? 06/02 Blue AMPS 160 update PMPS 146

Good morning,
here is yesterday:

https://felinediabetes.com/FDMB/threads/06-01-blue-amps-139-pmps-160-the-vet-nurse-asked.278153/

This morning I spoke to the vet nurse. Although Blue ate last night, this morning he was not interested in food. They will therefore give him a token dose 3.5u.

He has had some urination but they feel it is compromised by the obstipation, as he still has not had a bowel movement (it can take 24 hours and he's been on the PEG drip for about 14-15 hours). They are considering a mild enema to assist with the loosening of the impaction. They are currently doing an ultrasound to get some further information.

I am so worried about Blue.

 

Sending prayers.

 

Update: Spoke with vet around 2:00pm. Blue is peeing in a normal way but that's all. Just spoke with vet nurse now (3 hours later). Blue still peeing ok. All vitals are good but still only peeing. It's not been 24 hours yet but they've given him an enema ("tolerated really well") and they are still doing the wait-and-see although they may give another enema in awhile. I asked what happens if there's no action and she says that's a whole other level as they would sedate him and manually get done what needs be done. She did mention the possibility of megacolon and so if by the next time I talk with them I will ask about
cisapride or ranitidine. Has anyone any experience with these medications?

I feel so anxious.

Just spoke with them again re: cisapride and then she said it probably isn't megacolon but due to the anesthesia Blue received.

This is just the hardest part. I can't do anything.

Thank you for your support.

 

Thank you, Carla...

 

Sending poop vines for Mr. Blue.

Tagging @Max & Lori and @Deb and Sylvester and @Suzanne & Darcy who have had to do the poop dance with their kitties. I know we've had people use cisapride on here, but can't remember anyone who currently posts.

Also a website for you: https://felineconstipation.org/

 

I used cisapride with a civvie in combination with restoralax and a small amount of fluids. Cisapride helped a lot but it took a day or two to start working. She was on it to the end. (Did not change her littler box protocol of grand gestures to bury the stool by scratching the side of the litterbox 143 times … in the middle of the night … in my bedroom.)

 

Update: Blue remains in steady state, i.e. no action as yet, although he is peeing in a good way. They are relying on the naso-pharangel PEG drip., reminding me this is a marathon and not a sprint. The vet nurse said she agrees Blue should be kept overnight because a)hydration; b) the drip-line; c) appetite stimulant and they are now checking electrolytes. She said basically the manual removal procedure is only the next far-away step and they want to avoid having to sedate Blue again, which I appreciate. They will also give another token dose of insulin as this morning.

I will visit with him in the morning if nothing happens overnight. It may help him to know he really is safe.

The nurse also wanted to remind me the $$-meter is running. Thanks.

Too much.

 

Hi Jodey,
Poop troubles are so frustrating. I never used Cis, but have used Constulose, psyllium powder, and Slippery Elm bark. IMO the Constulose and the Psyllium work the best.

There is also a probiotic supplement called, Probiotic Miracle, its made by Nusentia. It's very powerful, and definitely elicits a response.

I have a gf with a "pre" megacolon kitty, and she has him taking pretty much all of the above, plus Miralax, to make sure he goes.

The constipation can definitely be from the anesthesia, it even happens with people.

If you need more specific info, just let me know!!

 

@Wendy&Neko @Red & Rover (GA) @Deb and Sylvester
Good morning, keeping to this thread for a moment: at 5:00 am I spoke to the vet nurse at the clinic. Blue has still not pooped; however, they have determined the contents of his bowels are soft and "not hard", which would be a "real problem". Is not pooping for so long not a "real problem"? Apparently not. They say it's common and as Deb pointed out, anesthesia may be the culprit. He is peeing but not really all that interested in food. Who can blame him.

They are proposing that I bring him home for 24 hours because cats, they say, feel they can relax at home and feel better about doing their business. At first, I had a fear response: like if he's on the drip and all of that in the clinic, how can I possibly care for him!!!!!???? But I'm wondering if they are right. They said if I bring him home and he hasn't pooped in 12-24 hours, to bring him back.

Does this make sense to anyone. They said there are no right or wrong answers; regardless, one still has to make a decision...I'm so afraid to bring Blue home and not be able to properly care for him. What if he doesn't eat? What should I do about insulin? What about water? Hydration?

Can someone comment please. I sometimes make hard decisions by hearing what others have to say and weighing it alongside the thoughts I am formulating, if that makes sense. I do appreciate your support so much.

 

Jodey, I’m so sorry you and Blue are going through all of this. I know how stressed you must be. I think the anesthesia is a big factor in what’s going on especially if he’s not been a cat to suffer from constipation in normal circumstances. I went through a similar thing with Max after he had his CT scan before he had his SRT. I ended up taking him back to the hospital because he developed pancreatitis. They kept him a couple of days to treat for the pancreatitis (caused by anesthesia) but said he had not had a bowel movement. They said they thought it was because he was stressed in the hospital environment and wanted me to take him home to see if things would go back to normal with his elimination. They were right and he did poop after we got home.

Max has problems with constipation and diarrhea because of what they think is IBD. He’s had this for a while now and he’s on Budesonide daily. I just treat his symptoms with either lactulose or Miralax if he gets constipated. I add water to his food. I increase fiber in his diet with either baby food squash or pumpkin. He’s on a probiotic call Visbiome.
That’s basically it for Max.
Only you can make the decision whether to bring Blue home now. It depends on how you are feeling, but if it were me I think if he was doing well eating, drinking and urinating, I’d be tempted to try him at home in a relaxed environment. If he’s not eating at all I’d want to talk to the vet more about that before you go home though. It sounds very reasonable to take him back after 12-24 hours if he still hasn’t had a BM. Ask them all the questions you have before you leave. Also ask if he needs something like lactulose to help him along. I wish I had more advice to offer you, but I do pray that you and Blue can catch a break and things get back to normal for you.

 

Lori, thanks so much for this! I can say that Blue regularly receives PEG (Restoralax) mixed with his food and it keeps things moving. I will ask about the lactulose but at the moment, he's also not very interested in food. But maybe being home will resolve the issue. I emailed the IM vet who agreed that being at home might be the way to go (in all senses of the word). I'm leaning in this direction. I'd feel more confident if he was eating but who wants to eat when you haven't pooped for days. Does pumpkin represent an issue for BG?? Thanks, again!!!

 

That’s right, nobody feels like eating when they are backed up like that! Hopefully when you get him home in his own space, he will become more relaxed then poop. Then maybe he would be hungry. I know Max is like that anyway. He doesn’t eat well when constipated, but after he finally goes, he’s acts like he’s starving.
I haven’t seen any rise in BG after Max eats pumpkin or the baby food squash. Max is very carb sensitive and it still doesn’t affect him. The squash actually works better for Max, but pumpkin works too. The lactulose is actually a sugar, but it is only contained within the GI tract, so that doesn’t affect Max’s BG either. Some vets don’t want to give it to diabetic cats because of that. My vet explained and understands that it doesn’t affect BG, but a lot of them don’t understand that. It works pretty well for Max. Good luck to you! Let us know how it’s going.

 

Hi Jodey!

I agree with the clinic and Lori. Trying to get a cat to poop at the Vet, who, 1. Had anesthetic 2. Has not eaten much 3. Is not in his environment. Is almost impossible.

My Vet usually says no bowel movement after 72 hours is when we start to get concerned and try an enema ( which I personally won't do myself)

If his stool is soft when they palpated his bowels, chances are he may be holding it. He'll probably go on the ride home or when you get home.

You can try adding powdered psyllium husk powder to water and mix it in with his food. So far, that is the best success I have found from a natural perspective. The other one is Constulose, which is great if they are willing to take it by mouth in a syringe, or will eat all the food you mix it into.

The psyllium I use, I found on Amazon, the brand is called, "It's Just...."

 

Like @Max & Lori said, no worries with the Constulose. I used it regularly with my late diabetic cat Luigi, and Sly was taking it at the beginning of DX as he was badly constipated.

No difference in BG at all.

 

Hi Deb,
I'm going to be calling the clinic in a few minutes to let them know I'll bring him home and give that a try.

The No Bowel Movement in this case is longer than 72 hours. He hasn't pooped since Tuesday when he had the anesthetic for an MRI in a clinic 5 hours away. He ended up in critical care there after not peeing; that got resolved so we came home and one day after returning we ended up at the emerg here: no peeing, no pooping. And, btw, they have given an enema in addition to the PEG naso-gastro drip line.

So, I'll pick him up and we'll see. I'm anxious but this might be the strategy that works. Thanks for the info on the psyllium...

 

Sending you lots of love and good JuJu for Blue