Outdoor cat with megacolon, advice needed

Discussion in 'Feline Health - (The Main Forum)' started by eightkitties, Jul 13, 2018.

  1. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    Hello! I have a predicament with one of my 8 outdoor (on a farm) cats and was looking for some advice.

    So one of our cats, Runty (neutered, vaccinated overweight 8 yo cat), was diagnosed with megacolon on May 7th 2018. We have never had any serious health issues with our cats, they have been typical outdoor cats until now just eating kibble and walking around etc. So it was a shock. It is amazing that we noticed that he had it at all since he is outside. Basically in early May we noticed that he was having difficulty going #2 (sitting in the yard trying to go for ages). We assumed it was worms since another cat had tapeworms. After all the cats had been treated for tapeworms though (a couple days later) he was still doing it. We tried giving him tuna in oil and olive oil to no avail. By May 7th he couldn't walk 20 feet in the yard without trying to go (by this time nothing was coming out #1 or 2). So we took him to the vet. The vet looked him over and after hearing that he couldn't go #1, said that it was extremely likely that he had urinary crystals (typical of neutered cats his age) and would need special food/medication for the rest of his life. She said that if he had this it would not be a one time thing and would need continuous care. We couldn't afford that and prepared to have him euthanized as he is an outdoor cat plus we couldn't monitor his litter box food etc as he is outside with 7 other cats. However we did say to at least confirm that was what it was and left him there. On the way home the vet called and said it was not urinary crystals and that he was constipated (so constipated he couldn't go anything). They kept him at the vet overnight and sedated and gave him an enema and x ray. We requested no medication. They had to sedate him because he is so fat the vet couldn't feel his colon. They said he responded well to the enema and had gone so much in the morning they had to give him a bath. They said that the stool was normal, there was just a LOT of it. When we came back in the morning to get him, the vet showed us the x ray and said he has megacolon. She said he would likely need medication but most cats with it end up being euthanized. She said that the fact that he responded so well to the enema (didn't need manual extraction) was a good sign though. We decided to take him home and if he relapsed we would have him euthanized. We got some wet food on the way home (we have never fed our cats wet food) thinking maybe that would help him. Right after we got home we saw him go #2 so we were hopeful. We started giving him 2 mini (half the size of regular) cans of wet cat food a day. This is in addition to the bowl of dry food all the cats eat from. I googled cat megacolon and did not have a good feeling, everything I read the cats were indoors and many had to be euthanized eventually or on expensive medication long term with side effects. Then I saw something that said Miralax was a cheap laxative that drew water into the colon and had no side effects. I thought, since we are already giving him wet food we could just add this to it. So I started giving it to him starting at 1/4 tsp. The next couple weeks were a disaster of me experimenting amounts of miralax, following him around the yard constantly to see if he goes, scares where he tried to go but didn't, and me thinking maybe it would be better to just put him down. Also trying to get him to drink more water which is hard since he is outside and water gets dirty fast.

    But by early June I had a system in place:
    In the morning I give him wet food mixed with a little water (oatmeal consistency) in a rabbit cage with a net over the door since the other cats steal his food. He has figured out how to leave the cage when he is done without letting them in. This took a while to train him.
    In the evening I carry him into the back yard and he goes #2 (I have been documenting he has been going almost every day for weeks). However I am not 100% sure when he is going as he is outdoors. He is a very playful cat though (loves chasing string)
    In the evening I give him 1/4 + 1/8 tsp Miralax in the broth from his food
    Then I give him his food mixed with water to a soup consistency
    Note that he rarely eats all his food (he just drinks the liquid out and leaves most of the meat) much to the delight of the other cats who all wait around the cage while he eats
    He is still eating dry food (this food: https://www.catchow.com/products/healthy-weight/ the rest of the time)
    Okay so here are my problems:
    I know that the dry food is junk, but I am scared to switch it because after researching online the high fiber may be helping with his constipation. It actually has higher fiber (6.5%) than this https://www.royalcanin.com/products...fiber-response-dry-cat-food-8.8-lb-bag/484288, which seems to be what a lot of people feed their megacolon cats for dry food.

    I also read that the "healthy weight" food is a trick, the high fiber actually makes them gain weight

    I read that at some point the miralax may stop working
    He is fat, and so is another one of the cats (10 yo Rusty who is 20 something pounds) but I have no way to diet them without the other cats eating their food or vice versa

    I know it seems strange that outdoor cats would be fat, but those two are SO lazy, you wouldn't believe.
    I do not provide income in my family and I know we could not afford any drastic, expensive measures with the cats. I did research better dry foods for them before he got megacolon but now I am unsure what to do. They all eat out of the same bowls so I'm afraid if I switch the food, then Runty might get stopped up again. But then again the food is unhealthy for the cats (makes them fat) so...?


    If anyone has any tips as to inexpensive ways to help with Runty's megacolon, they would be appreciated. Am I doing anything wrong with the miralax? Even thought they are outdoors I want to help them best I can.
     
  2. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Someone else here has a cat with megacolon. My memory isn't very good but when it comes to me I'll let you know.
    Once I reply to a thread I get an alert for any other replies so you're on my list. Sorry, that's all I have right now.
     
  3. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    I think Pig has megacolon, @LuvinThisPig is this so?
     
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  4. Mags920

    Mags920 Member

    Joined:
    May 18, 2018
    My vet suspects Houston has megacolon but euthanasia for this condition was never mentioned. The poor little pooper had 2 enemas while in the er for a hypoglycemic episode. He has pooped more than 1 foot 3x now - I thought 1 poop could have been a snake, lol. I was giving him 1/4 tsp MiraLAX daily when I remembered but per the er vet he gets it 2x daily. He has been pooping more but not every day. I can always tell when he's backing up, his belly gets hard & looks like a football. He is off dry because of his diabetes. I give him a small amount of food w/the MiraLAX to make sure he gets it all then give him the remainder of his food. I say continue with the MiraLAX 2x daily. Good luck, let me know how he's doing.
    Marianne
     
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  5. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    Yes. Pig a has megacolon and its a tricky thing to manage, but not impossible. They can even heal from this as Pig is case in point. We recently (7/6) had radiographs done and his colon was empty, despite constant feeding. It will be a bit trickier since yours will be outdoors, but I see no reason you should have to put him down over this.

    To begin, you are already doing a lot of things right. The MiraLax is a great place to start. However, I would up that dose a bit if he is still struggling. Not to the point of liquid poos, but with megacolon you do want looser stools. You can give up to a teaspoon in 24 hours safely, but I would spread that out. Also, the great thing about MiraLax is that its use as needed. So, you can play with that dose a bit.

    Secondly, fiber? Nope to that. Fiber may act as a laxative in normal cats, but it also acts as what we call a "bulk laxative". Meaning, that it bulks up the poo, which is exactly what you do NOT want in a megacolonic kitty. Stick to osmotic laxatives like MiraLax. I would also cut out ALL dry food if at all possible. Now, there are several laxative options you can look into and play with, but the go tos are MiraLax and Lactulose. Lactulose is fairly inexpensive and functions like MiraLax. You can use them together if you see the MiraLax looking potency, although I have never seen that happen. Miralax can be given daily and as often as needed.

    Now, I would personally recommend that you look into some prokinetic drugs as well. Cisapride is a great one that a lot use. It works to help the colon walls undulate, thus pass the stool. Another EXCELLENT kinetic is egg yolk. I use EZ Eggs from FoodFurLife, but you can just cook the yolk and mix it into food. There was a concern about phosphorus in the yolk, but in the amounts you will need it is not that large of a concern. I give between 1/4-1/2 tsp. BID. I am not sure on the dosing on just boiled yolk, but I imagine its just about the same. Egg yolk works by adding choline to the diet which works to stimulate the receptors in the colon walls. Plus, its great for hair balls!

    The more moisture you can add the better. I have also found it very helpful to feed in smaller amounts more often versus larger meals less often. This gives the digestive tract time to process the foods and is how a cat is biologically tuned to eat. Now, Pig has some serious digestive complications and some of the measures I go through are pretty extreme.. ECID. But, I also found it very helpful to blend all of Pig's food in a blender prior to feeding. Sort of like pre-digestion..

    Anything you can do to rebuild his gut back to its prior state is a good idea. So, probiotics and digestive enzymes are what we are learning about now. Although, with megacolon I would stress no fiber and softer stools. Some probiotics will firm the stools, such as S. Boulardi, so stray from that. We almost went down that road and I am glad I learned otherwise before doing so.

    This is just how I manage Pig. We have worked at home enemas before and well, that is a story all its own. I think you are doing great!! Megacolon is about as scary as diabetes... Its all about how much you know. If you need anything I am more than willing to help if I am able! Take heart! Its not impossible and you totally got this! It certainly does not warrant euthanasia... :bighug::bighug::bighug:

    P.s. I am on my phone so can't add links that easy. But, when I get to the computer I will edit to add them...
     
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  6. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    Thank you so much!
     
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  7. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    Since I will have to feed my other cats dry food (I can't afford to feed them all wet), what do you think of this food guys?: https://www.chewy.com/evolve-mainte...aign=f&utm_source=shopping.com&utm_medium=cpc

    It has 3% fiber (as opposed to their current food which has 6.5% fiber), and contains probiotics and dried egg! So if Runty does eat some (which he may have to eat at least some), wouldn't that be better?
     
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  8. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    I have never fed Evolve so I have no input on it. However, I do think the lower the fiber you can get the better. Of course, not all kitties are as sensitive to fibers as Pig is, but this is what they generally suggest for megacolonic kitties. The probiotics are good addition, but it looks to be only of the lactobacillus strand in the food and a cat's gut needs far more than just that. Although, it is a good starting point. It is unlikely that the probiotics that they add to this dry food are in the right count and potency that you will really need. Typically, it is recommended that kitties receive a human strength probiotic. Pig takes RenewLife Extra-Care, which is a 30 Billion CFU in several different stains. Here is a great article that explains everything about the importance of probiotics in our kitties guts..

    Another great option is Kefir. We are attempting to grow our own and @Bronx's dad also give kefir. Although, I think he buys his. Here is a read about that...

    It did not say whether the dried egg is the whole egg (which is most likely) or if it is just the yolk. RadCat adds egg yolk into their food, but I still give Pig his 1/4-1/2 teaspoon BID. While this little bag may seem expensive, in the grand scheme of things it is actually very cost effective. This is the EZ Egg I was talking about, with great read about how the yolk actually works.

    I think you will be fine as long as you are adding moisture and an osmotic laxative in the mix. I would maybe ask your vet about lactulose to combine with the MiraLax since he is outdoors and you need to know that he is getting what he needs. Lactulose is super cheap. I paid $16.00 for a pint of it and I only give about 1cc. And this was from a pharmacy that charged me $48 dollars for a week's worth of amoxicillin :eek:, so you know they are overpriced! But, moisture is your friend! Plus, if you are worried about whether he is pooping or now, you can always palpate his abdomen. Plus, most kitties will come off food when they are super backed up. My Tail will as I just learned to my dismay, but Pig will not. However, Pig is an acro and will eat anything as long as it is not pickled. :p
     
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  9. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    Thanks so much for the info. I saw him go today. :) I really want to go ahead and switch but I'm scared to. Right now he is eating a super high fiber dry food and going fine (with broth and miralax ). But from what I understand high fiber makes them worse over time? I just want to be sure before I switch. Reading the reviews of this: https://www.royalcanin.com/products...fiber-response-dry-cat-food-8.8-lb-bag/484288 makes me uneasy.

    Also: he is a crazy eater, the day we took him to the vet when he was clearly miserable/backed up he would still eat treats :confused:

    @LuvinThisPig
     
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  10. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    Oh my... Yes, this sounds like my Pig. When he was first dx with megacolon he had poo from stem to stern (literally) on the radiographs... But, he was still in the habit of eating half a can of wet food and then trying to polish off his brother's half as well.. So a whole 5oz in one sitting! :eek: Now he eats a total of 4-5 oz a day...

    Yes.. I would stress the less fiber the better. However, you also have to be comfortable with any moves you make on food, for sure. I can't access that link...? Maybe it is my internet. I am isolated and it acts wonky all the time.. :rolleyes:
     
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  11. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    I have a question for you guys. I will have to leave the house soon (from Wednesday afternoon to Thursday evening/night) and I don't know how I will give Runty his meds/food. Right now I am giving him wet food with added water 2x a day, with miralax added in the evening. He doesn't eat all the wet food though (the other cats eat it) just the broth, and eats some dry food (the kind I mentioned earlier, I still haven't switched to a better one). My problem is that since I will be gone I won't be able to give him the evening miralax/wet food or the next morning's wet food. The other cats are fine with dry food when we are gone, but I'm afraid Runty will pig out on dry food and get stopped up again if I leave. Right now I leave out almost no dry food at night but when I leave I will have to for the other cats since I won't be there the next morning to feed. Any ideas? Do you think he will be okay? I can't think of a solution other than starving everyone till I get back. I really don't want to board him at the vet since it stresses him out super bad and it just seems like one night would be okay....am I wrong? Could he get stopped up in that time?

    @LuvinThisPig
     
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  12. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    There were times before I fully understood exactly how to work Pig's megacolon that I probably made some ill choices.. And, really, ECID on that. But, I often felt bad that he was getting too much MiraLax so I would quit giving it for a day or so until I realized he needed it everyday, but maybe in smaller amounts. Nothing serious ever happened except he seemed a bit more uncomfortable.

    You can always increase his daily dose for Wednesday morning and Thursday night. As in, make up for lost time. MiraLax will not overdose him, per say, but it can cause excessive diarrhea if give too much and in that case dehydration is a concern. Of course, if you think he will be eating a lot more dry food the difference should balance out. Also, if you do not want to do it in a double dose you can feed Wednesday morning and then again just before you leave, then vice versa on Thursday. But, if you increase an osmotic laxative it is important to increase water intake as well considering that the laxative will draw fluid from the body into the colon.

    Another option is trying to get your hands on some lactulose. I would think your vet would be more than willing to prescribe it. The good thing about Lactulose is that in humans it can take up to 24 hours to reach the colon. Granted, this makes dosing a bit tricky, but the delayed reaction is nice in times like these. Now, you will need to consider that felines have one of the shortest digestive tract in the whole animal kingdom, so needless to say, the Lactulose will reach the colon a little sooner than 24. I will say this though, when I give it to Tail (he does not get daily laxatives so it is easy to judge onset times with him), I typically have to give a dose or two (1-1.5cc BID) before I see any action. Meaning, it still provides a delayed onset time. The good thing here is that you can give about 1cc the morning of Wednesday and then 1cc before you leave which will start to act while you are away and then when you return you can resume dosing MiraLax as usual... Honestly, that is probably what I would do... And make sure to provide ample water and 'broth' in his food before you leave.

    You might could freeze some water in larger Tupperware bowls so you can sit out large chunks of ice. In the hotter weather my kitties like to lick ice cubes. This might be a way to add more water in your absence... Just an idea.

    Hope this helps! :bighug::bighug::bighug:
     
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  13. LuvinThisPig

    LuvinThisPig Well-Known Member

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    ETA... On dosing the Lactulose: I am not sure of Runty's size, so I would ask your vet about it first. Pig was prescribed 1.5cc BID and he is 12.6lbs. Now, Tail is 15.8 lbs and he sees production with just 1cc BID. I have never dosed 1.5cc and in fact, tend to err on the side of caution when starting new medications. Sometimes just a dab will do ya! :)
     
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  14. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    Thanks so much for the advice. That made me feel better. :cat:

    So, turns out I'll be leaving Wednesday morning. I think I've decided to just leave him here and give him a increased dose of Miralax/wet food Wednesday morning and then when I get back Thursday night. I don't usually give him the Miralax in the morning, (I give it to him every evening, 1/4 +1/8 tsp), do you think he would be fine with a dose Tuesday evening and Wednesday morning? Considering he will be eating dry food while I am gone. I will leave some extra bowls of water out too. I'm kind of worried but there's no way he could get stopped up in that amount of time.....could he?
    I will see about getting some Lactulose, but I don't know if I could get it before I leave.

    Also, in the past few days he has decided he doesn't need to drink all the liquid out of his food :eek:.....had to trick him into it by dropping a piece of dry food in it. He never eats all his wet food (the other cats finish it for him), but he has to drink all the added water/broth out and eat a little bit of it!

    @LuvinThisPig
     
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  15. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    Realistically, no. He most likely will not get stopped up in a 48 hour time frame. Now, if things were to dry out in the colon there would be the concern of obstipation. However, that is unlikely as long as you are giving moisture in the food. Now, if he is not wanting to eat the broth there could be a few things going on. 1) he may just not need the water. As in, you have done such a great job with adding moisture into his diet that his body is saying 'enough'. 2) he could just be tired of that particular 'type' of broth or that particular flavor. I use a blender with Pig's food so he HAS to eat the water. But, even then, there are times he goes to the water bowl for more. Of course, Pig is diabetic and Acro, which is a dehydrating factor all its own.

    Here is how I dose MiraLax with Pig:

    1/4 tsp ML with morning BID shot meal/medication
    1/4 tsp ML with +3 snack
    1/4 tsp ML with +9 snack
    1/4 tsp ML with evening BID shot meal/medication

    So, you certainly have some room to increase in your dosage amounts. Of course, like I said, Pig takes a bit more or less depending on the quality of stool and how tight his tummy is. But, per my vet, ML is safe up to 1 tsp a day and the only reason they cap it is that it can cause potentially destructive diarrhea in larger amounts. The problem is, that I have been experimenting with ML for quite a while now and really know about how much to give based off need. It is a bit more complicated in your position. However, you can start doing 1/8tsp morning and night until you leave to maybe clean him out a bit and soften the way... lol. But, no. It will not hurt him to give in the morning and evening. Not at all. ML has no side-effects accept for diarrhea with larger amounts and in that case it is just about hydration.

    If you get some Lactulose that would be great, but it is getting closer to the day you leave and I get nervous starting new meds without ample time to monitor. In this case, you might just look at increasing the ML dose for a few days since you know he is already okay with that...
     
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  16. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    So, the trip ended up being canceled. :oops:
    But, now I have time to try and get some Lactulose for next time! Thanks for the tips. I will also try to spread out the miralax doses.

    I didn't see him go yesterday (just #1) but he was acting normal so I guess he went when I wasn't looking. He loves to scare me by making sure I don't see him go for 2 days,..

    @LuvinThisPig
     
    Last edited: Jul 25, 2018
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  17. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    Update: I saw him go a ton last night. I guess the high fiber dry food he is eating is making his stools so large.

    @LuvinThisPig
     
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  18. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    Just in case anyone wants to know what he looks like, here's a picture of Runty (taken through the window). Not so runty anymore (yes he needs to lose some weight). :D

    20180725_173908.jpg

    [​IMG]
    And here he is as a kitten for comparison (this was in June 2010).
     
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  19. Rardito

    Rardito Member

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    Jul 20, 2018
    oh my goodness how cute!!
     
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  20. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    Precisely. This is exactly what fiber does, it bulks up the stool making it huge! :eek:

    A few weeks a go we had this random and unexplainable outbreak of colitis in my house. Both my boys got it, so I have reason to believe it was bacterial. Either way, my vet thought that Tail's colitis might have been caused by lack of fiber. I guess, some kitties just need it. She sent me home with a high fiber, diet food and told me to include some psyllium husk in his diet.

    I gave some of the canned thinking "okay... we can try this". I waited for a poo so I could see if the mucous was gone. And I waited. And I waited. Mind you, this is from a perfectly regular kitty. He does one neat poo a day. Finally, something like 6 days later he took a poo and I swear to God, it was like he pooped out a small child.... :eek: And that is what fiber will do.. :)

    Good thing he did go for you, though. In megacolonic kitties, you learn to become very excited with each BM!
     
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  21. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    Oh! Not sure how I missed this! Its been some crazy days here for sure! At least you will have time to prepare for you next trip!

    I would not overly worry if you do not see him poop for one or even two / three days... On the 3rd day you can be a little more concerned. But, with a history like that... and like Pig's.. If I don't see a good solid output in 2/3 days I start upping ML and giving Lactulose.
     
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  22. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    He finally went (at least that I saw) yesterday afternoon (3rd day). I had increased his miralax to 1/4 tsp in the morning in addition to his evening dose for a couple days before that, and am continuing to do so. It seems like his colon motility is slowing down....I will see about trying egg yolk.

    @LuvinThisPig
     
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  23. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    I think you will be pleasantly surprised with the egg yolk thing. I was very taken aback by how well it actually worked for my boy. I don't even by the EZ eggs all the time anymore (but they certainly are EZ-er :p). Sometimes, I just boil the egg and steal the yolk. You only need about 1/4 tsp. morning and night... Or you could do 1/2 tsp once a day. You have to be a tad careful at first because some cats can and do experience diarrhea when they first start. Either way, totally worth the shot.

    It might just be that he is eating more dry when you are not looking or even getting a bit more dehydrated. It takes time and patience to solidly work out gi issues. Pig's took me almost a year and half to get straight. Now, anytime I make changes to his diet I do it over the course of several weeks. If I do not, I will see some major upset and glucose spikes that no insulin will touch..

    Have patience! You are doing great!
     
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  24. eightkitties

    eightkitties New Member

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    Jul 13, 2018
    Hi again! Thanks for the advice on the egg yolk. I actually haven't started that yet since he has been going regularly (with miralax 2x a day). Due to the dry food he goes in HUGE amounts.

    My most recent problem is that he has been refusing wet food. :mad: All I want him to eat is his miralax in a bit of broth, and at least drink the water out of the food (I mix it to soup consistency). However he is very picky about what he will eat wet food wise and I have been having to grind up Irresistables chicken cat treats and sprinkle/mix it on his food to get him to eat it. Dropping pieces of dry food in it works sometimes, but lately he has caught on to that.
    I think there are a few factors causing this. One, he is full on dry food a lot of the time. Two, he just does not like certain flavors and will not eat the wet food if I put "too much" water in it (which has been a lot recently since the wet foods I have now don't have much extra liquid in them) I have been using Friskies, and a couple of Tractor Supply brand wet foods. He hates some and likes others. Of course the ones I got to try today (Friskies turkey shreds in gravy), don't have enough liquid to mix his miralax in. I have learned that gravy is not broth and I need to get pate food with a lot of broth.
    The good thing is, I have 4 other cats crowding around his cage begging for his food that will gladly eat his leftovers. He seems to be the only dry food addict out of our 8 cats. Of course. :rolleyes:

    @LuvinThisPig
     
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  25. LarrysAngels

    LarrysAngels Member

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    May 21, 2012
    I had a cat diagnosed with a megacolon, probably about three years ago. It was so bad I had his euthanasia date picked out. Long story that I won’t go into, but we were eventually able to save him. I got the same doomsday forecast you got regarding the long-term prognosis for a cat with this condition. Well, for three years now all I’ve done is give him Miralax twice a day, and he’s been totally normal and healthy the whole time. I started out putting it on his food but had the same problems you are, so I eventually switched to syringing it down his throat twice a day. They get use to it, now he practically sits there with his mouth open and waits for it. He’s been on a combination wet food / dry food (Purina One) diet, and I add water to the wet food to increase his hydration. Every situation is different, but don’t give up hope. Cats can survive this and return to normal healthy lives. My Angel is living proof. Good luck.
     
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  26. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    Sorry it took me so long to get back to you. Work and school and Pig keep me very busy!

    Yes... That has got to be frustrating! That crazy dry food is like kitty crack. The McDonalds of cat food. Either way, so many of the kittehs like it and many do fine on it. In this case, hydration and the amount of fiber is a concern, but really you are doing a fantastic job in managing it.

    You could try several things as toppers. I know a lot of people use Purina FortiFlora as a topper and most kitties go crazy over it. I know Pig certainly did. Its a little pricey, but in the amounts you will use it, it is not really all that expensive. (No clue why that text was red - randomly my text goes full on rainbow... :rolleyes:). Recently I purchased this here - Super Snouts GLM - as an add in for Pig's food and let me tell you, it is pretty stinky. However, it is a good stinky apparently and both my kittehs go flipping nuts for the stuff. Even my picky civie boy Tail. Might be you just have to switch up flavors and toppers. Sheba has some VERY wet and brothy pates. This is what Pig ate before we went to Weruva.

    Of course, syringing the MiraLax is a good idea like @LarrysAngels suggested. Also, if you do get a script of Lactulose then that issue is a bit solved. Its a liquid anyways and will need to be syringed. If you go those two routes, the biggest challenge is getting the moisture that he needs into him. I know, it is a lot harder with him being outdoors, but I am confident you will come up with something. You might try the water off of tuna or something to that nature. You need it good and stinky and appealing to kitty.
     
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