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Megacolon: med managment vs surgery

beckiandthetrio
February 4th, 2010, 08:05 PM
Hi all--

Ive gotten such great advice here before so I thought Id come back for more.

Panda (the cat) is it at the vet currently to be manually extracted under anesthia. This is the 2nd time in 6months that he has been in but last time enemas worked. Anyhow, last time is colon was not considered to be a megacolon issue and now it has. My vet has shown me his xrays which are pretty bad, he has about 6-8inches and 2inches wide of stool in his colon. Tomorrow he will go under to have it removed.

My question is, will medical management be enough or am I prolonging the inevitable? He will be going home on Miralax and Cispiride for now and Im hoping and praying that will be enough to keep him regular and not get sooo constipated again. Is there something else that I should add to this or use instead of? There is talk of surgery which my vet doesn't do so I will have to travel to have that done. I really don't think surgery is feasable anyhow because unfortanetly I dont have 2,000 laying around:(

Has anyone else here gone through this and had sucess with managing it at home? My vet said she would show me how to give him an enema at home in case I need to use that. How long will this work for approximately?

I just don't want to have to think about putting him down because of this but I can't make him sufer like this either!!! I really am between a rock and a hard place.

Thanks for any and all advice you may have.

Becki and the trio

quincymycat
February 4th, 2010, 08:43 PM
Hey Becky,
One of my guys has severe chronic constipation as well, but not due to the megacolon dianosis. He has neuro deficits which prevented the "urge" to defecate and then the colon becomes engorged with what the vet has described as pretty much clay like feces. There is worry that when the colon is stretched repeatedly, mega colon will occur as it looses its ability to go back to where it was.
I will describe what we are doing for Quincy and how it came about.. This is not a diagnoses for your kitty, but perhaps will help open discussion with your vet.
When I first discovered Quincy's "problem" he was straining so hard at passing stool he was repeatedly vomitting while trying.
The first 2 visits were for enemas. X-rays of the bowel showed a huge mass of stool clogging the bowel. Enemas did not work, even the homemade hot water, soap sud and KY jelly mixtures. He was evacuated 3 times in about 4 weeks. My vet was seriously considering sub topical bowel resection surgery.
He was put on cissipride 10 mg twice a day for motilty issues, lactulose 3 cc 3 times a day to keep the stool soft and metamucil mixed into his food in the morning with a lot of added water to prevent it from defeating the purpose and causing blockage. He was also put on prescription fibre food which I tossed out almost as soon as I got home and saw the ingredients. I also used slippery elm bark mixed into his breaksfast "soup" every day for a few weeks.
I am happy to say that Quincy has been having at least one good BM each day for many weeks now and I hold my breath this continues.
IMHO, surgery should be a last resort. I would talk to your vet about these more time intensive, but for me successful methods. Water intake is a biggie. Canned food only and always mix extra water in even when you are not making the breakfast soup which my spoiled little man eats from a spoon when I feed him in the morning. Hey, it gets it into him! :laughing:
Good luck, and patience by the truckload! LOL

Chris21711
February 5th, 2010, 10:34 AM
My Herbie has megacolon, his last bout with the Vet visits finished 3 weeks ago...listening to him this morning another visit might be in order :(....We have been managing it the same way as QMC mentioned that she does with Quincy, minus the metamucil (apparently if the stool is compacted then added fibre can worsen the situation).

If you are feeding kibble, I would advise you to cut it out entirely. Adding water to Panda's canned food is important, I mix Herbie's to a soup like consistancy, I know some cats don't like it so soupy, in which case I would administer water with a syringe.

At his last visit with the Vet, he suggested surgery, it isn't 100% successful but apparently has a high success rate. I'm not sure if I would go that route though.

Personally I would try to manage it with medication and diet, excercise is important too. Herbie's problem roars it's ugly head in winter only, he doesn't like to go outside in winter and doesn't like to use the litter box to defecate....sigh. If the snow is not too deep, I carry him to the back of the yard so he has no choice......We have been dealing with this for 5 years now :yell:

quincymycat
February 5th, 2010, 11:16 AM
My Herbie has megacolon, his last bout with the Vet visits finished 3 weeks ago...listening to him this morning another visit might be in order :(....We have been managing it the same way as QMC mentioned that she does with Quincy, minus the metamucil (apparently if the stool is compacted then added fibre can worsen the situation).

l:

Chris is absolutely right about the adding of fibre to a cat's diet that has not had his colon completely evacuated prior to starting the regimine. You can kind of imagine shoving more clay into a tube already clogged with clay. It's got no where to go but to stretch the tube and get larger and more stubborn. Here is born mega colon!
I mix Quincy's morning meal to the consistansy of soupy food with the addition of a lot of water. I am just lucky he will eat the entire dish as long as his WELL TRAINED MOTHER stands there and feeds it to him from a spoon!

I definately opt for the medical route if at all possible It is more time consuming for you, but the quality of life for the kitty IMO is much better when he is able to do what nature tells him on his own - even if on his own means a few additives to keep things moving!:D

beckiandthetrio
February 5th, 2010, 12:22 PM
Thanks for replies both of you. I got a call from the vet about an hour ago and the evaction was unsucessful she said it was like bobbing for apples but in the dark. Anyhow, I dont really have any other options now. She is gonna send me home with enemas to give him twice daily for the next 5 days or so. If this doesn't work then my only option is to put him down:( Im hoping and praying that the enemas will soften up the stool enough so he can go!!!

Surgery is not an option, I dont have the money for it.

Thanks for your thoughts,

Becki

sugarcatmom
February 5th, 2010, 01:25 PM
Surgery is not an option, I dont have the money for it.


:fingerscr that the enemas do their job!!! :grouphug:
Otherwise, there are financial organizations that may be able to help with the surgery costs. Here are some links:
http://www.imom.org/fa/others.htm
http://www.uan.org/index.cfm?navId=163#National_Organizations_with_As sistance_Programs
http://www.aahahelpingpets.org/index.html

Chris21711
February 5th, 2010, 02:49 PM
Becki, I am sorry to hear that things are not going as hoped for at the Vet's....I find it kind of odd that the Vet is not continuing to try. Prior to Herbie's last visit to the Vet which was three weeks ago, a week before that he was there for 3 days (2 nights), the Vet kept on extracting bit by bit until the colon was empty.

I don't want to knock your Vet but maybe another more experienced Vet could be an option.

Case in point: Until recently (a little over 2 months) I had gone to the same Vet for 15 years and she had seen Herbie several times for the same problem, I am much happier with the way this new Vet handled the situation, the overall way in which he examined him prior to any manipulation was far more experienced than the old Vet.

I :pray: that Panda will get over this episode.....Chris

beckiandthetrio
February 5th, 2010, 03:38 PM
thanks sooo much for the links SCM!!! I printed out the app for IMOM.org and I think we qualify if there is money to be had. I will be bringing the form into my vets today and have her fill it out.

I will update you all when I know more.

Chris, thanks for advice too. I wish to God that I could get a 2nd opinion but I have no money left for that. My vet even told me that I should do that if it was an option. She said his colon is sooo diseased she was afraid of perforation of the bowel.

Im hoping the home enemas work but in the mean time Im going to try like hell to find some way to get him this surgery!!!

Thanks again,
Becki

quincymycat
February 5th, 2010, 03:43 PM
Becki, I am sorry to hear that things are not going as hoped for at the Vet's....I find it kind of odd that the Vet is not continuing to try. Prior to Herbie's last visit to the Vet which was three weeks ago, a week before that he was there for 3 days (2 nights), the Vet kept on extracting bit by bit until the colon was empty.

I don't want to knock your Vet but maybe another more experienced Vet could be an option.

Case in point: Until recently (a little over 2 months) I had gone to the same Vet for 15 years and she had seen Herbie several times for the same problem, I am much happier with the way this new Vet handled the situation, the overall way in which he examined him prior to any manipulation was far more experienced than the old Vet.

I :pray: that Panda will get over this episode.....Chris

I think I am going the same thought train as Chris here. My vet is like "a dog with a bone" - absolutey NO pun intended - when she sets out to get the job done. I wonder why she would expect a series of enemas, particulary the relatively small and less powerful isotonic versions she has likely sent home with you that did not produce results in the past to work now, when a manual evacuation was not working for her. You would think that she would attempt to break up the mass and extract bit by bit.
I strongly second that you should see another vet, hopefully one that a friend or family member has been happy with and at least see what they say. Euthanasia cannot be be corrected by a second opinion made too late.
:goodvibes: for Panda.

beckiandthetrio
February 6th, 2010, 01:29 PM
I strongly second that you should see another vet, hopefully one that a friend or family member has been happy with and at least see what they say. Euthanasia cannot be be corrected by a second opinion made too late.

I agree with this to a point but alittle harsh should we say. I realize euthanasia can't be corrected but thanks for reminding me.

My baby is now at home on once daily DSS enemas and cisapride and lactulose. I hoping this will work but in the meantime Im persuing every avenue I can so I know I did the most I could to save my Panda.

Becki

Love4himies
February 6th, 2010, 04:36 PM
Sorry to hear about your Panda :grouphug:.

Nobody has mentioned diet, just wonder if you have considered a raw, low bone content diet?

beckiandthetrio
February 6th, 2010, 05:27 PM
I have thought about diet, considering raw but we are kind of at an emergent state right now and the last thing I have time for is finding supplies to make my own raw meat. I work full time and I live alone so Im trying to focus all of my energy on finding an option for Panda.

I think though in the future I will switch to raw even if Panda does not come out of this ok. I think it will be better for my other 2 cats.

Thanks for well wishes. Im surprised he doesn't hate me for all Ive been putting him through!!!

becki

Love4himies
February 6th, 2010, 05:35 PM
You only need to visit the grocery store for chicken and liver/chicken hearts and livers.

Feeding a raw diet, low in bone may be an option for your cat.

Khari
February 7th, 2010, 08:19 AM
Sorry you are going through this with your baby!

First - If you can I would get a second opinion. Look for a vet that is well versed in megacolon. If you can't do this then have your vet call:

North Carolina State University
School of Veterinary Medicine
Internal Medicine Veterinarian
4700 Hillsborough Street
Raliegh, NC 27606

Phone # 919-513-6670 or 919-513-6786
Fax# 919-513-6713

"Ask for the vet that specializes in megacolon"

Also - here is a link for assistance
http://www.humanesociety.org/animals/resources/tips/trouble_affording_pet.html#Assistance_by_state

Second - Please join the group on yahoo - "Feline Megacolon" http://groups.yahoo.com/group/Feline_Megacolon/ Lots of people going through or have gone through what you are going through with your kitty - including myself.

Third - How much of the Cisapride and Miralax are you dosing? How many times a day?

What do you feed your cat? You will find on the feline megacolon group that many megacolon cats do badly on a high fibre diet. The fibre bulks up the stool and this makes it hard for them to pass b/c their muscles are not working properly as it is. You want the stool to be as small in diameter as possible to help with the passing of the stool. You would want to look for a grain free low fibre (MAX 1 to 1.5% Fibre content) canned food. The canned food also makes it easier to administer the miralax. Since Miralax is a tasteless/odourless powder you can add it into the cats food without them even noticing. Lactulose is sticky and sweet. Lactulose stopped working for my cat and administering it was hell. You will want to make sure your kitty is drinking alot of water. I add water to my cats food at each meal and have water bowls/glasses throughout the house. (my cat will not have anything to do with those soupy mixes so I have to make sure the food is still chunked and add the water around the food - she's picky!)

I went the raw diet route with my megacolon cat (because I believe raw is the best for our cats) but it made her problem worse. I tried adding fibre to the raw and not adding fibre and the problem still persisted. I've had the best results on a low fibre canned food. Even as much as 3% fibre content made her stools big. That's why I opt for the 1 to 1.5% max fibre content.

Love4himies
February 7th, 2010, 08:38 AM
Khari: a raw diet with too much bone can cause a cat to become constipated. The idea of a raw diet with a decrease in bone is that there is very little waste produced from a raw diet. This is very important, as you stated, because the muscles are not working properly. The more waste, the quicker the cat will become blocked.

Khari
February 7th, 2010, 08:57 AM
Love4himies: Trust me....I've been through all this - bone/no bone....fibre/no fibre....more liver/less liver....more fat/less fat....tried it all and it did not work for my megacolon cat...I worked through this closely with a animal nutritionist that advocates raw feeding. Finally she said do what works best for your kittie!!!

beckiandthetrio
February 9th, 2010, 10:34 AM
Just stopped in for a quick update. Panda is doing better. He started pooping again on Sunday night. Although he isn't outta the woods yet im cautiously optimistic and yes i did a "happy poop dance" this morning!!

Becki and the trio

Chris21711
February 9th, 2010, 10:40 AM
Happy to hear that Becki :thumbs up....Are you giving him lactulose and cisipride?...the lactulose is very cheap at the drug store, it really does help in softening the stool.

Love4himies
February 9th, 2010, 10:50 AM
Love4himies: Trust me....I've been through all this - bone/no bone....fibre/no fibre....more liver/less liver....more fat/less fat....tried it all and it did not work for my megacolon cat...I worked through this closely with a animal nutritionist that advocates raw feeding. Finally she said do what works best for your kittie!!!

But it doesn't mean it won't work for her kitty.

The problem with this disease is that is may be caused from the muscles in the colon no longer contracting to move the digest along, meaning that NO diet will change that and meds are required to stimulate the muscles or even surgery.

However, the lowest residual diet is one that the animal will use up most of the food that is ingested. If an animal is eating a bunch of junk fillers that just passes through the intestines then the cat will get blocked much faster than one who is being fed a diet that is being used up.

I have gone through junky kibble diets, to "healthy" kibble diets, to healthy canned diets to raw diets and have seen the difference in the feces produced by each diet in my cats and a raw diet produces the least amount of feces. Huge difference between a kibble and raw diet.:eek: Jasper's feces are about half of what they were when I first got him.


Another thing I thought of was exercise. There are many blood vessels that are linked to the colon and the increase in blood flow due to exercise can help the movement of bowels too.

beckiandthetrio
February 10th, 2010, 01:39 PM
Thanks Love4himies!!! Im still giving the meds and he is hanging in there. The enemas are going better too. he is getting mostly canned food right now. I do want to switch to the raw diet but I need to get the supplies first ie: meat grinder. Also Ive been trying to get him to do more exercise also to increase blood flow!!!!

Becki and the trio

Chris21711
February 10th, 2010, 01:44 PM
Good to hear that Panda is doing ok Becki :thumbs up.....I know what you are going through.

Khari
February 11th, 2010, 07:52 AM
[QUOTE=Love4himies;882542]I have gone through junky kibble diets, to "healthy" kibble diets, to healthy canned diets to raw diets and have seen the difference in the feces produced by each diet in my cats and a raw diet produces the least amount of feces. Huge difference between a kibble and raw diet.:eek: Jasper's feces are about half of what they were when I first got him.

I know it all sounds nice and easy and I believe a raw diet is best for our kitties in every aspect as well. But have you gone through a megacolon cat and a raw diet? Believe me - I pray you don't have to go through megacolon with any of your kitties but if you do you might understand the difference from a normal colon cat eating raw and a megacolon cat eating a raw diet. It would be interesting to hear from people that have megacolon cats that feed strictly a raw diet to them.

Another thing I thought of was exercise. There are many blood vessels that are linked to the colon and the increase in blood flow due to exercise can help the movement of bowels too

This too is what all the vets say but it too has not made a difference for Lexus unfortunately. That's what we started out trying on Lexus in the beginning. But it is worth a try for every cat. I find many vets are not versed in megacolon and treat it like less severe constipation. And the exercise route may work for that.

You could try the high fibre because yes it could work for your kitty - every kitty is different.....just giving suggestions that I know is a life saviour for many other megacolon cats....good luck!