Best Laxative with less side effects

My 14 year old cat has just been diagnosed with severe constipation. After emergency room enemas and subQ fluids, the vet recommended daily dose of Miralax 1/4 tsp twice/day. Since he was cleaned out, it took 3 days for new stools. He also has had 8-10 years of irritable bowel which I've treated successfully with grain-free, canned "cool" meats with added water (won't drink water separately from a bowl). Within a week he became stopped up again. I managed to get him to a new vet who also gave him an enema, and recommended Miralax supplemented by Lactulose. The Lactulose seems to be helping, but he's acting very uncomfortable, whining if I touch his tummy. I'm assuming gas and possible cramping. The vet assured me that this is uncommon with this product, but I'm not convinced particularly with his IBS. Online info about Lactulose for cats indicates that these are common side-effects, but that the cat will eventually adjust. Again, they are not allowing for his IBS condition. I read in this forum that one member recommended Prednisolone to soothe the inflammation in the GI tract. This steroid can have some serious side effects which would seem counterproductive to his constipation (increased thirst and urination, as example). So, my quandary is how to manage the constipation effectively without the uncomfortable or potentially harmful side effects. Any advice please?

 

How much miralax and how much lactulose are you giving? I don't know about giving them together.

Normal lactulose is 3 ml a day. Some get gassy some don't, can have cramps.

I was using miralax and pumpkin. It stopped having results. I use lactulose now but I started with 2 ml every other day. Olive is now pooping daily. She also gets subq fluids.

Make sure he is getting enough fluids.

 

My vet prescribed both Miralax and Lactulose, with varying dosage depending on the outcome of BM. I was advised that Lactulose is stronger and works faster than Miralax, but I'm witnessing what I believe is gas and bloating with the Lactulose, so I'm backing off the dosage (at this point, 1 mil 2x/day) to only 1 mil 1x/day and increasing the Miralax (1/2 tsp, 2-3x/day). The longer space of time between BMs however assure that he'll get constipated again. I mentioned previously that he doesn't drink water separately from his food, so hydration is a problem. I will be discussing regular SubQ fluid treatments with my vet. I have discovered that he is attracted to tuna water, although I don't like to feed him any fish because it's not recommended for cats with IBS. I'm currently experiencing longer periods between BMs than I would prefer (anywhere between 19-32 hours). My vet prescribed a 5-day round of Cisapride for motility because of his lax anal contraction, although it's not recommended for long term. I understand that this has been taken off the market in the UK because of cardiac issues and it's not recommended for cats that have elevated liver enzymes. So, back to my original question: I'd like to find a laxative that's gentle but effective (and not a hairball remedy!). I guess finding a "safe" contraction stimulant in addition to a stool softener would be ideal. thanks for your help!

 

I'm still learning about this with one of my cyvies since I had to start giving her phosphorus binder, so far I can't say is working perfectly but the best results I've gotten so far are giving her Miralax and SEB (slippery elm barck) but I'm still adjusting

 

Civie Erik has IBS-C. I add 1/4 tsp of miralax to his canned food twice a day. He also gets a probiotic (Advita) sprinkled on his food. He does drink enough water.

To get your cat to drink more water, try a fountain. Cats sometimes drink more when the water is moving. And some cats don’t like the taste of “city” water, so try purified water.

 

I AM giving my cat a probiotic (FortaFlora) with each meal now because of his enemas. I'll probably continue it for good measure. I have tried a fountain and neither of my cats are attracted to it. I've had some success with tuna water, so will add that once/twice a day as supplement. I am also going to start giving him periodic SubQ fluids myself. The last time at the vet was very traumatic for him (large needle and bleeding at the injection site). I will continue the miralax twice a day and probably Lactulose (.5 mil) once a day until I'm sure that he's regular. Thanks for the feedback!

 

Dre takes this for native remedies (whole capsule)
https://www.nativeremedies.com/natural-moves-remedy-to-help-maintain-regularity.html

he is a big boy 20 pounds 1 capsule every day-- and 2 mon wed and Friday but he is big some get the runs with too much
no side effects

also gets sq every day

 

Could you tell me more about the Sub-Q fluids? Is there a YouTube video or shall I just ask my vet tech to show me how? Also I understand the choice of needle is very important. What type do you use and where do you purchase them?

 

Hi
I am pretty sure there is a video on this forum

Hi,
I am pretty sure there is a video on this forum as well as you tube. I personally may do them differently but my boys are very laid back and don't fight me at all. I hang the bag as high as possible usually behind a door or a hinge and I sit on the floor with them (the higher it is the faster it runs)
I use terumo needles and they are awesome. I personally like the 19 gauge by 1 inch, they seem to be much less of a poke than the monoject I used to use. I also make sure they are warm by laying them on the heat vents during the day.

I give them in the scruff changing sides and in the middle. When giving 100 it takes about 3 minutes if you get the right flow.
I get my needles and plenty of stuff from. http://www.calvetsupply.com
If they do not have the gauge you want just ask them and they can probably get them.
I have been giving Rico who will be 21 this summer SQ since he was 11 and Dre only since about 16 and he will be 20
Their labs show kidney values in normal range because of the SQ (high end but still in range)

Many have different views on SQ but if there is no heart issue I personally think the sooner the better when the CKD starts. Remember it doesn't even show up until 75% of the function is gone.
If there is any suspicion of a heart problem or if on a steroid take caution with SQ- I was unable to give them to Rico for a while due to steroid/heart issue but he recovered and get the SQ again.

 

FYI you will not need a script from cal vet for needles.

 

Wow. You've Really Got A system down that seems to work. Hats off to you. Thanks so much for all the detailed information. I'll look into it right away and discuss with my vet to make sure I'm giving him the correct quantity and in the right frequency.

 

I was instructed to buy laxatone but it looks to me it is a hairball remedy and I want a gentle laxative.
Any suggestions? I don't want to give him any grain or sugar.
I vasoline an alternative?

 

Most hairball remedies are petroleum jelly with added flavors. You could try straight petroleum jelly. Vasaline is a brand name. Just look at the ingredient list to make sure it's just PJ.

I recommend starting a new thread and asking for advice. You might want to provide more info about your kitty and what meds they are one.. I see you have no signature.

 

This is a great reference: https://felinecrf.org/subcutaneous_fluids.htm both for supplies and technique. I needed a script for the needles and for the fluids themselves but not for the line set. Normally you give 100mL at a time, but concurrent health issues will dictate volume and frequency.

Personally, for our 18 year old (non-diabetic) we use:
Terumo UTW (Ultra Thin Wall) needles but we use one inch 21 gauge, which is a smaller needle than the 19 gauge that @jayla-n-Drevon uses, but note that it takes about 6 minutes. HOWEVER, my Miss Sugar is ridiculously calm, purring and falling asleep through it, so the speed is not an issue and I decided to reward her with a smaller needle. In our other cats I have used 19 gauge just to get it over with. 19g is pretty common. Some vets use even larger needles than that, but they look like HARPOONS and actually freak me out. I would only use anything larger than 19g (smaller gauge == bigger needle) in a cat that I just couldn't handle for very long. So choose accordingly. Here are ours, and with shipping Vet RX Direct was the cheapest when I got them last: https://www.vetrxdirect.com/product/view/terumo-needle-for-cats-and-dogs-rx/variation-11842

Line Sets (the tubing that goes between the bag and the needle, aka Giving Sets, IV Sets, DIrect Line Sets): These were cheapest last time: https://www.calvetsupply.com/IV-Administration-Set--Macro-Drip--1-set_p_1289.html

Lactated Ringers Solution, 1 case (12 bags with 1000mL each): The cheapest was found locally at a Walgreens with the GoodRX discount card for $28 per case. SCORE! Way way way cheaper than any I found online. I almost kissed the pharmacist. Note that I did have to deal with 3 bozos at other Walgreens and CVS drug stores in town before I found a pharmacist willing to put in the work to be able to get them, because it is apparently not something that they usually order. But he had done it for another cat, and was more than happy to do it.

Prior to me finding all of this, my vet was charging $35-40 for "fluid therapy at home", which is one bag, one line set, and 10 needles. That would not have been an option for us, because we are giving her 100mL usually every 24 hours, but sometimes 48, so that would only last us about a week and a half. Not affordable at all.

Good luck!

 

I use the 19g for Ollie. She is getting better at sitting long enough for fluids. She is supposed to get no more than 100 ml twice a week. Per cardiologist. So I only buy the 500ml bags from vet as no pharmacy near me sell them.

I also use these lines so I can give exact amount since she has hcm and I need to be careful with her fluids. I give 75 ml each time. Vet said I could use the line 4 times before changing. Of course new needle each time. Ollie has tough skin and just got the location down where it's easy and she doesn't mind to much.

https://www.shopmedvet.com/product/i-v-burette-set/iv-administration

 

WOW that is really cheap! I'm lazy and prefer to not have to talk to people, so I have been getting fluids from my vet. Since there is no shipping or tax, I didn't think $50 for 3 x 1 liter bags plus one line and 15 needles was horrendously overpriced. But it just went up to $60, so now I should consider Costco. Getting the vet to provide a prescription, though, is where they really are terrible. I tried to purchase the Advantage that required a prescription and it took forever for my vet to respond. I was not happy. And you have to go through this each time. I think you can purchase the line and needles without a prescription, but not the LRS. I need to stop at the Costco pharmacy when the store is empty and ask their prices.