Geriatric cat with unresolved GI tract issues
November 5, 2017 11:37 AM   Subscribe

I have a 17 yr old lady cat with IBD-like symptoms who is making my home life very... poopy. She is attentive, eating and drinking, lively and mentally alert. The ONLY issue we're having is that for Reasons (health reasons?), she poops on the floor, no matter what I do. For those of you with experience troubleshooting elderly cat bathroom behavior, what am I missing and what else can I try? All the dirty, poopy details contained within...

To head one big question off at the pass: we are actively working with her vet on this. He saw her last week and gave her a mostly great bill of health: liver, pancreas and thyroid are great. She has early signs of kidney failure, which he said is typical for her age.

The treatment plan is to treat the symptoms and emphasize quality of life for both of us. Quality of life for me is that she poops in the litter box and lives the rest of her old cranky-ass cat life in peace with lots of cuddles. If she was doing much worse, it would be a different conversation -- I've come to terms with the fact that she is at the end of her life, I don't mind the effort it takes to keep after her health, I just want both of us to be able to enjoy her twilight years without requiring me to clean poop off the floor 4+ times every day, it is driving me batshit crazy.

What's happened so far: the GI tract issues first started about two years ago. It started with vomiting, straining to poop and avoiding the litter box, which prompted me to change up her diet and we finally landed on one that worked for her about 9 months ago. She urinates in the litter box 100% of the time with no mistakes or accidents.

However! She's still having what look like bathroom emergencies, where she suddenly and urgently needs to poop. Her poop quality varies -- sometimes it's solid and well-formed, other times it's pure liquid. She's somewhat flatulent as well and will squat to poop sometimes only for a wet toot to come out.

She does have arthritic stiffness (and we live in a place with stairs), which seems to be contributing to her not making it to the litter box in time, so she just goes in a suitable spot nearby. I've put a wide variety of different kinds of litter boxes in virtually every spot she deemed worthy of gracing with her bowel movements, she still doesn't want to poop in them. Like, she poops near the box, but not IN the box, which means I have to clean it up every. single. time. I've laid mats down to spare my sanity, but the diarrhea and bad bathroom behavior persists.

The vet said based off her symptoms and the quality of her stool, what's most likely is either colitis or small cell sarcoma of the intestine, but she has not been definitively diagnosed yet. I do not want to take extreme measures to diagnose (endoscopy and biopsy, which would cost ~$2500 and require surgery).

It's been like this for months, it's been exhausting, I just want her to poop in the litter! Pretty please? Do you have any other ideas or tactics I can try?

What I'm currently doing:
- 1mL of Metronidazole twice daily
- Probiotics every other day (FortiFlora)
- heated kitty bed for easing whatever arthitis pain there is
- litter boxes at most 10 feet away from anywhere she could be

Things the vet and I are trying next:
- very low, very wide litter pan so she can poop the way she wants (squatting and moving around as she goes)
- urine test for underlying UTI
- ultrasound to get more info about what we're dealing with exactly ($500)
- switching to another steroid-based med for the diarrhea that has a higher likelihood of working

Upcoming changes in the future to treat the gradual kidney failure:
- subcutaneous fluids 2-3x a week
- renal diet
posted by Snacks to Pets & Animals (10 answers total) 1 user marked this as a favorite
Sorry, one last suspicion: could there be a protein allergy in the mix? What have you done to confirm or rule it out?
posted by Snacks at 11:46 AM on November 5, 2017

If she has arthritis, could it also be that she has a hard time physically getting into a box? Maybe try giving her a box with stairs or a ramp or a low clearance, like so.
posted by Bistyfrass at 12:07 PM on November 5, 2017 [1 favorite]

I have no real help, but I have a much younger cat (~10ish) going though exactly the same thing... severe IBD or small cell lymphoma. Her issues are coming out the other end though - vomiting vs the poop. Had the ultrasound, but thats what gave us the either-or... without the biopsy we wont know which it is exactly, but my cat has lost sooo much weight we're not sure she'll handle the surgery well, so that's a no-go for now.

Just started on prednisone (a steroid) and chlorambucil which apparently is used to treat both IBD and the small-cell. No results yet as it's too soon to tell, but the pred has already done wonders for her appetite at least, which is good. I also have FortiFlora in the mix, but that's mainly for my other cat but seems to be helping here as well.

Before the above, we tried all the fancy novel protein diets. When that didn't help, to rule out the protein allergy, we were on hydrolyzed protein cat food - Royal Canin has a variety or two. It's vet-only, so ask about that if you're thinking it might help.

As an aside, if if the poop is destroying your carpets like the vomiting has been doing to mine, I highly recommend this carpet cleaner. Looks like there's a pet version as well but that little green machine has been a floor-saver for me.
posted by cgg at 12:07 PM on November 5, 2017 [2 favorites]

Have you tried different types of litter? That would be my next try. Since you already have lots of boxes around I would get a bunch of different types and try them one at a time in one of the extra boxes and see if it's ok for her. I know that when I have tummy troubles, other types of sensory input like sounds, smells and textures become extremely irritating in my head, so maybe it's something about the sensory experience of the litter combined with the unhappy feeling in her tummy that's making her avoid the box.
posted by bleep at 12:44 PM on November 5, 2017

I have an older cat who has somehow learned that the place to urinate isn't inside the litter box, but right beside it. She has no trouble getting in and out of the litter box and she poops in the box without issue--just something got miswired and I've never been able to fix it. What I have found is that she prefers to pee on something other than the floor though - so if I have a mat, she'll pee on that. If I have a shallower tray around the litter box, she'll pee on that.

Have you considered something like puppy pads in favorite poop spots?
posted by Kutsuwamushi at 1:10 PM on November 5, 2017 [2 favorites]

Lower-sided litter box did a ton for me for a cat in a similar position, although her digestive issues have been lifelong and are just a smidge worse in her old age--it just wasn't a super noticeable issue before because she didn't have the mobility issues. She sometimes ends up going over the edge of the box instead of in it, but getting one low enough she could comfortably get in and out from all sides made a huge difference.
posted by Sequence at 4:17 PM on November 5, 2017

I had a cat with IBD and my current cats, I suspect, will ultimately develop the same thing (they have many of the same symptoms that my previous cat did, just much less frequently). My late cat was 11 when he passed away. The cat won’t poop in the box because pooping hurts, and they associate the box with the pain.

Stock up on puppy pads and think about how long you want to continue this. She’s 17. Yes, she’s still engaged, but you don’t have to wait until she is clearly circling the drain. I know how hard the decision is—in the end, I decided to deal with the mess because I knew that it was ultimately temporary.

I highly recommend Spot Shot for treating carpet stains (blue can with orange lid, at Target and similar). That stuff works amazingly well. You would never know my cats throw up on the carpet multiple times a month (and yes, I am so sick of cleaning up barf that *I* could barf). I keep multiple cans around the house and I go through a ridiculous amount of paper towels. My thinking on the long-term feasibility of this situation is that I will keep it up as long as I can afford to do it (mentally, financially) or until the cats become too sick to enjoy their lives, whichever comes first. Sucks but what can you do.
posted by Autumnheart at 5:46 PM on November 5, 2017 [2 favorites]

We have the litter box in a very large tray that I think is designed for putting under large appliances. We line the tray with newspaper. Our elderly cat with kidney disease industriously poops just outside the litter box on the newspaper. Everybody is happy.
posted by Peach at 7:37 PM on November 5, 2017

I've solved* a similar issue with my kitty (who has small intestine lymphoma) with multiple boxes containing Cat Attract Litter, Perfect Form herbal supplement, as well as the other medications prescribed by the vet, and rigorous litter box cleaning. If I'll be gone for a few days and know the box might not be up to his standards, I put old towels down in his favorite spot. I feel your pain!

*for now...
posted by girlalex at 9:05 PM on November 5, 2017

Update: I put her on the prednisone, but it didn't help much and she ended up taking a turn for the worse. Since she was so old and I was mainly concerned with quality of life, I made the tough decision to take her in to the vet again. I put her down today, she went quietly and quickly and now she's not in any pain anymore. I'm heartbroken, but it was her time to go.

Thank you for your help, everyone, I hope this thread helps anyone who finds themselves in a similar position.
posted by Snacks at 5:01 PM on November 19, 2017

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