Constipation - Miralax vs Lactulose?

Making a separate post for this - but when I told the vet office (tech) I bought Fena Miralax, according to the tech the vet said "she hadn't heard that it helped that much at all".

I ended up walking away from the vets with another bottle of Lactulose thinking it wouldn't hurt to have a backup plan but now I'm kinda stumped...

Which should I give Fena?

She's never had Miralax before, but the 1st bottle of Lactulose she had it's super hard to say if it helped since SO much happened in a short period.

Aug25th she was severely backed up so they did a manual evac then enema and fluids and started her on Lactulose that same night. Aug27th they sent her home with the bottle (2cc 2x daily) but by the 31st she STILL hadn't pooped so we went back to the vet for another manual evac and enema plus fluids.

On that x-ray the vet said it looked like she'd gotten all the hard stool out and only the soft stuff was left and sure enough 3 days later, she was pooping! Formed but nice and soft, was going a good amount each time, etc. She finished that bottle Sept8.

But then on Sept13th the "straining" started again - she'd pass a few small pieces, firm when I'd "squish" them right after scooping them into a bag and it would take her multiple tries to get even THAT out.

So between Aug25th and Sept3rd (1st time she pooped regular) she'd been on canned food with water added to it, had the evacs and enemas and subQ fluids and Lactulose to boot so did the LACTULOSE really help or..?

Granted she only got off kibble 100% on the 13th, which is when it "started" again - could the kibble have slowly started to back her up again?

And not long ago (starting at 5pm or 1.5 hours ago) she started straining MULTIPLE times in the box, nothing until about 5:50 when she got out 1 small piece but she kept immediately collapsing by the box, then trying again. At 5:55 she got out a 1.5" piece and a 1/2" piece - yey!

Then as I was doing the "litter stick/squish test" (wet on outside/very firm) BOOM - she threw up ALL OVER the place, lost all of her food she'd eaten! Before I could even grab paper towels the poor thing tried licking it all back up - I shooed her away and she finished her bowl instead while I cleaned up.

Since then she's been roaming around, laying down, getting back up, her tail is swishing like she's agitated but it's been doing that since I got her home. Just now she rubbed all over my legs, weaved around under my chair and is now laying down beside me, seemingly calm.

It's the first time she's thrown up since the Aug25th vet visit, no hair in it either. Could she have been "bearing down" so much that it triggered her stomach?

Ugh so now I don't know.. Lactulose or Miralax? I've read about pumpkin but forgot to buy a can when I was at Walmart, grr.

 

I’ve used both and they both seemed to work. The miralax was easier because I just mixed it in his food with added water whereas the lactulose had to be syringed and he hated it! As for pumpkin, it adds fiber and can help, but since it bulks up the stool it’s not always the best choice. Here’s some great info on constipation
http://felineconstipation.org/

 

Thank you SO much, I was so sure I had that link bookmarked but it's not there and I couldn't for the life of me remember it. I searched for "constipation in cats" and just the first search page had my eyes crossing and me wondering how long it would take to go through, LOL. Bookmarked now!

Yeah that's what I liked when I read about the Miralax initially - I hope she won't be able to tell even though it's supposed to be "invisible". Fena tolerated the Lactulose for awhile but one day it was like she'd had enough, so she started growling at me - then growling plus paw-swatting, then both of those plus trying to run away every 2 seconds. Towards the end some days were great, others were like I was wrangling a badger. She didn't try to hurt me though, just expressing her dislike.

Do you know off hand if one works a bit quicker than the other..?

I don't think her stool needs anymore bulk, it's a pretty good size as is so I'll keep that in mind. Thanks again!

 

Bama has had problems over the past 3 months with hairballs and constipation since converting to only wet food. I think the wet food is a contributing factor because it is much lower in fiber than kibble. He gets extra water with his meals because that's one of the ways I use to get him to finish all the wet. I've been adding pumpkin along with some probiotics [Renew Life Ultimate Flora] and have started feeding him some hardboiled egg yolk about twice a week. Problem is he goes from straining and only producing a little on some days to having very soft stools a few days later. I'm only feeding him 1/2 a yolk once every 3 to 4 days and I skip the pumpkin on his egg yolk days. His soft stools seem to be coming on his egg yolk days. Maybe if I cut back to 1/4 a yolk every 3 to 4 days. I'm also considering adding Dr. Elsey's Clean Protein dry. The company sent me a couple samples last week and Bama loves it.

 

Good to know! I’ve heard about the egg yolk, but haven’t tried it.
@Candy&Company I didn’t notice which worked faster. I went from lactulose to miralax when my cat started acting like yours does! I kept him on a minimum daily dose (1/8tsp) and increased when he had any straining (1/8 BID up to 1/4 tsp BID)

 

I've had great success with Miralax. Leo has had to go to the vet a couple of times for constipation and they recommended Miralax. I've been giving him some in his food every day for the past couple of years and haven't had problems since.

 

Oh bless, with my dogs - I'm so behind the times, the vast majority of my life I've only had dogs, exposure to cats was only through people I knew who had them, until I got these rascals. It's been nothing but intuition and tons of reading/googling! But pumpkin adds bulk (this I knew in dogs but only recently for cats too thanks to another poster here), so if Bama's stools are soft they're not forming so to speak - so what I would try, and what I had to do with our dog Missy (female spayed Doberman back in 1996 according to records) was do the pumpkin AND the yolk, the same day but different ratios to try and balance them out - you might not see results THAT day but definitely in the next 1-2 days, depending.

Granted Missy was a dog, but if I've converted right.. 1/2 egg yolk morning with 1/8 pumpkin then that night, another 1/8 pumpkin. Should see results, more reliably, the NEXT day. So if you do that on Monday for example, look for better results between Monday night (when you sleep) and about 6 - 10am next day (Tuesday morning).

If it's too firm, do just 1/8 with the 1/2 yolk in the morning and skip the pumpkin night, or vise versa depending on when you're most awake/active. Missy was 65lbs, so she got 1 whole yolk 2 times a week but with cats, I'd stick with the 1/2 twice a week until you can get a better feel for how it's going.

In the case of hairballs, my male neutered Irish Setter Laddy (litter mate to Shelley) HE had hairballs! I used 1 tablespoon extra virgin olive oil a day on his food (until it passed, usually within 9-13 hours per his records) but for cats it would be different. If you can get some good fish oil capsules (not sure which kind or brand) you can prick/squirt one of those on/in his food 1-2 times daily depending on the dose per capsule. Usually it's low and 1 (or 1/2) per day until results. Tasty plus lubricating!

Just NOT/NEVER cod liver oil. I know the type of fish otherwise matters too, due to mercury, etc.

 

Oh bless Sharon thank you!! It's so tempting for me to say, "Well my baby needs help NOW" and want to give too much - but I'd read about starting 1/8 maybe 2x daily and if nothing in a few days up it just a tiny bit more to 1/4th morning and night so 1/2 teaspoon daily. I think that's right..?

**EDIT - PS - is that your home garden, because just the small slice of it looks gorgeous!

 

Hi again Leo's parent! Good to hear he's doing good on it, I'll be switching to Miralax probably Thursday morning, giving the Lactulose a 2day chance to "kick start" things then saving the rest of the Lactulose for as needed - Fena is not a syringe-meds cat. She growled at me tonight, which she hasn't done in DAYS so it hurt my feelings even though that's really stupid. I think it might be my technique, not sure.

 

It's so much easier with Miralax. My cat hated the lactulose. It was sticky and syrupy and got stuck on his fur when he spit it out. Miralax worked like a charm with my IBD cat who was constantly constipated. I gave it to him in his food 2-3 times a week.

 

Hi Lillie! Yeah Fena inevitably loses a little of it too - but I keep a wet/damp paper towel handy so after I give it to her in 2 tries (2ccs split when syringing) I can wipe up her mouth, chin, chest, legs, paws, etc. Usually she likes this but tonight... not so much. Saves her from being sticky at least? Will def. be switching to Miralax!!

 

It's supposed to be mixed with water or watery wet food but I actually sprinkled it over a previous kitty's dry food and it worked!

 

I'm guessing you mean the Miralax? Yeah mines a fine powder formula, haven't used it yet but will - definitely sound less sticky than Lactulose. I even bought a "keyring" of measuring spoons since I couldn't remember if we had them all at home or where they were - the next day I found them in an empty peanut butter jar, just as clean and complete as ever. Figures. There goes $2+!

 

Yes- Miralax.

 

Awesome, thank you! Looking forward to seeing your baby's pic and how well they're doing!! Or is that bad? I never know, if I was awkward I apologize.

 

I would love to put up a photo of my Leo but my IMac computer is dying of old age and with vet expenses coming up (aren't they always? sigh) I'm not sure when I will be able to get a new one.

 

Ah, gotcha no worries! Can you describe for us? Sorry, am shameless in loving furry/fuzzy things.

 

I've had much better luck with Lactulose, just add it to his food 2x/day

 

Candy & Company- My Leo is a large frame long haired Turkish Van. He used to weigh 20 lbs but got him down to 15. Tan/ginger V mark on head, and tail is also tan/ginger. Rest of him is all white.
He is a big baby and I've never heard him growl or hiss even when the neighbors cat would come in and eat his food.

 

I haven't tried adding to food yet - it's soooo sticky and sweet smelling even to me I have no doubt Fena will pick it up in her food. But the last 2 times I gave it to her, she was an agel - sometimes it goes amazing, other times... no. But I can tell it's working! This morning she got out a 1.5" piece and then 2 one-inch pieces, all soft when I "bag squished" them. Tomorrow morning I'll be stopping the Lactulose and starting the Miralax, since the Lactulose has done it's job in kick starting her again. Fingers crossed!!

 

Oh he sounds GORGEOUS... hopefully we can have a picture in the future, I love pics! Turkish Van's are so fun too, least in my experience with friends' pets! Give him lots of cuddles and kissies from me, love on him a lot!!

 

Does anyone know if lactulose affect the blood glucose? My cat has kidney disease and he’s often constipated. He’s in remission so I’m worried if lactulose will affect it.

 

it's a synthetic sugar but not sure how or if it effects glucose levels in the body.

 

Lactulose does NOT affect the blood glucose. The sugars in it are not digestable. I stayed away from it for a long time until I learned one of it's side effects is to help clear ammonia out of the brain with kidney failure kitties. I started using it with Dakota expecting to see numbers rise - I was shocked when they did not. After researching further, I learned they aren't absorbed by the body.

 

Note that lactulose syrup/solution does contain some digestible sugars that can affect BG
"Lactulose is a synthetic disaccharide in solution form for oral or rectal administration. Each 15 mL of Lactulose Solution USP contains 10 g lactulose (and less than 1.6 g galactose, less than 1.2 g lactose, and 0.1 g or less of fructose). "
https://www.rxlist.com/lactulose-solution-drug.htm#description

 

Thank god, I was shocked in another search to read a lot of people stayed away from Lactulose due to diabetes because it has sugar - my vet, which I got off the phone with an hour ago, wants NO part of Miralax, etc. Only wants to push Lactulose and Digestive Health Royal Canin RX food. Needless to say I'm discouraged, upset and DON'T agree. My baby got jump started PM Aug 17th with Lactulose 2ccs, and had it for another 4 days - 18 cc total before switching to 1/8 Miralax 2x daily. Tonight at 8pm will make day 3 of Miralax.

What prompted my call was to reschedule Fena's 2nd curve, since my car isn't anywhere near ready - it's now Oct 1st, plus I asked about her constipation, she's been going a little each day - 1" pieces mostly but this morning one was soft but firm, the other broke in half easily using mild pressure when I squished. The outer millimeters were soft (and easily coated in litter) but the break was due to slightly crumbly/dry stool in the interior - never saw anything like it, so I called the vet.

They were NOT happy with the Miralax and NOT happy I'd started testing - as scant as it is thus far. I don't know whether to be angry, disappointed or what. And if they asked once they asked a million times about "when I can get her in" - like they didn't believe my car was broke and in the shop and they hadn't gotten to her yet! Why in the sam hell would I lie about that?

Ugh. Tonight I'll do the other 1/8th teaspoon then in the morning I'll switch her to 1/4 in the morning and night, and watch, closely. It'll have been 3 full days of 1/8 2x and while it's "working" it's not REALLY doing its job so I'll try and see.

 

Years ago when I had a severely constipated cat who had intestinal lymphoma her GP vet was appalled I was giving her Miralax instead of Lactulose. I contacted some specialty hospitals who said they were fine with it. She was fine on the Miralax for two years- no problems, and it gave her a good poop every day. I don't know what the problem is with some vets who think lactulose is the ONLY thing to use. ??
I'm sure it depends on which one does the best job for your cat, and if Miralax works- what's the problem with using it?
Has your cat had any ultra sounds to check the condition of her intestines? X-rays don't always show everything.
Also- my previous cat would strain so hard to defecate she would throw up and fall over! The regular vet kept giving her enemas until I started the Miralax and then had her diagnosed with IBD from a specialist.
It all gets so very stressful.

 

Amen on the stressful part.

She's only had x-rays, she did have 1 "partial" ultrasound - the vet did it for her own curiosity and didn't charge me since she said it lasted a few seconds only back on the 25th or 26th of August. She checked because she thought she felt a "shadow", a mass, but when she did the check apparently it was nothing to worry about, but I haven't forgotten what it might have been. That's the last I heard of it, honestly - no clue if it was real, or really a shadow etc.

She's had 2 manual clean outs, 2 enemas, 2 separate days of fluids, etc.

Tonight marks the 3rd day of 1/8 Miralax and it's.. well she's pooping but 1" pieces at a time and still straining a bit. Tomorrow I'm starting 1/4, 2X daily.

No matter how careful I am she chokes on the Lactulose, so I'll save that for "omg holy ****" time. NO pun intended. I don't want her tummy upset from choking, or her throwing up, etc. especially since she has pancreatitis and the vet doesn't seem willing or able to track it.

 

Maybe it's time for a new vet? My stress level is through the roof right now. Leo is in the hospital again. Heart problems, and he's in the oxygen cage. As if he didn't have enough things wrong to begin with.
It never ends. Good luck with the pooping! I've monitored litter box poop issues for so long now it seems normal .

 

Ooh god, I hope not.. this one works in a hospital, so whatever my babies need, it's THERE. There a scant few other places.. none hospitals... god I dunno, sigh. I said it once, I'll say it again - Ill be driving Fena's diabetes, with help of this site.. but the rest, her brother Mao... yeah. *shakes head* I don't... I don't know.

Wait and see I guess... my eyes are open, senses too, so we'll see.

Thanks though, and good luck to you too and your baby(ies), god bless Leo - course you know we WILL be married.. *winks* The chamber is just a good excuse. I love him! His whiskers, his little cute mouth, his twitchy little ears and squirrely feet.

He's fixing to run away with someone, granted I have no family - a poor relation, but he could hie off with anyone! He's dashing and fun, charismatic, tender and loving. Oh no, I think he'll abscond with a woman who steals his furry little heart - and Mamma, you might be powerless to stop that love. Your boy is a lady's man, and he means business despite his diabetes.

*whispers* I think he's playing us, and he'll run off with some femme fatale - Siamese probably, or maybe Persian - someone.. fancy. Oh yes, he's got taste!

You MUST snuzzle him within an INCH of his life - snuzzle, snuggle cuddle, kiss, pet... it's hard being human and up against a stunning female kitty, but you can do it! You're his mamma.. oh yes, you can do it. Distract your boy, and love him till you're tired.

God love you and your Leo, forever and always. xxxx

 

My cat is on 2 ml of Lactulose. I mix it in with wet food and he seems to like it (usually, there are times he's finicky and won't eat it). He's had chronic (severe) constipation all of his life, since he was a kitten. He had Miralax and pumpkin. Pumpkin worked well for him, if I remember correctly, pre-Diabetes diagnosis. He's had the Lactulose for I belive about a year now. He's had to have 2 enemas over the last 2 years. He still strains a little but he's able to poop, whereas without the Lactulose he would strain for too long and have very hard poops. Lactulose I believe is working well for him, that said I am concerned about him being on it, what seems like indefinitely. Good luck! I hope you got the information that helped your kitty!

 

Oh bless! Yeah I started Fena on her new RX of Lactulose at 8pm EST on the 17th - then she got 2cc's 2x a day from Sept 18th - 21st.

During that time, she had:

18th = 2" fat piece (firm) + (7+) 1.5" and 1" firm pieces.
19th = 1" firm.
20th = 3" and 4+" softer.
21st = 1.5" and two 1" soft, formed.

---------lactulose stopped.

22 = nada, but did 1/8 teaspoon 2x at shot times.

23rd = lots of straining and nothing but did get 4 1" pieces, mostly firm 1/8 x2 daily Miralax).

24th = two 1" pieces, both formed and litter-stick good but one soft, the other broke (crumbly in middle) - 1/8 2x daily.

25th = 4" and 2" very soft, litter-stick good, well formed - 1/4th teaspoon 2x.

26th = nada, 1/8 tsp morning and 1/4 tsp. evening.

27th = 4" and 2" pieces good litter stick, soft squish but formed at 9:40am. Then 3:55pm 3", 2" and 1" pieces good litter stick abit firmer than before but still in the soft range. Got 1/4 Miralax in morning and 1/8 at night.

28th, today = a 4", 3" and 2" piece - good litter stick, soft (minimal pressure squeeze) and formed - 1/8 Miralax morning, tonight will be 1/4.

I used Lactulose to kick start her, then went to Miralax - started at 1/8, then moved to 1/4- she seems to be hovering in the "between" 1/8, 1/4th for optimal poop softness and formation so I'm still tweaking. But she's feeling SOOOOO much better!!

Since the 22nd when I started the Miralax, I've been adding 3 or 3.5 tablespoons water to her main meals - breakfast, lunch and dinner. Snacks, just 1 tablespoon (2x).

Overnight they (2 cats) get 1 5.5oz can of Friskies, split, with 1.5 tablespoons in each bowl, set out for them plus their big regular water bowl.

I don't know if starting the Lactulose helped the Miralax, or what.. but I'm still riding the wave, happy my baby is popping and saving the majority of the Lactulose for when I REALLY need it again to maybe jump start, etc. I can't call this a win, but I'm watching and hopeful.

I'm gonna keep her on 1/8 morning and 1/4th night now, and see how it does - not sure how "backed up" she still night be, but DON'T want the runs.