? 02/26 Butters PMPS 92 - emergency vet visit today

Discussion in 'Lantus / Levemir / Biosimilars' started by Butters & Lyla, Feb 26, 2021.

  1. Butters & Lyla

    Butters & Lyla Well-Known Member

    Joined:
    May 30, 2020
    Yesterday

    tl;dr: Butters was at the vet today for constipation. She got an enema and subQ and is currently locked in my bathroom leaking liquipoo. I need to give her more miralax and get her to drink as much water as possible. The vet diagnosed the constipation as being related to CKD.

    My questions if anyone knows:
    1) Is S. Boullardi indicated for constipation? Her vet didn't know. I'm not sure if that would be an okay thing to introduce or not. Any thoughts?
    2) How long can I expect the liquipoo to keep leaking out of her from the enema?
    3) Does anyone know what HydraSense is? I haven't researched it yet but I will. If anyone knows it and has thoughts, please let me know.

    The long version:

    So after kind of neglecting butters the past few days, I ended up having to take her to the vet this afternoon because she was constipated. I feel horrible about that because it probably wouldn't have happened if I hadn't been so distracted.

    The vet took an x-ray and palpated her. He said she was in pain when he palpated her colon. Diagnosis was moderate constipation. He went through her whole pooping history with me and believes the constipation is related to CKD and hydration, as it is more of a recent thing for her.

    He gave her gabapentin, a warm water enema and 100mL subQ fluids (taking into account the DCM...he'd otherwise have done 150 - 200mL he said). He said I am to give her 1/4 tsp miralax twice a day and then work my way down from there if need be, and to make her food as soupy as possible. He also suggested I look into something called "Hydra Sense", which is supposed to help kitties drink more (water additive?), and Fortiflora S.A., which is indicated for constipation. He said to research them.

    He checked her out and also noted that she needs a dental but I can't do one right now because the cardiologist said no anesthetic. I worry about what happens when her mouth starts to bother her.

    Anyhow, the vet visit was three hours ago. They kept her for about an hour after the enema and subQ and she passed some poop. She has been leaking liquipoo ever since. I locked her into my bathroom (which is doll house sized) with towels and puppy pads on top of them. And I put her litter box in there. It barely fit. She is long haired and a mess. I am going to have to bathe her and she will definitely injure me in the process. lol.

    Thanks so much :bighug:
     
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  2. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Oh no. Poor Butters and poor you. Is she getting ondansetron? Whenever Max was on it he needed more Miralax. I used to add water to all meals, very soupy.
     
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  3. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Feb 19, 2012
    Poor Butters. I don't have any answers. Just sending prayers. :bighug::bighug::bighug::bighug::bighug::bighug::bighug:
     
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  4. Mariette

    Mariette Member

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    Nov 15, 2020
    Oh my goodness. What an ordeal! I wish you strength and betterness for Butters.
    It sounds like you're going to have a long night. :(
     
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  5. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    I haven't been giving her ondansetron. SHe hasn't needed any meds lately (anti-jinx). Actually the vet asked me whether I was giving her ondansetron too, and/or bupe. He thinks the constipation is related to CKD and something I'm going to have to deal with long-term, unfortunately.

    I'm worried because I was making her meals pretty soupy...1.5:1 water:food ratio. I'm going to up it to 2:1 water:food and see if she will eat. I'll have to start feeding her in a bowl!
     
  6. JaxBenji

    JaxBenji Well-Known Member

    Joined:
    Jul 10, 2020
    https://felineconstipation.org/prevention.html (I know you have this site...:bighug:) Maybe start with Slippery Elm + miralax? then back off miralax when the LB improves? Just a thought to brainstorm.

    I've been giving Jax s boulardii for general gut health (& to see if I could cut back off on miralax...but since Jax in on antibiotics right now I'm not giving miralax and am giving a therapeutic dose of s boulardii) - I'm personally not sure if s boulardii helps with constipation specifically though it's known to help with diarrhea specifically - https://www.ibdkitties.net/supplements/probiotics/ (this site also talks about FortiFlora too...).

    Hang in there mama bean :bighug::bighug::bighug:
     
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  7. thebigfuzz

    thebigfuzz Well-Known Member

    Joined:
    Mar 9, 2012
    It is usually several hours, but the worst is in the first few. After his enemas, we gave Cosmo the occasional wet paper towel dab to clean him up. It kind of depends on how many CC’s the vet used.

    It could also be a day or so before Butters poops again, depending on how much they got out. Other times, several days worth can come at once :confused: If you peep Cosmo’s SS comments from July, he went up to 6 times in a day (6 big, normal poops) once things got moving. But...he had weeks worth in there at the time.

    PS. You are one of the most committed and dedicated cat mamas I know :bighug: I’m sure Butters agrees :cat: She is lucky to have you.
     
  8. Tina Marie (GA) and Jan

    Tina Marie (GA) and Jan Well-Known Member

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    Jul 24, 2019
    I'm sorry you both had such a day, and that the gorgeous long hair is in the way. Last August, poor Tina got so constipated, she had to be sedated and have manual extraction performed (two enemas failed). Yes, I felt awful, and like you, had been distracted for a few days. She was already getting 100ml lactated ringers every 36 hours. She has stage 3 CKD. All this time later, she goes without fail, every day.

    She takes 1/8 tsp miralax twice daily, .75ml fish oil (Nordic Naturals) once daily, and SEB twice daily (two hours apart from any meds) and Food Fur Life egg powder. I may be overdoing things, but she is very well.

    Butters has been doing so well after the big scare, when she was so ill. Give the little doll some extra love. I'm sorry I didn't really answer your questions.
     
    Last edited: Feb 27, 2021
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  9. Abdullah

    Abdullah Member

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    Sep 5, 2020
    Hang in there!! I'm sorry that I'm not able to answer your questions but just know that I'll be praying for you and Butters. Hopefully Butters starts feeling better soon, and she's very lucky to have you. Keep your head up :bighug::bighug::bighug:
     
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  10. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    I'm so sorry to hear about poor Butters. The IBD and CKD kitty folks are crazy about S. boulardii + MOS and its magical benefits, extolling its virtues for both diarrhea and constipation. I thought Ruby was better on S. boulardii at the beginning with just the maintenance dose of ¼ capsule 2x a day, but now she's gone back to doing it just every other day but her poops are softer, so maybe it is doing something. I am also giving Ruby powdered egg yolk but I don't know if you should do the same since you're already feeding her with EZ complete which I believe has it in the mix already.
     
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  11. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    It’s okay to use EZ Complete and add egg yoke, just start with the smallest amount.
     
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  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Poor Butters, poor you. :bighug::bighug::bighug:
    HydraSense is a nasal decongestant spray. Purina HydraCare helps with feline hydration. No idea what's in it.

    I used EZComplete with extra egg yolk for Neko.
     
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  13. Butters & Lyla

    Butters & Lyla Well-Known Member

    Joined:
    May 30, 2020
    @PerfumedCatMom &
    @tiffmaxee &
    @Wendy&Neko I give her egg yolk powder that I made myself, but I think egg yolks are high in phosphorus so I only give a very small amount. I wonder if my homemade isn't as good as FFL's though. It hasn't helped her at all.

    He must've meant HydraCare (or I misheard). He didn't know what was in it, either but suggested I look into it. I just checked. THe ingredients are: Water, whey protein isolate, glycerin, guar gum, liver flavour, potassium chloride. A250219.
    I personally wouldn't use it for Butters before exploring other options first.

    I have a call with Butters' naturopath vet on Monday. Maybe she will know more about whether S. Boullardi is indicated for constipation. Everything I read, even on the raw IBD kitties site says it is great for diarrhea but I haven't found anything that specifically mentions it is good for constipation as well.
     
  14. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I’d stick with Miralax and what you already feed and check into anything else. I think that Hydracare was discussed in the CKD group but not sure.

    I just looked. It was mentioned but nobody has tried it yet.
     
    Last edited: Feb 26, 2021
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  15. JOJI and Kit

    JOJI and Kit Well-Known Member

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    Dec 19, 2019
    poor dears :bighug::bighug::bighug:
    hoping butters feels better soon and can venture out from the dollhouse commode.

    and, nope. don't believe this for a nanosecond.
    :bighug::bighug::bighug:
     
  16. Butters & Lyla

    Butters & Lyla Well-Known Member

    Joined:
    May 30, 2020
    poor Tina:(. I'm glad she has been well since then!
    Thank you for this. It's helpful. I keep thinking about adding fish oil to Butters's food. 75ml seems like a lot, though! Is it a lot? If it works for Tina, I don't think you're overdoing it!
    I'll definitely give her some extra love. Maybe even extra cuddles if she doesn't scratch my arms up during the bath...which I'm about to do. I'm procrastinating now. lol.
     
  17. Butters & Lyla

    Butters & Lyla Well-Known Member

    Joined:
    May 30, 2020
    Thank you:bighug:
    I will take a peek at Cosmo's ss. Thanks for letting me know and the vet said the next 24-48 hours will be key...so I'm glad that this aligns since I know you have a lot of experience around BMs (or lack thereof).
    I never thought to ask how many CCs he was giving her:facepalm:. I kept dabbing her with wet paper towels but her entire fur pants and tail are still covered in poop. I won't be able to get it off her without a bath.
    It has been about an hour without any anal leakage...so I think I'm going to go bathe her now. Where is my suit of armor?:nailbiting::nailbiting::nailbiting:
     
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  18. Tina Marie (GA) and Jan

    Tina Marie (GA) and Jan Well-Known Member

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    Jul 24, 2019
    Oh Lyla, I had to get my reading glasses - oh my goodness - I meant .75ml; I corrected above! I followed the directions on weight on the bottle - this amt is for a 10-14 lb cat. Thank you!

    Good luck with that bath!
     
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  19. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Oh, my. The things that the vet office does not tell you about enemas.

    I had a chronic constipation civvie who would not leave my bedroom and needed the occasional enema. The vet's office had her in the carrier and out the door as fast as they could. I kept a throw away dollar store shower curtain on hand to put over the duvets with an old sheet pinned to the uppermost side of the shower curtain. It was a crinkly sleep but saved a lot of laundry.

    When a different civvie needed his back end cleaned, he reacted less if the water was warm. Use an old facecloth and mimic mother washing/petting. If you end up using baby shampoo or some such, rinse well using the shower wand with a gentle flow. At the end of it all, a bottle of wine is absolutely necessary. Enjoy your Friday night. :bighug:
     
  20. Adrienne & Molly (GA)

    Adrienne & Molly (GA) Well-Known Member

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    Jan 18, 2019
    Sending prayers :bighug::bighug::bighug::bighug:
     
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  21. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Thank you for looking, Elise:bighug:
     
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  22. RachelG

    RachelG Member

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    Jan 8, 2021
    Butters is the opposite of a neglected kitty, and it sounds like you got her great care! :bighug::bighug:

    We recently had to give Fortune his first bath in YEARS because he peed himself during a longer vet visit / car ride. I commiserate with you.

    Sending big hugs and healing vines to you and Butters!!
     
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  23. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    They have discussed HydraCare on the Tanya CKD support group (on groups.io). I have seen it.
     
  24. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    So sorry about poor Butters bad day. And your bad day :-( I had a cat with a bad tooth who couldn't undergo anesthesia. We had her on a periodic (I recall once a month) short course of Antirobe to keep the tooth from getting too bad. It worked. Just a possibility for when/if that bridge has to be crossed.
     
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  25. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I checked the other CRF group. Did Tanyas think it worked?
     
  26. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    This PJ party I'm having is just awesome.
    Her tush is still leaking. When does it stop. Now I get to worry about whether they caused damage and if so, will she be like this forever. Gosh I wish I could shut off my neurotic brain sometimes.
    At least she is so tired she isn't fighting me so I can do the warm paper towel/old washcloth thing. She is going to have to spend tonight in her dollhouse bathroom. I'm going to wash her as best I can and have her stay in the bathroom so hopefully I can get maybe three hours of sleep.

    On the bright side, her BGs are actually not too bad, all things considered.

    In case I don't respond to everyone individually, thank you so much for the support and suggestions and experience sharing. It definitely makes this easier in some way. :bighug:
     
  27. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Lyla I hope this bad dream ends soon. Poor Butters. Poor you. :bighug: Get some sleep. Tomorrow has to be better.
     
  28. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    There were mixed reactions to it. I will check the whole thing again tomorrow.
     
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  29. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I’ll try and look too but might not get to it.
     
  30. SashaV

    SashaV Well-Known Member

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    Apr 25, 2020
    My civvie has problems with constipation. He was leaking the first few hours after his enema, specially if he was startled or was jumping.
    I've tried Royal Canin fibre respons, and that's what worked the best.
    Lactolose witch worked like a charm, but very hard to get him off it again.
    Slippery elm.
    Paraffin oil.
    Cat malt.
    Brushing, he has short hair but when he get blocked it's hair :banghead:
    Metoclopramide, it's used for nausea but the side effect is that the colon is moving - only did once, since it hurt.
    Pain meds.
    Microlax an at home enema. Syringe up the bottom and within 5-10 minutes the kitty REALLY has to go.
    Water! Constipation is hard stool, dehydrated and therefore hard to push out. So water fountain, oralade, adding water to canned food.

    Now both is fed raw, so no dry food. So I'm using protexin pro fibre for cats and dogs. It has pre and probiotic and a lot of fibres to get the colon moving.
    A gentle massage of his belly works as well, it takes time for him to relax enough to move things along, but when his gut starts making noises it's working.
    And then I got something weird from my vet, it's mashed shrimps, algees(?), and it smells like the ocean, but it's working!

    If he has an acute situation, I'm using the Microlax, pain meds and some subq fluids.

    Be aware that fibres can lower the need for insulin, so watch out!
     
  31. Laura and Gremlin (GA)

    Laura and Gremlin (GA) Well-Known Member

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    Sep 26, 2015
    Oh my gosh Lyla, what an ordeal for you and Butters!

    The one thing I can comment on is the mouth issues. Grem hasn't been allowed a dental in several years and they refused to do it during any of his other surgeries, and now ALL surgeries are banned no matter what. So, of course, at 18 years old he has HORRIBLE teeth and there's nothing that can be done. I tried adding the teeth stuff to the water, but he and my civvies all flat refused to drink. Not ideal. It's supposed to be flavourless but mine knew! Anyway, the only issue Grem has had was when he broke a tooth trying to swallow a pill late last year. He had antibiotics (injection) and Bupe for a few days and then was fine. He did have a bit of a flare up, infection wise, at New Year's but after another dose of antis, he's been perfectly fine. Yes, there's risk of infection and abscess but he's doing really well. He eats fine as long as his food isn't chunky or lumpy (although he still manages raw chicken... o_O) so Butters will hopefully be perfectly fine too!
     
  32. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    I will post more later, but it was pointed out on tanya’s group that this product could reduce urine specific gravity and that isn’t what you want for a CKD cat. Also the electrolyte were not balanced .... here is a sample of some of the concerns ....

    “I am not sure this would be advisable for CKD cats. It might be possibly useful for cats with highly concentrated urine prone to FLUTD and/or formation of uroliths.

    The site says it can decrease USG. For most CKD cats they already have low USG. If it's acting as a diuretic that's not really what we're looking for with CKD, as the cat is already weeing too much and losing hydration.

    I would not be keen to give my cat something with glycerin as one of the main ingredients, and guar gum can give some cats diarrhea.
    I expected it to at least have a balance of electrolytes, but weirdly it only contains potassium chloride. This might not be good for CKD cats as it could contribute to metabolic acidosis (and obviously it's potentially dangerous for cats who already have high potassium).
    http://felinecrf.org/potassium.htm#potassium_chloride”.


    Does this help?
     
  33. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    If I had to guess, I would think more in terms of the dupe being the cause for the constipation. Most opioids will cause constipation. It's a common side effect.
     
  34. Pamela & Amethyst

    Pamela & Amethyst Well-Known Member

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    Dec 11, 2016
    Lots of love and healing prayers:bighug::bighug::bighug::bighug::bighug:
     
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  35. Our Dolly Girl (GA)

    Our Dolly Girl (GA) Well-Known Member

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    Nov 2, 2019
    Good morning Lyla, I kept trying to write last night and it kept putting me in the middle of your post. I was so sorry you and Butters were going through so much. I hope she is feeling better today. I hope she stopped leaking, poor Butters, and you could let her out. I hope you got some rest. Sending you both big hugs and healing prayers for Butters. :bighug::bighug::bighug:
     
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  36. LindyNova

    LindyNova Well-Known Member

    Joined:
    Nov 11, 2019
    couldn't you use pumpkin for both the runs & constipation? I hope Lyla feels better soon, and I'm happy you spent some time on yourself. Lyla could not be in better hands. :)

    My apologies, If I am way outta line, here.
     
    Last edited: Feb 27, 2021
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  37. Purrberry

    Purrberry Member

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    Dec 11, 2020
    Just wanted to add that you are Butters are in my thoughts; you so kindly welcomed me when I first joined, and gave me a little hope on higher dose cats!

    I hope Butters is feeling better this morning!
     
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  38. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Well I know this is yesterday's post - and there is probably a new one around here somewhere...but OMG! Lyla I'm sorry to hear you're going through such a poopy day/night/time...I do hope by how things are settling down in the dollhouse bathroom...sheesh...I can't imagine...

    Sending prayers and hugs your way! :bighug::bighug::bighug:
     
  39. Tina Marie (GA) and Jan

    Tina Marie (GA) and Jan Well-Known Member

    Joined:
    Jul 24, 2019
    Lyla - looking forward to your new post; hoping all is better. I looked over what I posted and had to laugh (really needed those reading glasses). First, I said 75 ml of fish oil, but I corrected to .75 - whew. Then, I said I gave Tina lactated fingers solution. I do not give her any finger solution, lol.
     

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