet prescribed 150 ML of SubQ fluids every 2 days. And I'm still mixing water into her wet food as well. The vet said she was only borderline dehydrated, so the fluids should give her the little boost she needs. So I should split her SubQ fluids up into 75 ML's daily then? And yes, if you have advice in this area.. please share. I haven't given her any yet, and it makes me nervous with her. I've given them to my male cat before, but Pepper.. she's a different story. She's extremely skittish, doesn't like to be held or touched, and she will bite, scratch and hiss. Aside from allowing me to pet her for a moment or 2 here and there, she gets very angry when attempting to mess with her. Plus she doesn't have alot of loose skin like he did, her skin seems tighter and hard to pull up alot of skin on her to stick the needle in. So administering tips will be greatly appreciated. I'm sure after I do it a couple of times, it'll be fine. Just need to get her (and me) into a routine. The vet said the medications/fluids may or may not be a temporary thing. She said right now, with no signs of megacolon.. she has hope that its only temporary, but no guarantees, because some cats contiuously need help staying regulated. So time will tell.

With everything going on, I forgot to ask my vet about the methylcobalamin and folic acid, I'll have to give her a call and ask her. I don't want to add in anything extra while on Cisapride, without the vets ok. The vets office did call this morning just to check up on her, which I was surprised. Vet offices rarely do that. At least none of the vets I've ever gone to anyways... never seemed to care what happened once I left. I just started going to this vet a month ago, when these constipation issues started. So hopefully this vets a keeper. Hard to find good ones that you can trust.


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## GeorgesMom

I have only scanned the posts so far, but given your frequent reference to her being easily stressed and exhibiting anxiety, have you or your vet ever considered that as a possible cause for the constipation? Perhaps treating her high levels of stress and anxiety would resolve the constipation issue. I'm not a big fan of putting kitties (or people) on psych drugs as a matter of course, but as you said she has lived with you in the same house since she was a kitten, and still has high levels of fear, stress and anxiety, I wonder if it might not be called for in this case.

For most cats I would not recommend this, but having lived with Gabie, my Meezer who was stressed about *everything* his whole life (it took him a year to get over moving from our apartment to a house), I know that some cats just have mental issues. Some physical problems have both a physical and mental aspect.

Edited to add: Oh and I forgot to mention, it is fairly common for people to report their pets are relaxed and calmer after a change in diet to a higher quality food that has less additives, so part of the improvement after her change in diet might be related to that too.


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## laurief

Kattt said:


> I definitely plan on asking them to teach me how to give her enemas, and to provide me with some enemas to have on hand if this happens again.


You can buy pet enemas through many online sources, including amazon.com. They don't require a perscription.



> I did spend lots of time researching Cisapride for hours last night in both humans and cats, along with some packet information my vet gave me as well. And from what I read, I felt safe attempting it with Pepper.


In your place, I would have considered using cisapride, also, though I would have exhausted all other options first (Lactulose, methylcobalamin & folic acid, Zantac 75, etc.).



> I did read as you stated though, that it can cause cramping and diarrhea. Which my vet did advise me of,


Ah, I feel better knowing that your vet didn't really claim that there were "never" any side effects. That comment in your earlier post made me quite suspect of your vet's competency and/or honesty.



> I'm not sure how to tell if a cat has cramping, given cats often hide their pain. But I'd imagine she'd probably hunch over, or at the very least show signs of discomfort.


That depends on the cat. When Tommy was constipated and had an enema a few weeks ago, she growled and hissed in pain just before passing the hard stool. I suspect that was her response to abdominal cramping.



> She's had 2 doses so far (One last night, and one this morning). And so far she seems fine, she doesn't appear to have any cramping or anything and she appears happy and relieved. And she did again poo this morning on the first try, with no straining, about 8 hours after her first dosage. The stool was solid and normal size.. on the soft side, but not diarrhea.


That all sounds very encouraging. I'm not sure if that's a result of the cisapride working already, either, but it's all good news no matter what's causing it.



> The vet prescribed 150 ML of SubQ fluids every 2 days. ... So I should split her SubQ fluids up into 75 ML's daily then?


75 ml daily is what I'd admin if she was one of my own cats.



> if you have advice in this area.. please share. I haven't given her any yet, and it makes me nervous with her. I've given them to my male cat before, but Pepper.. she's a different story. She's extremely skittish, doesn't like to be held or touched, and she will bite, scratch and hiss.


My first CRF cat, Pea, had much the same personality. To my amazement, she accepted subQ admins with little fuss once she realized how much better they made her feel. Billy, too, had to be handled carefully because he had an extremely short fuse and violent temper when riled.

With both of those cats, I found that the less restraint I used, the smoother the procedure went for all concerned. With Pea, I sat in the bathtub with her between my legs. That worked will with her because she was too old and feeble to jump out of the tub on her own, so the tub itself was the only restraint I needed.

Billy was a different matter. He was more than capable of fighting me off if he wanted to, so I had to stage a different setting for him. I placed a couple of diningroom chairs next to each other starting in one corner and extending down one of the diningroom walls toward a large window. I would sit on the corner chair with my legs extended across both chairs toward the window. Then I'd place Billy on the chair closest to the window, between my leg and the back of the chair. So without my having to actually hold him, the chair back, wall, and my body were blocking all of his exits except the front, and I held my hand casually in front of him, when necessary, to block that exit, too.

Billy also didn't appreciate being petted, cooed to, or any of those other "annoying" comforting techniques we humans like to employ. He did best when I kept my mouth shut and my hands as quiet and passive as possible until the admin was finished. In short, Billy was a "shut up and get it over with" type.



> Plus she doesn't have alot of loose skin like he did, her skin seems tighter and hard to pull up alot of skin on her to stick the needle in.


That's probably because she's pretty well hydrated to begin with. Also, they can make it a lot harder to tent the skin if they tense up their muscles, so try to keep all of this as low key and matter-of-fact as possible. Actually, I find it a lot easier to admin fluids to a cat with greater skin elasticity. Billy's skin was so loose that it was difficult to not push the needle all the way through the skin tent and squirt fluid out the other side all over my leg or chair.



> So administering tips will be greatly appreciated.


1) warm the fluids (I'll provide more details if you need them)
2) use the right needles (Terumo 20 ga UTW are the best, IMO)
3) don't admin more than 100 ml in the same spot during the same admin or the fluid pocket can become uncomfortably large
4) don't use the same needle more than once (they dull substantially after the first insertion). If the needle slips out during admin, have fresh needles within reach to swap and continue the admin.
5) maintain an air of relaxed confidence. If you tense up and expect resistance, she'll give it to you.
6) give fluids fairly early in the morning so that your girl learns that after fluids, she gets to be pretty much left alone and relax for the rest of the day. 



> I forgot to ask my vet about the methylcobalamin and folic acid, I'll have to give her a call and ask her. I don't want to add in anything extra while on Cisapride, without the vets ok.


I'm sure your vet won't have a problem with them. They are just water-soluble B vits, after all - same as she gets in her food every day.



> The vets office did call this morning just to check up on her


That's one sign of a good vet.

Laurie


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## Kattt

Laurie, thanks so much for the tips.. You've been great.

She poo'd again with ease this morning, so I think its safe to assume at this point, that the meds are working. That’s 2 mornings in a row that she's had a bowel movement with ease. But 2 days is too soon to get excited, so I'm keeping my fingers crossed that it will continue to work.

Sorry about the confusion on the side effects. I just meant she said that I shouldn't worry about the side effects humans had resulting in it being pulled off the market. She did say with any medicine, all cats (and humans) bodies react differently, so advised to always monitor her very closely for behavior changes, eating/drinking changes and bathroom habits while on meds, to make sure her body is taking it well.

I haven't given her any subQ fluids yet. She still seems well hydrated. The vet told me to play it by ear and administer only if I felt it was necessary, since we'd prefer that she drink on her own rather than requiring fluids. She's been eating and drinking as normal, and her skin/gums show no signs of dehydration, so I think its safe to hold off and see how the week plays out as she starts feeling better. I'll keep monitoring her closely to make sure she doesn't dehydrate.

I'm thinking about switching her from Evo dry cat food, to Wellness Core, because it has folic acid in it. I know dry isn't good for her, but she won't eat no where near enough wet food for that to be her sole diet yet. The vet visit seems to have set our progress with the wet food back a bit. Probably because I mix the Lactulose/Cisapride in twice a day, and she hates the taste. The vet did say she could have the meds compounded out into a powder, but I don't really think that would change the taste of it, so not sure what the point would be?! Plus I think her butt is sore from 2 enemas, and she's still stressed/angry from the vet visit.. so she's not quite feeling her fiesty self yet, which means she's not really into the multiple small wet feedings I was making progress with before. But obviously its important that she eat, because we certainly don't need more issues on top of this problem.. so dry it is for now, until we can make more progress with wet. So I'm trying to figure out which healthy dry brand would be best for her needs right now, until we can start making progress on wet again. 

I'm also considering trying some raw chicken. Both cats seem to go crazy when I'm eating chicken, and I've given them tiny pieces of cooked chicken from time to time, in which they ate it (My female enjoyed it more than my male, of course.. hes so picky!). I'd have to mix it in some chicken broth or something though, so I can continue mixing in her meds. I know nothing about feeding raw though, as far as whats safe/how to prepare it, and how much to give. So I'll have to research that rawfedcats.org site.


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## laurief

Sorry! I somehow overlooked your most recent addition to this thread.



Kattt said:


> She poo'd again with ease this morning, so I think its safe to assume at this point, that the meds are working. That’s 2 mornings in a row that she's had a bowel movement with ease.


That's terrific. I hope it keeps working for her or that her system normalizes so that she no longer needs it. I gave propulsid to one of my CRF cats for a couple of days when it became apparent that he was having a problem with gut motility. After just a couple of doses, his system started to function normally again, and I was able to discontinue the drug.



> Sorry about the confusion on the side effects. I just meant she said that I shouldn't worry about the side effects humans had resulting in it being pulled off the market. She did say with any medicine, all cats (and humans) bodies react differently, so advised to always monitor her very closely for behavior changes, eating/drinking changes and bathroom habits while on meds, to make sure her body is taking it well.


I'm glad to know that your vet is being straightforward about the potential side effects, because there are waaaaay too many vets out there who don't provide full disclosure to their clients about the meds they prescribe. It's an inexcusable and dangerous oversight of the profession, as far as I'm concerned.



> I'm thinking about switching her from Evo dry cat food, to Wellness Core, because it has folic acid in it.


You don't need extra folic acid unless you're also supplementing methylcobalamin, and methylcobalamin is the B vit that may help with constipation. Besides, all cat foods contain folic acid.



> The vet visit seems to have set our progress with the wet food back a bit. Probably because I mix the Lactulose/Cisapride in twice a day, and she hates the taste. The vet did say she could have the meds compounded out into a powder, but I don't really think that would change the taste of it, so not sure what the point would be?


First of all, stop mixing them into her food if that's making her reject her canned food. Second, it may be the stickiness of the Lactulose that's making her reject it, so getting it in powder form may make it a lot more palatable to her. Your vet doesn't have to have it compounded, though. It's already available commercially in powder form, and you can order a sample with a veterinary prescription here - http://www.kristalose.com/. Third, you may not need the Lactulose at all now that you're giving cisapride, or you may be able to use Miralax instead of Lactulose if she still needs an osmotic laxative in addition to the cisapride. At any rate, you need to stop mixing meds into her food. Instead, mix them into a little of the food gravy and syringe that directly into her mouth immediately AFTER she's eaten her unmedicated food. Don't give it right before the meal, or the medicinal taste in her mouth may still make her reject the unmedicated food.

Alternatively, cisapride can be compounded into flavored chews that she may eat readily. That's how I gave Billy and Tommy their thyroid med. I had it compounded into liver flavored chews that they ate up like candy. I ordered mine from here:

http://www.bcpvetpharm.com/products_vetchews.htm

If you scroll down to the bottom of that page, you'll see that your vet can contact them for free samples of several of their medicated chews, including a chicken-flavored cisapride chew. Your vet can also request free samples of unmedicated chews in all of their different available flavors. Ask your vet to get those free samples so that you can try them with your girl. Don't be discouraged if she doesn't like the chicken-flavored cisapride chew. BCP told me that liver is their most popular flavor, and my cats certainly love it. BCP can also compound many meds into tasteless capsules, transdermal gels, and flavored liquids. In other words, you've got a lot of options other than mixing disagreeable meds into her food so that she won't eat what's best for her to eat.



> I'm also considering trying some raw chicken. I know nothing about feeding raw though, as far as whats safe/how to prepare it, and how much to give. So I'll have to research that rawfedcats.org site.


You know we have a raw feeding forum right here, don't you? You should spend some time going through that forum, as well. I feed raw to most of my cats, so I'm all for you trying it with your cats.

Laurie


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## Kattt

Thanks again for all of the useful info. 

4 days into the meds, and still poo'ing daily. So far, so good. The vets been great, and very informative and helpful throughout all of this. I had already discussed the possibility of lowering the dosage and/or stop using the Lactulose (They're mixed into one bottle as of right now), because I'd prefer her to not be dependent on these meds at the age of 7. The vet said given how long her issues had gone on, she'd like to keep her on both meds for a full month for now, to give her digestive tract and colon a rest and time to heal, and to give Pepper a relaxing break overall, since she had such a rough month... and time to retrain her brain that its ok to have a bowel movement without worrying now. And then we'll attempt to wean her off both meds slowly, and see how she does without them. She said she kept her on the very low end of the dosage chart with these meds, so it’s a very good sign that they're working. And said she'd like to do bloodwork and a full exam in a month to make sure she doesn't develop hypercalcemia or any other related symptoms, and continue with bloodwork every 4-6 months afterwards to be safe. 

I so wish I could find a house-calls vet to come do the bloodwork/annual shots, so I didn't have to put her through the stress of office visits with her high anxiety, but sadly.. not a single one in my area, at least not that I could find. Theres some 15 minutes from me in a bordering state, with no license in my state though. Sucks! 

I had discussed getting powder/tasteless forms of the meds with my vet yesterday, and she said she'd be more than happy to write me a prescription and give me suggestions on where to buy them. But now that she's feeling better and settled down from the vet visit, she's been taking her meds like a champ in a little bit of gravy again. After she licks that up, I give her the regular food without the meds, and we're having no issues at all getting the meds into her again for now. I'm actually surprised she licks it up with the meds in it, but she does.. so I don't question it. So I told the vet I'll leave things as is for now, and contact her again if progress changes with the liquid. I'll keep those sites you gave bookmarked, just incase I need them. 

Now that she's back to herself again, we're also back on track with the wet food.. and she's eating the same amount as she was prior to the vet visit. So things are finally improving and starting to get back to normal.

I have been looking through the raw food diet section of the forum, and reading websites on raw diets as well. I don't want to rock the boat with her digestive tract right now, changing up her food on top of new meds while things are going so well. But I definitely want to try both of my cats on some raw meats in the very near future, and see how they do if I slowly introduce them to raw meats. I think they would probably both enjoy raw meats more than the canned gooey stuff. But we shall see, these 2 are so picky... hard to tell what they'll do.

Today has been an especially great day. She's back in full swing to her usual fiesty, chatty self. Makes me happy to see her feeling better after the stressful month we've both had.


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## laurief

Kattt said:


> 4 days into the meds, and still poo'ing daily. ... The vet said given how long her issues had gone on, she'd like to keep her on both meds for a full month for now, to give her digestive tract and colon a rest and time to heal, and to give Pepper a relaxing break overall


That sounds like a reasonable strategy to me, and I'm so glad that the meds are working well for her so far. 



> I so wish I could find a house-calls vet to come do the bloodwork


Been there, done that, not a great idea. It's fine for a routine physical and vaccinations, but bloodwork should be performed in the clinic so that blood is handled properly and processed quickly. It's too easy for blood to clot, warm, or hemolyze in a mobile vet truck - all of which are going to skew or invalidate test results.



> I had discussed getting powder/tasteless forms of the meds with my vet yesterday, and she said she'd be more than happy to write me a prescription and give me suggestions on where to buy them. But now that she's feeling better and settled down from the vet visit, she's been taking her meds like a champ in a little bit of gravy again. After she licks that up, I give her the regular food without the meds, and we're having no issues at all getting the meds into her again for now.


That's terrific. I hope the easy admin keeps up.



> Now that she's back to herself again, we're also back on track with the wet food.. and she's eating the same amount as she was prior to the vet visit. So things are finally improving and starting to get back to normal.


That's terrific, too!



> I have been looking through the raw food diet section of the forum, and reading websites on raw diets as well. I don't want to rock the boat with her digestive tract right now, changing up her food on top of new meds while things are going so well.


I'm inclined to agree with you. That girl's been in enough rocky boats lately. Time to sail the smooth seas for a while before venturing into white water again.



> But I definitely want to try both of my cats on some raw meats in the very near future, and see how they do if I slowly introduce them to raw meats. I think they would probably both enjoy raw meats more than the canned gooey stuff. But we shall see, these 2 are so picky... hard to tell what they'll do.


The raw meat introduction can certainly be an adventure. Some of my cats took to it easily, while others were convinced I was trying to poison them. Persistence paid off, but the transition was not without its frustrating and maddening periods.



> Today has been an especially great day. She's back in full swing to her usual fiesty, chatty self. Makes me happy to see her feeling better after the stressful month we've both had.


[/quote]

I'm so glad for you both. Maybe she just knew it was her brother's turn to give you fits. Cats, gotta love 'em.

Laurie


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## Kattt

So I figured I'd get back to Pepper's own thread today.

She looked so uncomfortable last night, I felt terrible. But finally after much straining as stated in the previous thread, she passed a very large stool last night. This morning we had some more straining going on, and she passed a very small piece. Once she got that out, she had a normal bowel movement, long semi-soft piece, that wasn't huge, so she passed it very easily. So thank god, no enema today. I cancelled the mobile vet visit for now, and told him I would contact him again if need be.

I'm fairly confident that the meds shes taking do work for her, given once she got past her constipation episode, this mornings stool was the same texture consistency as its been the past week on the meds.

So at this point, I think theres 3 possible causes that she had a relapse. One, I may not be getting all of the meds into her. When she was on Miralax, I could easily put it in a tiny bit of gravy, and she licked it all up. With the Lactulose and Cisapride, she won't drink it unless I put it in a full bowl of food with water/gravy. She usually licks up all the gravy/meds, but doesn't eat the meat, and occasionally leaves a tiny bit of the gravy. So its very possible the meat is absorbing some of her meds, and shes not getting it all. I've tried syringing it into her mouth as well, but with 2ML, its extremely difficult, given shes a biter... and on top of that, she spits it out. My vet won't be in until 1pm, but at that point.. I'm going to get the prescription for Kristalose powder. I called the compounding company you suggested, and they don't do Cisapride in powder from, they only do pill or treat form. And have a transdermal option, where I can put it on her ear, but said that’s not as effective as giving it orally. I'm not sure if she'll eat the treats, given she can taste the meds in them. But I might give it a shot. I'd prefer a tasteless powder though, because as finicky as she is, she may get sick of the treats. Do you know of any other compounding companies? Theres a million when I google, but hard to know who to trust.

Second possibility, is that the stress of Cody coming home caused it. He was using her litterbox, and given she hates him, it probably stressed her out that he was invading her space, causing her to relapse. And the last possibility, is not enough water intake. It could very well have been a combo of the 3 reasons, I really don't know. I can only pray that the fact that she passed softer stool this morning, means we're over the hump and the meds are working again. This is all so extremely frustrating.


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## laurief

Kattt said:


> This morning we had some more straining going on, and she passed a very small piece. Once she got that out, she had a normal bowel movement, long semi-soft piece, that wasn't huge, so she passed it very easily. So thank god, no enema today.


That's great news. Glad she managed to get back on track without another enema.



> I'm going to get the prescription for Kristalose powder.


I think that'll be a lot easier to administer, and by giving it separately from the cisapride, you'll be able to adjust the dose, if necessary. I suspect Kristalose isn't tasteless the way Miralax is, though. I expect Kristalose will look and taste like granulated sugar. I may be wrong about that. You could call the manufacturer and ask.



> I called the compounding company you suggested, and they don't do Cisapride in powder from, they only do pill or treat form. And have a transdermal option, where I can put it on her ear, but said that’s not as effective as giving it orally.


As I suggested before, ask your vet to call BCP and request free samples of their medicated chews. That way you can try the chicken flavored cisapride chew on Pepper and see if she'll eat it on her own. What I have found with the medicated chews is that even if the cat won't eat it willingly, she's a lot more willing to swallow it when you stick it down her throat.



> I'm not sure if she'll eat the treats, given she can taste the meds in them. But I might give it a shot.


Even if she doesn't like the chicken flavored med-chew, she might like the stronger liver flavored one. It can successfully mask some pretty nasty tasting meds.



> I'd prefer a tasteless powder though, because as finicky as she is, she may get sick of the treats.


The compounders can't make a bitter med tasteless. All they can do is put it into something with enouigh taste to hopefully mask the bitterness enough to make it palatable.



> Do you know of any other compounding companies?


 The only other one I know of is VPA - http://www.vetrxrx.com/member-login.php - but their chews aren't as palatable for my cats as the ones made by BCP. Your vet can order free unmedicated chew samples from VPA, too, but since their freebies aren't medicated like BCP's, you won't know whether Pepper will eat their cisapride chews until you order the prescription.



> It could very well have been a combo of the 3 reasons,


That would be my guess.

Laurie


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## Kattt

I spoke with the vet. Shes calling in the prescriptions now. I can pick up the Kristalose at my local pharmacy, and the Cisapride will be over nighted via mail. According to the Kristalose website, it supposedly dissolves in water and is virtually tasteless, at least that’s what they claim. I guess I'll find out. For the Cisapride, the vet recommended Dr Fosters and Smith. Because unfortunately, BCP didn't offer the powder capsules that can be broken open into powder form, and no way I can get a pill down this fiesty cat. BCP only offered gel pills, treats and transdermal forms. But Dr Foster and Smith offers Cisapride in capsules, that I can break open and pour the powder out. She said its not tasteless, but not as bitter and overwhelming as the liquid taste of it. So she's going to order a small sample of both the capsules, as well as the liver and chicken flavored treats, to see which Pepper favors. Once I know which she'll take, then she'll have a full prescription filled. She said as a last resort, we can try the transdermal gel that I would rub into her ears. I'm hoping she'll like the treats, because that would ideally be alot easier. 

She also said to go ahead and administer the fluids as well, but only wants me to give her 150 ML every 3 days instead of every 2 days, since she did have soft stool this morning after the constipation. She said hopefully every 3 days, will be enough to keep her from forming the large, hard stool again, and hopefully a small enough amount to keep her drinking water on her own as well. So per your suggestion, I should probably just give her 50 mil per day then, vs doing it all at once preventing her body from fluctuating between hydrated and dehydrated.

I'm going to need some anxiety meds of my own after this month LOL


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## laurief

Kattt said:


> I should probably just give her 50 mil per day then, vs doing it all at once preventing her body from fluctuating between hydrated and dehydrated.


That's what I'd do. Maintaining more even hydration will help the Lactulose work more effectively, keep Pepper drinking on her own more consistently, and be more comfortable for her during admins (150 ml given at one time can be very uncomfortable for some cats).

I strongly recommend you purchase a box of 20 ga UTW Terumo needles for the fluid admins. They are sharper, thinner, and therefore MUCH more comfortable for Pepper than the standard 18 ga Monoject "kitty harpoons" that vets typically use. You can order Terumos without a prescription here:

http://www.thrivingpets.com/index.php/t ... edles.html

You can order admin sets through the same site, but you need a prescription for them. You can also order admin sets without a prescription through http://www.kvvet.com.

You can usually buy fluids MUCH cheaper by the case with a veterinary prescription. At my local Target store pharmacy, I can buy a case of 12, 1000 ml Lactated Ringer's for $25. You should call around to all of your pharmacy chains and see which one can give you the best price on a case of whatever fluids you're using.

Laurie


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## Kattt

I ordered the smaller needles, so I'll be good to go with those. 

How long is the fluids bag good for once you open it and start using it? I'm not sure if they go bad after a certain period, or can only have so many safe dosages administered from it once opened. I meant to ask my vet that, but forgot. If this turns into a long term thing, I'll shop around to buy fluids for sure.

The Kristalose is quite pricey. It was $92 just for one box at Walgreens. I should have checked Walmart, maybe its cheaper there. I'll be shopping around online for price quotes if I have to buy more. Not sure how long that box will last, but I hope a long time for that price. If she takes it easier, I don't mind paying the extra money to have less daily stress for us both though.

Do you have any experience or opinions on using transdermal gels for meds? Given Cody's high stress level right now with administering his meds, and the fact that he's picky and most likely won't eat Baytril treats, my vet and I discussed using Baytril Transdermal that I would just rub on his ears. Unfortunately by the time we thought of it, the compounding pharmacy was closed, so it has to wait until tomorrow. He wouldn't like me rubbing anything on him at this point, he runs everytime I go near him in fear I'm going to shoot something in his mouth. But it would beat having to squirt something that tastes nasty into his mouth. I think he would tolerate that much easier, and at least get the full dosage.. where as right now, he's spitting lots of it out. He only needs the baytril for 12 more days, but 12 days can seem like a year having to fight it down his throat twice daily.


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## laurief

Kattt said:


> How long is the fluids bag good for once you open it and start using it?


After you've spiked the bag with an IV set, it's good for 10 days, assuming you don't contaminate the fluids by leaving a used needle on the set after admin or do anything else to cause contamination of the remaining fluid. You should immediately discard any bag that is leaking or which contains cloudy fluid.



> If this turns into a long term thing, I'll shop around to buy fluids for sure.


Unopened bags of fluids can last pretty much indefinitely, from what I've been told, though they do all come marked with an expiration date.



> The Kristalose is quite pricey. It was $100 just for one box at Walgreens.


YIKES, YIKES, YIKES!!!! That would have made me immediately switch back to Miralax, esp. since you don't know if Lactulose is working any better for her than Miralax did. For all you know, her improvement could be exclusively the result of the cisapride.



> Do you have any experience or opinions on using transdermal gels for meds?


I have no personal experience with transdermals, but a lot of folks on the hyperT mailing list administer methimazole in transdermal form to avoid digestive upset. From what I understand from those folks, dosing isn't any different whether oral or transdermal (for methimazole, anyway). It's also apparently quite important to clean the residual gel out of the ears between doses to avoid skin irritation.



> Given Cody's high stress level right now with administering his meds, and the fact that he's picky and most likely won't eat Baytril treats


You know, you REALLY need to approach Cody with a more positive attitude. He is undoubtedly reading your anxiety and anticipation of his med rejection, and he's responding to it in kind. You need to chill and anticipate cooperation, instead. It may just help.



> He only needs the baytril for 12 more days, but 12 days can seem like a year having to fight it down his throat twice daily.


There are other options, you know. Your vet could give him a long-acting antibiotic injection (Convenia) so that you wouldn't have to administer any antibiotic at home at all. Or your vet could prescribe a different antibiotic with a less disagreeable taste. Or you could learn to use a piller that would quickly place a pill in the back of his mouth so that you can pill him successfully. Or you could buy some Pill Pockets in both available flavors and see if he'll eat them without any pills placed in them. If he''ll eat them as treats, he may very well also eat them with pills inside. Or maybe he'll gobble down the Baytril chews, after all. Like I said - options.

Laurie


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## Kattt

10 days isn't very long. So I guess I better start shopping around for fluids now so I can have them ready. 

That’s very true about the Lactulose. I don't know if it’s that or the Cisapride that worked. I'm half scared to switch it at this point, especially after the relapse we had this past weekend. I'm yet to see what tomorrow brings, if she'll strain or be back to normal. Maybe if I can get her regulated, once this box runs out.. if she still requires it long term, I'll try the Miralax again. The Kristalose box contains 30 packets, which are 20 grams each. And shes supposed to get 3/4 teaspoons twice daily.

I'm keeping her stress levels as minimal as possible for now. I set up a "safe zone" for her in my closet, with a big box, and a kitty house inside (It's cute, it looks like a mini dog house.. but its soft and comfy for cats). And left the opposite end of the closet door open so she can get in and out when she wants. Because we're having heatwaves up to 105 degrees this week, and with that brings lots of thunderstorms.. which terrifies her. She normally hides under the bed, but I thought the closet with a cat bed might make her feel more safe and secure. She was sniffing it out earlier, so we'll see if she uses it when she's scared.

I agree, administering Cody's meds does stress me out.. because he fights me so hard. I try to play with him, and pet him first to keep things calm, and use the sneak approach.. but he always has one eye alert, and darts away from me the minute he sees me pull the meds out. Which is why I thought the transdermal gel might be easier. Because he allows me to pet him, and I can just pet him and rub it on. 

I was aware that they could give long-acting antibiotics for some things, but wasn't ware that they could for surgery, and it annoys me knowing that. Because I told them prior to his surgery, that he's impossible to administer meds to, and if they could give him a shot of antibiotics instead, to do that before I bring him home. The vet said she would note his chart. When I picked him up, it wasn't the normal hospital staffing.. it was the emergency vets/techs on call, and they said he had to have meds orally. God forbid there is a next time, but at least I'll know now.

How many pets do you have all together? I saw quite a few past and present that you have on your website. I just have the 2 cats. Anymore than those 2, and I probably seriously would need prozac or something LOL!


----------



## laurief

Kattt said:


> 10 days isn't very long. So I guess I better start shopping around for fluids now so I can have them ready.


Since you'll only be giving 450 ml every 10 days, it might be worth it to see if you can order a case of 500 ml bags rather than the standard 1000 ml bags. I think some types of fluids do come in 500 ml bags, though I'm sure they're a lot more costly per ml than the 1000 ml bags.



> That’s very true about the Lactulose. I don't know if it’s that or the Cisapride that worked. I'm half scared to switch it at this point, especially after the relapse we had this past weekend.


That's understandable. I was just stunned at the cost of Kristalose. I suppose that's because it's a new formulation of the med.



> I'm keeping her stress levels as minimal as possible for now. I set up a "safe zone" for her in my closet


That sounds like a wonderful hidey hole for her. I hope she adopts it.



> I agree, administering Cody's meds does stress me out.. because he fights me so hard. I try to play with him, and pet him first to keep things calm, and use the sneak approach.. but he always has one eye alert, and darts away from me the minute he sees me pull the meds out.


When I'm dealing with a cat who I know will be problematic (esp. when taking a temp), I just take the cat into a small bathroom with me and shut the door. That gives me an immediate advantage because the cat and I both know there is no escape. Then I try to get the business done as quickly, quietly, confidently, and efficiently as I can. It doesn't always work that way, of course, but that's what I aim for.

That said, I'm in real trouble when my ex-feral, Phantom, needs meds. Phantom's "inner feral" is still very much at work in his psyche. Although Phantom will often INSISTENTLY demand attention by walking, lying, and/or drooling all over me, those displays occur ONLY at his initiation. Even though he's been one of my kids since 2005, he still will only rarely allow me to approach him. If he has even the slightest suspicion that I might want to DO anything to him, forget it. I'm not getting within 10 feet of him. If I do somehow manage to corner and capture him, he's pretty easy to medicate, but it's actually getting my hands on him that can be darned near impossible.



> I was aware that they could give long-acting antibiotics for some things, but wasn't ware that they could for surgery,


Well, different antibiotics have different effectiveness against different bacteria. Baytril, for example, is particularly effective against bacterial infections of the urinary and gastrointestinal tracts, which is probably why they sent you home with that one for Cody.

I don't know against what types of bacteria Convenia is effective, but it would be worth asking your vet about.



> How many pets do you have all together?


Currently 3 dogs, 3 horses, and 17 cats. I was just sitting here thinking about the last time I actually "picked out" a feline to add to my family when I realized that I've only "chosen" one feline in my life, and she was my 13th birthday present from my father. Every other feline with whom I have shared my life has either strayed in, been dumped, or required rescue. I doubt if I'll ever have occasion to "pick out" another feline in my lifetime ... not when they just keep showing up.



> Anymore than those 2, and I probably seriously would need prozac or something LOL!


Tell me about it. If all of these beasties didn't rely on me for everything, I'd have checked myself into the psyche ward decades ago just for a little break. ;-)

Laurie


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## Kattt

I'll be administering her fluids for the first time this morning, once she settles into her morning nap. Over the past couple of weeks, I've been petting her lots in the scruff area, and even pulling her skin up to get her used to the feel of me messing with that area just incase it came to having to give her fluids, and she normally just lays there purring. So I don't think administering them will be a problem with her.

Sadly, I couldn't get her full dosage of meds into her yesterday. Tried in food, with no luck. Tried by syringe, got some down her.. but she spit lots of it out. So she'll most likely end up constipated again today. I had a bit more luck this morning. I picked up her dry food again last night, fed her wet mixed with kibble this morning, and she hate more than she normally does, but still not all of it, and I only gave her half a 3oz can, so still very small progress. But she did at least drink all the watery liquid out of it this time, so hopefully she absorbed all or most of the meds this morning. She's real chatty this morning too. I think she's yelling at me for "starving her" last night LOL.

I finally spotted her drinking out of her new water fountain this morning too. I've never had issues with Cody drinking water, but he absolutely LOVES his fountain too. I got them each their own. Cody dips his kibble into his fountain, then fishes it out and eats it. He used to do the same with his water bowl, which I still keep down for him as well.

I was stunned at the cost of Kristalose as well. Its not that much different from Miralax, so you would think the price would be fairly close range. I expected a bit more, since its prescription.. but did not expect that price. That was crazy.

And wow! You have your hands full with 23 pets. I'd be in the psyche ward for sure. Between vet visits, illnesses that creep up and administering meds, I have no idea how you do it. I feel exhausted just from 2 cats! The bigger part of your day and night must revolve around taking care of them. Mine does as of lately, with just the 2.


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## laurief

Kattt said:


> I'll be administering her fluids for the first time this morning, once she settles into her morning nap.


I can't wait to hear how it goes. Don't forget to warm the fluids for her. 



> Sadly, I couldn't get her full dosage of meds into her yesterday. Tried in food, with no luck. Tried by syringe, got some down her.. but she spit lots of it out.


Hopefully she'll enjoy the medicated chews when they show up. They make it soooo easy.



> She's real chatty this morning too. I think she's yelling at me for "starving her" last night LOL.


Gotta love a spoiled princess. ;-) Stick to your guns, and she'll get used to the new feeding schedule before you know it.



> I finally spotted her drinking out of her new water fountain this morning too.


That's good news.



> I was stunned at the cost of Kristalose as well. Its not that much different from Miralax, so you would think the price would be fairly close range.


It probably will be once its been on the market as long as Miralax and liquid Lactulose have, but it's a new drug form at the moment, so I suppose the manufacturer is trying to make back the cost off developing it.



> And wow! You have your hands full with 23 pets.


Ya think? LOL! Yes, the vast majority of my time is spent caring for this crew. I must say, though, that I have a little more time to breathe since Billy passed. My last few years have rotated very tightly around Billy's med and feeding schedules. Now I can at least leave the farm for a few hours without worrying about what I'm NOT doing for Billy.

Laurie


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## Kattt

The fluids went fairly well, once I finally got her to let me administer them. I was pretty calm and confident about it, because I watched a few youtube videos on it, and its fairly simple. It was her that had the anxiety.. everytime she saw me coming, she'd flip over on her back and smack my hand away and holler at me LOL.. So I waited until she was more relaxed and fell asleep on her favorite chair, then I snuck it in. She was a bit ticked off and tried to resist to get away, but I managed to get her through it. 

She did have a bowel movement yesterday, but straining again today with no luck, so its gonna be a rough few days until she gets her stool out again. But like I said, I couldn't get her full dosage into her yesterday... so its my fault really, and I feel really bad about it. But I worked hard trying to get it into her, and had no luck. 

Today however, I came up with a new method, which I was stupid to not think of before. Prior to today, I was mixing the meds into a little bit of the wellness pouches that includes gravy and meat morsels, and sprinkling a little kibble in there since she favors the kibble. And she would only take a few licks, and call it a day.. and not absorb all of her meds. So this afternoon I had a revelation, since she doesn't care for the meat.. I squeezed the gravy out of the packet, mixed in her meds, and mixed it with dry kibble only, no meat. She licked the bowl dry, including all of the meds. I have no idea why I didn't think of that prior to her getting bound up yet again. But as always, I keep living and learning throughout this process. I won't get too excited yet, incase it was just a one time thing licking it up. But hopefully she'll continue to eat it up that way. I just pray she'll be able to pass her stool without another enema, and I can get her back to normal with full dosages again. Do you think since I administered fluids, that might help her pass it easier than previously without the fluids? I also let her lick up some Laxatone as well. I can't imagine she'd be that backed up, given she did go yesterday.

Cody's new meds are coming tomorrow and Friday. The vet was kind enough to have them send me samples of both the treats and the transdermal gel. So if he won't take the treats, I can just rub the gel onto his ears. So that will be one less stress in my day, having to wrestle meds into him.

I definitely know the feeling about not wanting to leave, without worrying about how they're doing and what you should be home doing for them. Its quite stressful when they're ill. So with the huge crew that you have on your hands, its good that you can breathe a sigh of relief for awhile. Are they all currently healthy now?


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## laurief

Kattt said:


> everytime she saw me coming, she'd flip over on her back and smack my hand away and holler at me


LOL! What a girl. I'm glad you outsmarted her, though.



> She did have a bowel movement yesterday, but straining again today with no luck


This too shall pass, sooner or later.



> Today however, I came up with a new method, which I was stupid to not think of before.


Doesn't that just make you want to knock yourself over the head with a hammer? I've been known to do something the hard way for years before having a "well, DUH" revelation that makes it MUCH easier. Glad it didn't take you years to come up with your better way.



> Do you think since I administered fluids, that might help her pass it easier than previously without the fluids?


Sure can't hurt!



> I also let her lick up some Laxatone as well.


Good idea. That should help lubricate the passage of any constipated stool.



> Cody's new meds are coming tomorrow and Friday. The vet was kind enough to have them send me samples of both the treats and the transdermal gel. So if he won't take the treats, I can just rub the gel onto his ears. So that will be one less stress in my day, having to wrestle meds into him.


I hope the treats will work for them, because they'd be easiest.



> I definitely know the feeling about not wanting to leave, without worrying about how they're doing


Leaving the farm is always a production because I have cats who can't be trusted alone together without potentially getting into violent fights. I have to make sure the combatants are sequestered in separate rooms when I'm off the property. I also have to separate the GoBoys from one of the dogs because they might try to snuggle or play with him, and he's been known to get nervous and go after them if they scare him. 



> Are they all currently healthy now?


They're never all healthy, because some of the animals are very geriatric with chronic physical concerns. One of the old mares has only one eye, and that eye is nearly blind (moon blindness). She is also very heavey (COPD). One of the other mares is also heavey, and she has a loose stifle joint that occasionally pops out, leaving her 3-legged until she manages to pop it back in (which she's actually quite good at). Both of those old ladies require daily meds. One of the cats, Tommy, is hyperT and quite arthritic and gimpy in a front leg. She also occasionally constipates. She gets daily meds and dietary supplements, as well. Noddy (cat) has a sensitive stomach, so I feed him a special diet with supplements. Oh, and somebody swatted Somer (cat) in the eye, so I'm battling her to put ointment in that eye daily. Then there's Tasha (dog) with her two torn achilles tendons and orthopedic braces. I think that's it at the moment, knock on wood.

Laurie


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## Kattt

Breathes a sigh of relief. We had huge progress today. She poo'd last night after a bit of straining, but she got it out on her first try. Then she was back to straining again this morning, but after about 3 attempts she passed yet another fairly large stool. Then right after that, she easily poo'd a huge pile. It was all on the extremely soft mushy side, but not diarrhea. I'm pretty certain she cleaned her system entirely out with that bowel movement, because it was alot. I felt so relieved that she poo'd that much without an enema. I was so excited that I felt like calling family and friends to share in my happiness, but nonetheless, I figured they'd think I was crazy for celebrating poo. It's one of those things you gotta experience the stress of the situation for yourself, to be so happy about it LOL.

That makes 4 days in a row she's poo'd again. Some days it was harder for her to get out than others, but I think it was because I wasn't getting her full meds dosage into her. Yesterday and this morning she licked up her full dosage, so after 3 full dosages, she cleaned her system entirely out. So I'll be praying that’s a sign that if I can continue to get the full dosage into her, she'll stay on track. I think I'm learning to combat it better on the days I see her straining, by giving her Laxatone and sometimes an extra dosage of meds (per the vets instructions). So watching closely and staying very on top of the situation, has somewhat helped I think. But I'm never quick to get too excited with the up and down rollercoaster we've been on. So time will tell what the upcoming days will bring.



laurief said:


> Leaving the farm is always a production because I have cats who can't be trusted alone together without potentially getting into violent fights. I have to make sure the combatants are sequestered in separate rooms when I'm off the property. I also have to separate the GoBoys from one of the dogs because they might try to snuggle or play with him, and he's been known to get nervous and go after them if they scare him.


I have to do the same thing before leaving the house, make sure the 2 cats are separated, and can't get to each other. It's fairly easy for me though, given Pepper rarely ever ventures out of the 2 upstairs rooms, so I just shut the door when I go out. But it sounds like quite the task for you and your crew.

And wow, it sounds like you still have your hands full administering daily meds and keeping up with diets. I commend you, I have no idea how you do it. I'm exhausted just from 2 cats being sick in one month. They're all lucky to have you though, with all of your knowledge about pet care, I'm sure all of your pets have a longer extended life. 

P.S. I liked the old Forum format better. Seemed easier to find my own posts. I wouldn't say this format is unusable like someone else commented, but it's gonna take a few to get used to the new format.


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## laurief

Kattt said:


> I was so excited that I felt like calling family and friends to share in my happiness, but nonetheless, I figured they'd think I was crazy for celebrating poo.


Yeah, you really have to have been there in order to understand the poo celebration. I'm so glad that Pepper is working things out.



> And wow, it sounds like you still have your hands full administering daily meds and keeping up with diets.


It's a routine like any other, and I'm one of those folks who is very comfortable with routine. It only gets overwhelming when multiple animals are in medical crises at the same time. 



> with all of your knowledge about pet care, I'm sure all of your pets have a longer extended life.


That's generally true, but much of that knowledge came at the expense of the animals who taught me over the decades. I've made more mistakes in terms of animal care than I'd want to admit, but every mistake is a learning experience that makes me a better caretaker in the future.



> P.S. I liked the old Forum format better.


I participate on so many forums that it's six of one, half dozen of the other as far as I'm concerned. It'll be a very nice addition if we can upload pics into posts here without having to host the pics offsite first. I'm going to give that a try right now. If this works, you'll see a pic of BooBoo wearing a party hat.

Laurie


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## Kattt

Well, no bowel movement today.. but also no straining either. So maybe she just doesn't have to go, after all she let out yesterday. As always, we'll see what tomorrow brings.


It is quite sad when we have to learn at the expense of our beloved pets. I feel like I learned some very hard lessons at the expense of my 2 cats health as well. I am fortunate enough that they are still both with me, and I can hopefully make the necessary changes and be aggressive enough with treatments to keep them with me alot longer. But its just all very scary now, always worried if I'm doing everything wrong now.


Cody's results came back today, and sadly he had calcium oxlate crystals.. which apparently are the worst kind, and he's at high risk to get them back. The vet did of course strongly advise me that I need to put him on Hills Prescription c/d immediately, which as we know.. is crap food. I expressed my extreme concern about the ingredients in that food, and she said at the end of the day, its my choice since he's my cat, but she said that if he does not go on that food, that his chances of reforming the stones are much higher, given that food is specifically formulated to combat these issues. She also said he still has a chance to get stones again on Hill's as well, but the risk is much lower. So basically I have to feed him crap food, and he's still at risk of getting sick again. But for now, I had no immediate options, so I had to put him on the Hill's per the vets strong recommendation until I can do more research on other foods. It was too risky to keep him on Blue Buffalo & Evo, given the situation. At this point, I'm terrified that he'll get those stones back again. As picky as he is, he oddly seems to like the Hill's food, I really didn't expect him to. Do you have any experience/food suggestions for those types of crystals? 


He goes back in 4 weeks for follow up xrays and a urinalysis. I'm going to worried sick until then. She said given he completely refuses wet food, he may need to go on subQ fluids as well to flush out his bladder on a regular basis, pending his pH level results. She said we'll play it by ear, and see how he's doing in 4 weeks, and continue to check his levels regularly. Lots of stressful vet visits ahead, ugh! 


That pic of BooBoo is too cute! My cats would freak if I stuck something on their head like that LOL. I finally, got some pics (I didn't realize what fatty's they looked like until I took these pics. Wow, I really do need to get their weight down).. 


Cody (You can see how his big belly is folded in where he has his stitches):










Pepper (I was interrupting her nap on her favorite chair right next to me at the computer):


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## Kattt

Pepper had an easy bowel movement today, so it looks like we're back on track again. For now anyways.

I read that free feeding cats that develop oxalate crystals is a bad idea. So I stopped the free feeding for both cats, given the circumstances and the fact that they both need to lose weight. I think not free-feeding also promotes more water drinking.. because that’s all that’s there when they go to where they're used to their food bowls being, so they'll drink instead of eat. My vet also advised I should give Cody distilled water as well, because I have no idea whats in my tap water mineral wise. I'd have to call the township to find out, or get a test kit. I could just boil water to make it distilled, but distilled water is cheap enough, only 88 cents per gallon.. so I figured its just easier and safer to just buy a couple gallons of that and use in his fountain instead. 

And since I'm new to the scheduled portioned meals thing, I wasn't sure how to go about it. As you know, Cody will only eat dry food.. and Pepper will not eat enough wet to constitute a full meal. According to the food bag, I can give Cody up to 1 1/4 cups per day (He's 21.5lbs). I know that we're not supposed to go by the bag, because they just wanna sell more. But he is a big boy, so I want to make sure he gets enough food (Especially since Hill's food has alot of filler crap. And I'm too terrified to feed anything but the vets recommendation at this point, without documented proof that something healthier works). Since he does need to shed weight, I was thinking along the lines of 1 cup per day, and splitting it into 3 times a day, 8 hours apart. Pepper I can give a bit less, since she's only 15.75lbs and eats a little bit of wet with her meds. Since they're used to free-feeding, I thought 3 portioned meals would be best for now, instead of 2? 

Also, what if they don't eat the whole bowl in one sitting (Which they haven't so far). Leaving it out will constitute to free-feeding, but picking it up means they didn't get their full meal and could go hungry. This is all a learning process for me, so I'm not sure how to handle making sure they get the right amount of food, without free feeding and without making them feel hungry.

I also purchased a baby scale, to monitor their weight. Hopefully all of these changes will help. Our world has been turned upside down this past month.


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## laurief

Kattt said:


> Pepper had an easy bowel movement today, so it looks like we're back on track again. For now anyways.


That's good news.



> According to the food bag, I can give Cody up to 1 1/4 cups per day (He's 21.5lbs). I know that we're not supposed to go by the bag, because they just wanna sell more. But he is a big boy, so I want to make sure he gets enough food (Especially since Hill's food has alot of filler crap. And I'm too terrified to feed anything but the vets recommendation at this point, without documented proof that something healthier works). Since he does need to shed weight, I was thinking along the lines of 1 cup per day, and splitting it into 3 times a day, 8 hours apart.


Here's what I'd do (until I can convince you to throw out the Hill's garbage and feed him real food). Start Cody on 1/4 c kibble three times a day. Leave the breakfast meal down for 10 mins, then pick up any remainder and add it to the midday meal's portion. At midday, leave that meal down for 10 mins then add any remainder to the night meal. At night, leave that meal down for 10 mins, then pour any remainder back in the cat food bag and start over with fresh the next day. 



> Pepper I can give a bit less, since she's only 15.75lbs and eats a little bit of wet with her meds.


I'm not sure what to recommend for her since I don't know exactly how much wet she's eating relative to dry, but since the goal is to wean her off of kibble entirely, if possible, then it would be advisable to give her wet for breakfast and dinner (I assume that's when she gets her meds), and kibble at midday only. If she's eating EVO kibble, she shouldn't need any more than 1/4 c. at midday ... probably less.



> Also, what if they don't eat the whole bowl in one sitting (Which they haven't so far). Leaving it out will constitute to free-feeding, but picking it up means they didn't get their full meal and could go hungry.


A little hunger won't kill them, esp. since we're only talking about a few hours before the next mealtime. Hunger will just inspire them to eat more heartily at the next meal.



> I also purchased a baby scale, to monitor their weight.


Excellent! Weigh them now and again next Saturday, just to see how they're responding to their starting portions. Then weigh them every two weeks and adjust food portions as necessary. I weigh all of mine on the 1st and 15th of every month and chart them in a spreadsheet on my computer. I can tell you what every one of my cats weighed on the 1st and 15th of every month since July 2007.

Laurie


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## laurief

> Kattt said:
> 
> 
> 
> its just all very scary now, always worried if I'm doing everything wrong now.
> 
> 
> 
> I know, but it's important to keep things in perspective. Consider how much you've learned in a very short period of time and how much better you're managing their health concerns than you could have done 2 mos ago. Every day you're becoming a more knowledgeable and skillful caretaker, and every day your cats are benefitting from it. You've even been sharing your new knowledge on the forum, so other cats are benefitting from it, too. Be proud of what you've accomplished so far, and look forward to what you'll continue to learn.
> 
> 
> 
> 
> Cody's results came back today, and sadly he had calcium oxlate crystals.. which apparently are the worst kind
> 
> Click to expand...
> 
> I'm not aware that one type of stone is worse than another. They're all potentially life threatening, and you really can't get any worse than that.
> 
> From what I've read, struvite used to be the most common type of urinary crystals. Then cat food manufacturers started producing foods formulated to support urinary tract health (by discouraging formation of struvite crystals). As those foods became popular, struvite crystals became much less common, and calcium oxalate crystals took over the lead.
> 
> 
> 
> 
> The vet did of course strongly advise me that I need to put him on Hills Prescription c/d immediately,
> 
> Click to expand...
> 
> Surprise, surprise. Apparently I don't understand urinary crystals as well as I thought I did. I always understood that crystal formation was strongly (but not exclusively) influenced by urinary pH, so that a food that caused urinary pH to become more acidic would promote the formation of one type of crystal, which a food that shifted urinary pH to the alkaline side would promote formation of the other type of crystal. C/D, however, claims to discourage formation of both struvite and oxalate crystals, which I didn't even think was possible ... and I'm not sure I believe it.
> 
> 
> 
> 
> which as we know.. is crap food.
> 
> Click to expand...
> 
> That much I am sure of. After reading its ingredient list, there is no way I would feed that garbage to any of my cats, esp. to a fat cat who is already at higher risk of developing diabetes.
> 
> 
> 
> 
> she said that if he does not go on that food, that his chances of reforming the stones are much higher, given that food is specifically formulated to combat these issues.
> 
> Click to expand...
> 
> Maybe, maybe not, but there are substantial risks associated with feeding such a low quality, high carb food, too.
> 
> 
> 
> 
> for now, I had no immediate options, so I had to put him on the Hill's per the vets strong recommendation until I can do more research on other foods.
> 
> Click to expand...
> 
> I've been doing some research on this, too, and have come up with some potential options and information sources for you to look into. I've found two sources for custom homemade veterinary diets:
> 
> https://www.petdiets.com/Consult/default.asp
> http://www.balanceit.com/
> 
> And this link will provide you with contact information for several small animal nutrition services that offer telephone consults:
> 
> http://www.acvn.org/site/view/103264_NutritionResources.pml;jsessionid=1wwaq9k357758
> 
> 
> 
> 
> He goes back in 4 weeks for follow up xrays and a urinalysis. I'm going to worried sick until then. She said given he completely refuses wet food, he may need to go on subQ fluids as well to flush out his bladder on a regular basis, pending his pH level results.
> 
> Click to expand...
> 
> Well, at least you know how to administer subQ fluids and know where to purchase the necessary supplies inexpensively.
> 
> 
> 
> 
> I finally, got some pics (I didn't realize what fatty's they looked like until I took these pics. Wow, I really do need to get their weight down)
> 
> Click to expand...
> 
> My very first family cat, Mariah, was a black tuxedo male like Cody, and the cat who raised me after Mariah disappeared was a tortie named Tempest. Needless to say, I'm feeling a certain fate has brought us together so that I can help you with your tuxie boy and tortie girl. It's official; we're family now.
> 
> 
> 
> 
> Cody (You can see how his big belly is folded in where he has his stitches):
> 
> Click to expand...
> 
> Uh, yeah, I can see Cody's rather expansive belly. I hate to tell you, but he doesn't have anywhere near as large a bone structure as Noddy, and Noddy's optimal weight is between 16.25-16.5 lbs. Cody should weigh less than that. Cody is a very handsome dude, though.
> 
> 
> 
> 
> Pepper (I was interrupting her nap on her favorite chair right next to me at the computer):
> 
> Click to expand...
> 
> I'm going to give that girl more of a benefit of the doubt since the camera angle doesn't give a good view of her overall weight. Still, it's a good bet that at over 16 lbs, she's carrying significantly more weight than she should. My females, at optimal weight, range from 8.7-11.45 lbs, and the 11.45 pounder (one of Noddy's cousins) is quite large-boned.
> 
> Pepper is gorgeous. I have a MAJOR soft spot for torties. I keep hoping that some day a tortie will stray onto my farm, but I have a feeling that Tempest, rest her queenly soul, is seeing to it that she remains my one and only. It is her proper due, after all.
> 
> Laurie
Click to expand...


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## laurief

OK, this is weird. Your latest post was emailed to me directly, but it doesn't appear on this thread (not in either of my browsers, anyway). And you don't seem to be able to see both of my responses that I posted today (not including this one). The first response I wrote today - response #61 on this thread - seems to be the one you read, but my other response - #62 on this thread - seems that you didn't read. I'm going to PM you my response #62 so that you can read it (hopefully).

I think it's great that you're charting litterbox progress. It's so helpful to keep track of anything medical-related, esp. when dealing with an ongoing problem. I chart all of my animals' blood test results, but I must admit to being occasionally lax about notating med changes. I need to be better about that.

Laurie


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## Kattt

All of those links will be a huge help, thanks so much for all that info! I think I'll start with the phone consultants, and get some professional opinions on what to feed for this type of issue. Because like I said, I don't want him on Hill's.. but for the moment, it was my only option until I could do more extensive research. After surgery I had him on Blue Buffalo, which has sweet potatoes in it.. and I read online that cats with oxalate crystals should not have sweet potatoes, so of course that freaked me out that he was eating that for 5.5 days after surgery, but I had no way to know it was bad for him until they called with the results. The vet told me that he can still live a full, long life with the right diet, and I hope shes right. Because it scares me to death to think otherwise.

The main thing I'm curious about, and I really need to ask my vet.. is which ingredients is it in Hill's that they find so crucial for him to eat. They told me I can only buy it with a vets prescription, so I thought maybe something special was in it. But that’s not true.. because I found it online, so it can't be that special. And that crappy food is quite expensive too. 

Your food portions/times sound like a great place to start. 1/4 cup seems like a good amount. I never previously measured out their food when I was free feeding, but I'm almost certain they never ate more than a cup of food per day anyways. So it should satisfy them just fine, it'll just be getting them used to eating it at certain times that will be the bigger challenge. 

Pepper really doesn't even eat any of the meat in the wet food, so its not even really a meal for her. I mainly give it to her for the extra water intake, and to get her meds into her. I give her Wellness Turkey gravy twice a day in the morning/evening just so I can mix her meds into it. She licks up all the gravy, and leaves any meat/kibble in the bowl. Then 2 more times throughout the day/evening, I give her 1.5oz of Blue Buffalo Chicken, with 2oz of water mixed in, and again.. she just licks up the water and leaves the meat. I do the 2 Blue Buffalo feedings for the sole purpose of getting water into her, because she won't drink enough otherwise. And then the kibble was down for her at all times to snack on when she was hungry. So I think I'll continue my wet routine with her, since its important to get water into her while on Lactulose, and give her 1/4 kibble in the morning, then another 1/4 kibble at night... and that should be enough for her, since she's getting the gravy in between. 

I guess we never really notice a weight issue when we look at our pets daily, until something happens.. then it’s a real eye opener. The vet was concerned about their weight, but wasn't overly concerned. She said she would definitely like to see them lose some weight though. A previous vet told me Cody should be 11lbs, and the current vet told me that’s a crazy recommendation for his size, he would be skin on bones. She said she wouldn't want to see him drop no lower than 15lbs for his huge size, and Pepper around 10-13lbs.

I'll definitely start charting their weights as well. As crazy as this might sound, I already chart their bathroom habits. Because with her constipation issues, and his urinary issues.. I think its crucial to know exactly what goes on each day with both of them. Because some days I have to be more aggressive with Pepper's medications if she shows signs of constipation again. And its extremely important to make sure Cody is having normal urine releases. So I chart it all daily, otherwise I'll forget what happened the previous day. Luckily they use separate litterboxes, so it makes it easy.

It was definitely fate that brought us together on the forum, since we had the same type of cats LOL. Family works for me, you've been my sanity throughout this whole nightmare! 

These 2 cats were the first cats I've ever actually picked out in my life. Previous cats I had from childhood, and they all ended up there as strays and such. When I got these 2, I specifically set out to get an all black cat and went to this specific foster house because the lady said she had several black kittens. But when I got there and spotted Pepper.. I fell in love with her, and just had to have her. I later learned that she was a tortie cat (never saw a tortie prior to getting her, I must have lived a sheltered life LOL), and now call her Tortitude, because she has quite the little attitude. And Cody lucked out, because he looks exactly like my 19 year old cat that I had to have put down the month prior to getting them. And my sis-in-law came with me, and was chasing Cody all over that lady's house, saying you HAVE to get this one, he looks just like Sugar! (The cat I had put down) So he won over the black kitten, even though that’s what I set out to get. He actually lucked out in more ways than one. I told the lady I wanted 2 female cats, no males. For one I didn't want to risk spraying prior to getting him fixed, and secondly I didn't wanna risk pregnancy with 2 of the opposite sex. And she told me they were both female. And they were so tiny, and I was inexperienced.. and trusted what she said. I figured out the next day once I got him home, after calling him Phoebe for 24 hours, that he was male LOL. I only had him less than a day, but was already attached.. so Phoebe became Cody, and got to stay. 

Oh yea, I meant to note too - That Cody's belly, all that bulk you see in the pic, isn't all fat. He's obviously overweight, but that huge belly is an excessive amount of loose skin that hangs. Both of them developed bellies like that after getting fixed as kittens. I thought the vet screwed up or something, because it seemed abnormal to me. But I asked the vet about it, and she claimed it was normal for fixed cats to have loose skin that hangs like that. I really don't remember any of my other fixed cats belly hanging like these 2 though.


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## Kattt

Oh, and I deleted that to re-adjust what I wrote. Because just as I posted my response, I saw you responded to the first post. 

So I deleted it and combined my response into one post to make it easier LOL Since you had already answered some of the questions.

Thanks again!


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## laurief

Well, thank goodness I'm not going completely crazy, and you deleted that first response that I got in my email. I couldn't figure out what the heck was going on in this thread!



Kattt said:


> All of those links will be a huge help, thanks so much for all that info! I think I'll start with the phone consultants




Don't be surprised if they charge you a consultation fee. I would assume they will.



> The vet told me that he can still live a full, long life with the right diet, and I hope shes right. Because it scares me to death to think otherwise.


I've never had a cat with bladder stones, but I have had three of my boys suffer complete urethral blockages in the past (all with struvite crystals, if I remember correctly). Each of them only blocked once, but once was enough. I only put one of them on S/D for two weeks. The others never went on a prescription diet at all. For my cats, I have found that the key to avoiding urinary blockages is water, water, water. The more urine they produce, the more frequently they flush crystals out of their systems before they have a chance to clump together and form stones or blockages.



> The main thing I'm curious about, and I really need to ask my vet.. is which ingredients is it in Hill's that they find so crucial for him to eat.




The veterinary nutritionists should be able to answer that for you.



> it'll just be getting them used to eating it at certain times that will be the bigger challenge.


That won't be as hard as you think. You'll be surprised how quickly they adjust to scheduled meals.



> Pepper really doesn't even eat any of the meat in the wet food, so its not even really a meal for her.


With any luck at all, that'll change when she no longer has the all day kitty buffet. My guess is that the meat in the wet food will become a lot more appealing.



> I guess we never really notice a weight issue when we look at our pets daily, until something happens.


.

Oh, I KNEW how obese my cats were. I just didn't do anything about it until Noddy's blood glucose shot up into the stratosphere.



> A previous vet told me Cody should be 11lbs, and the current vet told me that’s a crazy recommendation for his size, he would be skin on bones. She said she wouldn't want to see him drop no lower than 15lbs for his huge size, and Pepper around 10-13lbs.


You shouldn't shoot for a specific weight. You should shoot for healthy condition. You'll know that your cats have reached their optimal sizes when they have waists and you can feel their ribs under light pressure.



> you've been my sanity throughout this whole nightmare!


Funny, I drive most people crazy. LOL! 



> When I got these 2, I specifically set out to get an all black cat and went to this specific foster house because the lady said she had several black kittens. But when I got there and spotted Pepper.. I fell in love with her, and just had to have her. I later learned that she was a tortie cat (never saw a tortie prior to getting her, I must have lived a sheltered life LOL),


Tempest was the only cat I ever picked out, and she was an unintended gift from my father. My next younger sister, oldest sister, and I have birthdays within four days of each other, with mine being the last of the three. On my thirteenth birthday, my dad thought he was finished with March birthdays after the second one (forgot all about mine) until my mom asked him the night before my birthday what he had gotten me. Having gotten me nothing, Dad woke early and typed up a gift certificate for the kitten of my choice. So the day after my birthday, my mom and I answered kitten ads and found Tempest at a floral shop. Like Pepper, Tempest was the first tortie I'd ever seen, and I was awestricken by her exotic beauty. Turned out she was the best birthday present my dad ever gave me.



> Cody lucked out, because he looks exactly like my 19 year old cat that I had to have put down the month prior to getting them. ... I figured out the next day once I got him home, after calling him Phoebe for 24 hours, that he was male LOL. I only had him less than a day, but was already attached.. so Phoebe became Cody, and got to stay.


My next older sister found our tuxedo boy, Mariah, on her way home from school one day and brought him home as a stray. He was the first cat to join our family, and apparently none of us knew how to identify gender in cats at that time. Thus Mariah's rather unmanly name.



> That Cody's belly, all that bulk you see in the pic, isn't all fat. He's obviously overweight, but that huge belly is an excessive amount of loose skin that hangs


.

Oh, I know the difference between belly fat and a "lion's pouch". Most of my cats have a lion's pouch, though a few do not. That has nothing to do with spay/neuter. It also has nothing to do with weight, though it will store fat in obese cats. It's just a genetic predisposition of some cats, and it won't go away when a cat loses weight. It's there to stay.

Laurie


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## Kattt

I'm going to try calling around to those nutritionists tomorrow. I figured most would be closed today, since its Sunday.

I agree, one blockage is enough.. and very scary. The vet was actually the one that told me oxalate stones are worse than struvite. She didn't really get into why, other than to say they're harder to combat. Which of course, made my paranoia 10x's worse. 

I'm glad to hear you only had the blockages once, and no more. I pray that’s my case too. Cody does drink ALOT of water. If Pepper had this problem, I'd have serious issues.. she doesn't drink much. But Cody's always been a huge water drinker, so that’s why I'm having a hard time wrapping my head around why it happened to him, and it scares me to death knowing that he was drinking that much water, and it still happened. I wish I knew exactly what caused it, then it would be so much easier to combat. I feel like I’m going into this situation entirely blind.. and that’s a terrible feeling.

I've been googling like crazy, but haven't found any overly great sites that would help me understand oxalate crystals better. And almost every single site I have found, all say to feed Hill's or Royal. Its all very frustrating, since I don't want him on that garbage. Hopefully the vet nutritionists will have some more insight.

I did the scheduled feedings today. Cody only ate like 2 pebbles for breakfast, then just a couple more for lunch. I felt horrible, like I was starving him. I'm going to give him one more feeding tonight, to see what he does. Pepper ate fairly well each feeding though. That girl loves her food, Cody has always been uninterested in food (Never know it to look at him though).

You definitely don't drive me crazy LOL I have greatly appreciated all of your knowledge, and have learned SO much from you over the past couple of months. I can't thank you enough. I'm quite certain I drive my vet nuts, because they don't like knowlegable people questioning their advice. But she's grown used to it, given how much we have to talk these days between the 2 cats issues. She really has been great throughout this whole nightmare.

She actually did agree with me that she would never recommend Hill's or even suggest a cat eat that, if not for Cody's case. She said for a healthy cat, she would recommend Evo, Blue Buffalo and Wellness. But she had very strong opinions about him needing to be on Hill's, but said its ultimately my decision. She already knows that I'm researching other options, but she doesn't seem comfortable with it, and feels I'd be making a mistake putting him on something else.

And aww, that’s such a cute story about your 13th birthday LOL.. You got lucky that he forgot. Did your tortie have a major attitude problem? Lord knows Pepper does. And my vet once told me that torties were known to have bad dispositions. I've read conflicting info about torties online though. Some sites say they have bad dispostions, while others say they're very affectionate cats. Pepper can be the sweetest little girl one minute, then trying to viciously bite me the next. Shes lucky I love her so much and have alot of patience for her little tantrums. Its all second nature to me after 7 years, once she gets mean.. I know that’s when she's had enough, and just leave her be for a bit.

Another thing I thought of today that made me laugh, how you said it was fate and we're family now. My best friend growing up.. her name was Laurie too! LOL


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## Kattt

I just wanted to give a quick update. I've started researching those links you provided.

I put in an appointment for a phone consulation at Angell Animal Medical Center. I chose that place to start with, because they have a board certified vet nutritionist. So we'll see what they say.

I've been reading the FAQ's section on petdiet.com. And given their answers I've read, and the price they charge, they're not worth investing money into. They want to charge $250 to give the same advice my vet already gave me. 

I'm only about 6 pages into their FAQ's section, but so far a few people have asked about diets for cats with FLUTD, urinary tract issues and crystals, all of which they recommended Hill's :?

Also, they seem to give conflicting info about raw vs cooked diets. Their very first answer on page 1 of FAQ's suggests that meat should be cooked. Then another answer a couple pages in, suggests raw is better. So those people sound very confused, especially when they're recommending Hill's garbage. 

Hopefully my phone consultation will have some better advice.


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## laurief

Kattt said:


> Cody's always been a huge water drinker, so that’s why I'm having a hard time wrapping my head around why it happened to him, and it scares me to death knowing that he was drinking that much water, and it still happened. I wish I knew exactly what caused it, then it would be so much easier to combat.


It sounds like he probably has a mineral imbalance or funky urine pH. Hopefully the veterinary nutritionist will be able to shed some light on his problem. You should have current urinalysis results on hand for the telephone consult, I would think.




> I did the scheduled feedings today. Cody only ate like 2 pebbles for breakfast, then just a couple more for lunch. I felt horrible, like I was starving him. I'm going to give him one more feeding tonight, to see what he does.


Is he eating better today? 



> I'm quite certain I drive my vet nuts, because they don't like knowlegable people questioning their advice.


I've gone through most of the vets in my area, leaving a trail of nearly hairless and fingernailless vets in my wake. My current vet makes no qualms about calling me "high maintenance", though I do believe he respects my dedication to my animals, even if I do drive him up the wall at times.



> She actually did agree with me that she would never recommend Hill's or even suggest a cat eat that, if not for Cody's case.




Well, that's something, anyway.



> Did your tortie have a major attitude problem?




Tempest was the ultimate feline. She moved with slinky elegance and assurance. She was superior and aloof, loving and nurturing, demanding and disciplinary, and completely committed to her family. Tempest knew exactly who she was, what her obligations were, and all that she deserved. Tempest was a cat. Tempest was THE cat. There has never been another like her. Her attitude was not a problem. It was her greatest asset.



> my vet once told me that torties were known to have bad dispositions.


Does your vet believe all the nonsense she hears?



> Pepper can be the sweetest little girl one minute, then trying to viciously bite me the next.


In other words, Pepper is passionate. I, for one, appreciate a passionate personality.



> once she gets mean.. I know that’s when she's had enough, and just leave her be for a bit


.

That's not mean; that's overstimulated, and your response is correct. Just leave her be until she settles down.



> My best friend growing up.. her name was Laurie too! LOL


If you tell me your real name is Lisa (the name of my childhood best friend), this whole thing's going to get a little bit creepy. ;-)

Laurie


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## Kattt

OMG. That IS indeed my real name. No lie. Too funny, in a creepy sorta way LOL.

So after more googling, I just realized the phone consult I had with Angell Animal Medical Center set up for tomorrow, is actually the same vet nutritionist that owns petdiets.com and advising to feed Hills in her FAQ's. Ugh. I already had his medical records and lab work all faxed to her too. But given she's pricey - Charges $106 for the consult (yikes), and reading what I have in her FAQ's, I feel speaking to her would be a waste of time and money, if shes just going to tell me to feed what I'm already feeding him. So I cancelled the appointment. 

Info on oxalate crystals seems to be extremely limited online, so researching it seems to be a dead end. Cody has his follow up appointment on the 31st. I know what I'm about to say will make you cringe, but I'm thinking I should just stick with the Hill's for now like my vet strongly recommended (As well as almost every article I've read online suggests Hill's or Royal too), and wait and see if its working for him.. and go from there. While I do strongly agree Hill's is pure junk (So was the Fancy Feast he ate for the past 5 years too), my options are limited. I can change his food to something else against my vets advice, and put him at high of getting the stones back again, which would result in another painful traumatic surgery. Or I can just take my chances on this food, hope it works at preventing stones.. and pray it causes no additional health issues. Scary options either way I go. I SO need to get him on wet food though. Every article I read says cats with crystals have to be on an all wet diet. But he outright refuses, even if I fast him into being hungry. I'm fortunate that he drinks alot of water, but given he always drank alot, that didn't help him prevent the stones before.. so I'm scared it won't again. SubQ's might be in his near future, depending on what the results are on the 31st. 

My nerves will be completely shot by the 31st LOL. At least with Pepper, I can visually monitor her progress, and can see with my own eyes if shes doing good or bad from day to day. Cody however, completely blindsided... and sick with worry each day wondering if stones are reforming. I saw that I can buy pH test kits to check his urine levels. But how in the heck do you get a cat to pee on that.

Cody's issues have now hijacked Pepper's thread. Pepper is doing very well though. She's been having regular daily bowel movements, most days with ease. I made a judgement call to stop the pumpkin about a week ago, when she fell back into those bad straining episodes last weekend. It seemed the pumpkin was bulking her up too much, causing way too much straining. And I can say that things seemed to have improved since the pumpkin stopped (knock on wood). 

Tempest sounded like a great cat. Its too bad that our furbabies can't live as many years as us humans. 

I think the vet that told me that about torties having bad dispositions just made things up as she went along. Hence why she's a previous vet. They nearly killed Cody back in '08, I never went back. 

Pepper is indeed passionate, and knows what she wants and when she wants it. And will demand to get it LOL Cody is my more lovable one, but they are both quite demanding. They own me, not vice versa LOL


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## laurief

Kattt said:


> OMG. That IS indeed my real name. No lie. Too funny, in a creepy sorta way LOL.


Now all we need is a dog named Happy and a horse named Beau, and I'll know exactly who you are.



> I just realized the phone consult I had with Angell Animal Medical Center set up for tomorrow, is actually the same vet nutritionist that owns petdiets.com and advising to feed Hills in her FAQ's. Ugh.


Well THAT'S unfortunate. But there are other options on that list for phone consults. Perhaps you'd have better luck with one of the others. Before setting a consult appt, you could ask if the nutritionist would be willing and able to provide an oxalate-appropriate homemade diet during the consult. That way you wouldn't waste each other's time ... and your money.



> Cody has his follow up appointment on the 31st. I know what I'm about to say will make you cringe, but I'm thinking I should just stick with the Hill's for now like my vet strongly recommended (As well as almost every article I've read online suggests Hill's or Royal too), and wait and see if its working for him.. and go from there.


You're only talking about a couple of weeks before his next evaluation, so I don't see anything wrong with maintaining the status quo for now. But I do think you should continue to seek out a veterinary nutritionist who can recommend an appropriate homemade diet for you to try.



> Cody however, completely blindsided... and sick with worry each day wondering if stones are reforming.


I know how you feel, since I've been down a similar road with urethral blockages. Phantom blocked completely back in '06 and required catheterization and flushing to get him cleaned out. Last year he started peeing tiny amounts every couple of minutes all over the house, but with him being a skittish ex-feral, I wasn't able to catch him to take him to the vet to see if he was partially blocked again. I tried countless times to sneak up on him over the next five days, during which time his pee drops turned to what looked like pure blood. I knew he wasn't completely blocked because he was still expressing drops, but he was clearly in trouble. I finally caught him after a slow speed chase with a broom. At the vet's, his diagnosis was interstitial cystitis - no crystals, no infection, and no treatment other than trying to keep him calm (something he definitely hadn't been after I'd been chasing him around the house for five days).



> I saw that I can buy pH test kits to check his urine levels. But how in the heck do you get a cat to pee on that


.

Don't ask me. I've never indulged in that particular pleasure.



> Pepper is doing very well though.


Sounds like you're getting a really good handle on what does and doesn't work for her.



> They own me, not vice versa]


As it should be.

Laurie


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## Kattt

Now I can say that I've never had a dog named Happy, and never had any horses at all LOL

Yea, I was disappointed to see that the nutritionist recommended Hill's as well. Almost made me feel like I'd really doing bad taking him off of it, given even a board certified nutritionist says he should be eating that too. 

But I'll call around to some more of those numbers, and use your recommendation to ask if any of them can recommend a homemade diet for his situation. I'm not even sure Cody would take to a homemade diet, but its worth a shot. I was reading the ingredients in the Royal Canin food, and while its still junk food.. it doesn't seem quite as bad as the Hill's. The first ingredient is Chicken Meal, where as Hill's first ingredient is Ground Corn. They did give me the choice of either of the 2, but said Hill's has been more effective with oxalate crystals, which is why I went with that one. 

Is there anything wrong with mixing water into his kibble that you've heard of? He likes to take his kibble and dip it into his water fountain. Always makes me smile. The fountain has 3 levels, he drops it into the top level, then watches it flow down into the 3rd level, and fishes it out with his paw and eats it. So cute. But I thought since he likes it wet, maybe I could mix some water into his kibble and maybe that'll eventually get him into wanting to eat wet food. But I could have sworn I read somewhere once that was bad to do that. But I can't remember the reason why, and now I can't find the article again. Aside from it getting mushy fast, and needing to be picked up right away if he doesn't eat it.. I can't see why it would be bad getting the extra water into him. 

I just read an article earlier about the catheterization flushing process. Sounds like a painful process as well. 5 days of chasing a cat around was exhausting I'm sure. Is he ok now?

I've been attempting to slowly re-introduce them to each other today, after being entirely separated for a week, in fear that Pepper would hurt his stitched up belly, since she gets quite violent with him. I did the towel trick, rubbing it on him.. then her. But shes still quite ticked off by the sight of him, hisses and growls.. makes attempts to attack. Seeing him just entirely stresses her out, and I really don't want another set back with her again. She was this way prior to his surgery as well, some days shes less aggressive than others... but always hateful and vicious towards him. 

So on top of both of their health issues, I also gotta deal with her hating him and wanting to hurt him. Oh the joys of being owned by cats!


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## Kattt

So, stupid me.. I rocked the boat.

She was doing fairly well. She has her off days, but overall she was having bowel movements daily for the most part. Some days easier than others, depending on if she took all of her meds or not.

She had a really good bowel movement on Thursday. So I figured since she released a large amount, it was a good time to try Miralax again.. because I can get her to take Miralax MUCH easier than I can get her to take the Lactulose. I started on the larger dosage end - 1/4 2x's daily, figuring that would be my safest bet.

Well, BIG mistake. Now she has been straining lots yesterday and today, with no success. If she doesn't go by tomorrow, it means vet visit for another enema. I have that Pet Enema I got off of Amazon, but I'm too scared to use it, because I've never given one before, or been shown how. So I fear I'd damage her rectum or something worse.

I gave her Laxatone a couple times today to try to help her out, but still no luck so far. Sighs... I shouldn't have messed with her meds. Now I feel horrible. Yet another lesson learned.


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## laurief

Well, if it makes you feel any better (which it probably won't), I probably would have done the same thing. I would have assumed that her successful eliminations were due primarily, if not exclusively, to the cisapride, so switching from Lactulose to Miralax would have seemed like no problem to me. Like you said, another lesson learned.

Did you ever get that oh-so-expensive Kristolose? I would think that's as easy to administer as Miralax, but the cost would be prohibitive over the long term.

If she does need another enema, have your vet teach you how to administer it so that you can do it at home if the need should arise again.

Laurie


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## Kattt

Well yea, that does make me feel a bit better knowing you'd do it too. I figured since they're both stool softeners, it would serve the same purpose as long as she was getting the Cisapride pill. 

Good news though. I got up extra early today to prepare for a vet visit first thing when they opened at 8am, because she was straining SO much throughout the night, I didn't wanna make her suffer all day like that. But when I got out of the shower, she had a HUGE bowel movement. She surely cleaned her system out with as much as it was. Just in time to save a vet visit. What a relief. 

Odd thing was - It was all soft stool. Not diarrhea, but soft.. so not sure why it was so hard for her to get out. So it may have had nothing to do with the Miralax or Lactulose, she may need an increase in Cisapride for her weight. They put her on the very low end - 5mg's 2x's daily. The vet said I can give it up to 3x's daily, and if need be she has room to up her dosage of mg's. So maybe today, since she cleaned her system out - I'll start fresh with the Cisapride pill 3x's daily and Miralax 2x's to see what that does. Hopefully I don't make her worse again using Miralax. 

I did get the very expensive Kristalose awhile back, and she doesn't like that either - refuses to even touch the food with that in there. So it either has a strong odor (I can't smell it, but she might) or bad taste. So that was a waste. I'm still working through every wet food brand/flavor on the market to find one she likes too, since a fully wet diet would help alot. I've tried junk to healthy, no luck yet. These 2 love to test my patience.

In other good news - I got Cody to lose 1lb.. YAY! I was excited that something I was doing was finally working right. So the scheduled portioned meals are helping. Plus on top of that, I keep them both alot more active daily than they used to be by making them chase Da Bird & the cat charmer around multiple times a day. So I think thats helping too. His vet visit is this saturday, I'll be a nervous wreck all week waiting for the outcome, and praying theres no stones.


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## laurief

Kattt said:


> when I got out of the shower, she had a HUGE bowel movement.... Odd thing was - It was all soft stool. Not diarrhea, but soft.. so not sure why it was so hard for her to get out.


Maybe it was just the huge size of it that made it difficult to pass in spite of being soft. Are you still giving pumpkin? If so, maybe you should cut back on it and see if that reduces stool size. Also, you might want to reconsider trying a raw diet with her, since raw fed cats typically have very small stools. That might really help with her constipation issues if you can convince her to eat it.

Regardless, I'm very glad that she didn't have to go to the vet today.



> maybe today, since she cleaned her system out - I'll start fresh with the Cisapride pill 3x's daily and Miralax 2x's to see what that does. Hopefully I don't make her worse again using Miralax.


Well, we know that cisapride isn't without potentially serious side effects, so if her problem can be managed, even partially, with diet so that her cisapride dose can be kept as low as possible, it'd be worth a try, wouldn't it?



> I did get the very expensive Kristalose awhile back, and she doesn't like that either - refuses to even touch the food with that in there. So it either has a strong odor (I can't smell it, but she might) or bad taste.


Taste it and find out. Compare its taste to Miralax. It won't hurt you to taste a tiny bit of each one, and then you'd know if there's a difference that Pepper is objecting to. Since Lactulose tastes like sugar syrup (yes, I've tasted it), my guess is that Kristolose tastes like granulated or powdered sugar. Miralax has only a very faint hint of sweetness to it - mostly tasteless.



> I'm still working through every wet food brand/flavor on the market to find one she likes too, since a fully wet diet would help alot. I've tried junk to healthy, no luck yet


. 

I thought Pepper was starting to eat canned food OK.



> These 2 love to test my patience.


Isn't that part of the mandate of cathood?



> In other good news - I got Cody to lose 1lb.. YAY!


Yay is right! Isn't it great when something finally starts working out the way you want it to? Congratulations!



> His vet visit is this saturday, I'll be a nervous wreck all week waiting for the outcome, and praying theres no stones.


Keep good thoughts!

Laurie


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## Kattt

I stopped giving her the pumpkin quite sometime ago, 3-4 weeks or so.. because it was bulking her up too much, and stopping did help. Her stool today was normal size, and not real fat.. and semi-soft/not dry, but it was very long.. like she had a spiral pile when she was done, and it all looked connected. So maybe that’s why she had so much trouble. She never goes a whole pile, usually just one stool piece at a time.

I'd love to get her off the meds because I fear megacolon developing if we don't get this situation under control sooner rather than later. But at this point.. she really can't have a bowel movement at all without the meds. I did actually try her on raw chicken twice last week, and the stubborn princess ran from the plate LOL.. ugh. I honestly thought she'd like it, given she likes cooked chicken, but nope. My next attempt is trying WerRuVa. I've read on this forum that others cats really love it, and it supposedly looks like real chicken vs processed chicken. My local pet store didn't have it, so I had to order it.. and it should arrive tomorrow. So we'll see what she does with that.

As for eating wet, still very little progress. Mostly just licks up the water/gravy, and leaves the meat still. She eats a couple pieces here and there, depending on her mood. But not enough to consist of a real meal. So she still gets 1/4 cup of kibble daily - split between a morning and evening meal.

I stopped the combined liquid of Lactulose + Cisapride Friday night, and started giving her a Cisapride pill + Miralax instead. So I don't know if the pills are helping her less, or if she was already starting to get backed up from not taking the liquid all in during the week (She had some straining episodes prior to me stopping the liquid as well, but not as bad as this past weekend). I would think a pill would be more effective, because I know for sure she's getting the full dosage of both Cisapride & Miralax, where as before.. she was leaving a bit of gravy in the bowl, which means she could have left a little of the meds behind. But I gave her the liquid Lacatulose + Cisapride again last night, since she was having so much trouble.. and she did finally go today. So at this point, its hard to tell whether it was the pills or liquid that finally got her to go today, since she got the pill in the morning and liquid at night. Today I did the pill + Miralax, so I guess I'll see what tomorrow brings.

Chronic Constipation is such a frustrating thing to deal with! Everything seems to be trial and error with this disease.


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## icatguy

I've seen Metamucil mentioned in this thread, which is good, because that's what I think is most effective for constipation, but I wanted to add that even unflavored Metamucil has a large amount of sugar in it. So I suggest going to a good health food store and see if they have, or can order for you, pure psyillium husk powder, which is the "active ingredient" in Metamucil. And when you use it, make sure that you stir it well until it absorbs the moisture and turns into kind of a thick sauce or gravy. It you don't do that, then it will feel chalky and gritty and a cat will reject the food it's put into.


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## laurief

icatguy said:


> I've seen Metamucil mentioned in this thread, which is good, because that's what I think is most effective for constipation, but I wanted to add that even unflavored Metamucil has a large amount of sugar in it.


That depends on the Metamucil. The Metamucil I buy is smooth texture, unflavored, and sugar free. It does, however, contain maltodextrin and citric acid in addition to psyllium husk.



> So I suggest going to a good health food store and see if they have, or can order for you, pure psyillium husk powder, which is the "active ingredient" in Metamucil.


That's a good idea. When I finish my current jar of Metamucil, I'll buy pure psyllium husk from my local health food store. Neither I nor my cats have any need for maltodextrin or citric acid.

Laurie


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## Kattt

From my understanding, Metamucil/Pure Psyllium Husk works the same as pumpkin... and pumpkin was bulking my girls stool up too much, to where she had massive trouble passing it daily, which is why I stopped the fiber.

I also do not like the warning that Amazon has listed for Pure Psyllium Husk, if this is the correct product you are referring to? (See link below) I would use extreme caution giving it to a cat after reading this, given a cat may not drink the required amount of water:

*Safety Information*
Take this product as recommended. Without drinking enough liquid the product may swell in the throat, causing blockage or choking. Avoid use if you ever had esophageal narrowing, or swallowing difficulties.

Amazon.com: Psyllium Husk Powder, pure (Vegetarian) 12 Ounces: Health & Personal Care


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## Kattt

Oh an exciting update too... 

She poo'd with ease today. This was after giving her 1/4 Miralax + Cisapride in a Greenies pill pocket 2x's yesterday. So I was excited. And I hope it continues to work now that she's actually taking her full dosage.

She may have had so much trouble yesterday because it was building up from the entire week of not taking her full dosage of Lactulose + Cisapride all week long, at least thats what I hope caused it. 

So hopefully I finally did something right for her by getting her off the liquid she hated and switching her back to the Miralax + Cisapride capsules. Keeping my fingers crossed.


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## laurief

Kattt said:


> From my understanding, Metamucil/Pure Psyllium Husk works the same as pumpkin


You are correct. Psyllium and pumpkin are both fiber sources that serve the same function in the gut.



> *Safety Information*
> Take this product as recommended. Without drinking enough liquid the product may swell in the throat, causing blockage or choking. Avoid use if you ever had esophageal narrowing, or swallowing difficulties.


The important caution to take from this is to never administer psyllium dry. It must always be mixed with sufficient liquid to prevent gelling. Also, it must be dosed correctly (no more than 1/8 tsp. for a cat). When a proper dose is mixed thoroughly with "canned food soup", it is perfectly safe.

Laurie


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## Kattt

Ok, good. Glad to know its safe.

Since she had an easy bowel movement today, I'm going to stick with the Miralax + Cisapride for a week, and see how she does on that. She's been such a great sport about taking her full dosage of meds with the new method. It's so much less stressful than when I was trying to get the Lactulose into her.

And we had success with WeRuVa Paw Lickin Chicken wet food tonight as well. She devoured it! She didn't eat the full 3oz, but ate at least half, and got her belly full, because she had NO interest in kibble afterwards, and thats extremely rare for her. So hopefully I finally found a wet food that the princess likes. 

I wish I could have tried Cody on it, I think he would have liked it too, but it has potato flour in it, and potatoes have to be avoided due to the oxalate crystals. Figures they had to put that ingredient in it!


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## Kattt

So maybe I wasn't so stupid after all for switching her regimen. 5 days now, and she's been having normal bowel movements with ease, releasing more stool than she ever has before each time she goes. Knock on wood, everytime I say that.. I jinx us. I'm not ready to do a happy dance just yet, but I sure hope this is the calm after the storm, with her anyways.

Cody's vet visit is tomorrow at 9:45am. I'm extremely nervous. He seems to have an increased thirst drive the past few days, and he vomitted a little food this morning  I will freak if they tell me he has stones back already. I'm trying to stay positive, but these signs make me very paranoid.

I did give him WeRuVa wet once daily the past 3 days, so that could be why he vomitted, since his system isn't used to wet food. I read that can happen when you first give them wet food. So I guess I'll find out tomorrow.

On the plus side, they both LOVE this WeRuVa Paw Lickin Chicken. Pepper is almost on a fully wet diet now thanks to this brand, eats very little kibble now. And while I don't know if its good or bad for Cody just yet, he does seem to enjoy it too, and its been getting more water into him.. so I don't think that can be a bad thing. I'll discuss with my vet tomorrow. He's only had it 3 times, so if he does have stones again, its not from the Weruva.


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