Cat constipation - what treatment options, what to do right now?
December 8, 2020 3:11 PM   Subscribe

Our cat has had several episodes of severe constipation, one resulting in a trip to the emergency vet. Today she had another. Details are unappealing.

I heard her howling in distress and when I found her she was in the pantry, where she struggled and then passed a large chunk of stool on the floor, then dragged her hindquarters over the floor. This has never happened - she is a very neat and mannerly cat.

I cleaned up and she snuck away. Looking for her, I went to her litterbox and realized that she had both vomited and urinated on the floor, presumably from straining.

She has been using the litterbox normally in recent days otherwise. Until this happened her behavior had been totally normal - playing, jumping, etc.

Right now she's upstairs with me and seems dispirited and physically slumped but has also looked up to see if I'll give her any treats.

She gets wet and dry food plus 1/16 tsp miralax daily. Almost exactly a year ago, we had to take her to the emergency vet because she was totally constipated, probably because she had gone off her wet food and wasn't getting enough liquid. They did imaging and bloodwork which were normal and prescribed a laxative.

Obviously a vet visit is in the future. We don't have a car and due to the pandemic cannot take a cab, so we'll need to borrow a car from a friend, which will take overnight at least to organize.

Have you had any experience dealing with a chronically constipated cat? What do I do right now? (Keep an eye on her, obviously.) What treatment options are likely? What could be causing this when she's eating a good wet and dry diet and drinking plenty of water? Any thoughts or advice would be appreciated.
posted by Frowner to Pets & Animals (22 answers total) 5 users marked this as a favorite
Feeding the cat small amounts of Vaseline, and take dry food out of the rotation, replace with wet mixed with water, or liquid treats.
posted by jeather at 3:15 PM on December 8, 2020 [1 favorite]

My suggestions (having had cats with various intestinal dysfunction):

1) Try mixing in some canned pumpkin with her wet food. This can help tremendously with both constipation and diarrhea in cats, if they find it palatable.

2) Edit - just saw she already gets Miralax. Cats can take Miralax; again, this would be mixed in with their wet food (add extra water, too, when you do this). Check with your vet about dosage, as it will be based on your cat's weight. But it's very gentle and safe.
posted by aecorwin at 3:17 PM on December 8, 2020 [3 favorites]

There is vet-prescribed high fibre food for cats. Mine takes it because difficulty pooping resulted in poops in places poops did not belong. Sometimes they just need a little help.

(Be warned that if she does take it eventually her poops will be alarmingly large. This is normal.)
posted by urbanlenny at 3:24 PM on December 8, 2020

I am really not a cat health expert so please if this is Wrong someone should correct it, but when my cat doesn't seem to get enough water I pour off the water from a can of salmon or tuna and she totally laps it up.
posted by nantucket at 3:27 PM on December 8, 2020 [2 favorites]

Does she have a kitty water fountain? My cat really likes his and he drinks more because of it. Sometimes too he seems to have trouble pooping when he has hair balls and more brushing helps.

I hope your kitty feels better soon!
posted by SpaceWarp13 at 3:55 PM on December 8, 2020 [1 favorite]

Is Miralax the same as Lactulose?

My cat has a super colon that causes her to get impacted super easily. Has your cat had an X-ray to check that out?
posted by Kitchen Witch at 3:57 PM on December 8, 2020 [1 favorite]

Our beautiful cat Vash tends to straining/constipation, resulting in one trip to the vet.

Here's what we've learned and how we're proceeding.

1. Don't over-groom your cat, they need to swallow some hair (as roughage).
2. Make sure the water you put down is constantly refreshed, at least morning/night.
3. It's apparently better to locate the water in a different area than the food.
4. Multiple water dishes are better than one. Make the cat happy to drink.
5. Feed wet food as much as you can afford, and if you need to use dry, the best.

For treatment, our vet recommended adding PEG 3350 (polyethelyne glycol white powder, sold as "RestoraLAX") to wet food, starting at about a gram a day and adding/subtracting half a gram a day gradually ("titrating") to get a soft but not squirty poop consistency. (You should absolutely need to add more than 5 grams per day, with 2-3 as an average.)

Vash is currently getting about a gram a day and his poops are much more comfortable.
posted by seanmpuckett at 3:59 PM on December 8, 2020 [2 favorites]

Sorry you and your cat are going through this. I also have a chronically constipated cat.

What you do right now: You're being a good cat caretaker. Given that you're not able to get to the vet right away, try to arrange to get her in for a checkup as soon as it is feasible for you. I second the suggestion to try to get her to drink some water, even if it's salmon juice or tuna juice from a can. The miralax is also good, double check with your vet on the dose.

A little concerning to me is that you mentioned she's starting to slump. The last two times my cat has gotten very lethargic after failing to poop/straining magnificently to poop, she needed an enema. Please keep in mind that my cat also stopped eating for 2 days due to discomfort, your cat may be more lively. It is my understanding that cats need to eat at least once a day, as they get most of their water from their wet food. (knowledgeable folks, please chime in if I'm wrong...)

Treatment options: enema, possibly IV fluids if she hasn't been eating, and prescription laxative. (Vet might say Miralax is fine.) You cat might need an X-ray to determine if there's more poops inside or if she has megacolon. Also blood work, as maybe something that will have changed over the last year.

Why is this happening?:
Something about my cat's blood work let our vet know that her muscle contractions that push food through her digestive tract aren't working well. She takes Cisapride to stimulate her GI tract. It's a tiny pill, surprisingly easy to give to an ancient (20 yr old), pill-averse cat.

Hope that is a little helpful, and best wishes for all involved.
posted by Guess What at 4:10 PM on December 8, 2020 [2 favorites]

With my sister's chronically constipated cat (old age + mega colon) we used to actually give him a dose of miralax by squirting a a bit into the back of his throat* with a syringe rather than mixing into food. He was a picky eater, so by giving it to him outside of his food they made sure he got enough miralax even when he turned his nose up at dinner. So my be worth considering it your kitty occasionally skips a meal.

*He was initially brat about it. But I started giving him a treat after he got his medicine. After a few days he'd jump on his chair and open up with minimal manhandling when I told him it was medicine time.
posted by ghost phoneme at 4:11 PM on December 8, 2020

Response by poster: Cat update: She sat around sadly for a bit but then jumped up on the bed and from there to the dresser; she's followed me downstairs twice in search of treats and came back upstairs. She also drank a bunch of water and just ate a half of the Very Fancy Expensive wet food mixed with a little extra water and miralax that I made. At least for the moment she seems to be feeling better. She is hanging out on the rug in my room, though, which she usually does when she's a little shaken up.

I'm going to call the vet in the morning and try to make arrangements to borrow a car. Hopefully the extra miralax (which is PEG) will mean that the next few days until I can coordinate a vet visit will be more comfortable. In a real emergency, I could probably get to the emergency vet within twelve hours, but that would take a great deal of coordinating.

Hopefully since she has in fact been pooping regularly we have a little time to sort things out.
posted by Frowner at 4:18 PM on December 8, 2020 [3 favorites]

I also have a chronically constipated cat. I think it is related to the fluoxetine in his case. We've taken him to the vet multiple times and they reassured us that miralax is safe and that we could increase the amount if we need to. They started us with laculose but said that miralax is better.

We give him a tablespoon of pumpkin and a teaspoon of miralax with each meal. We also add a good amount of water to his food. It is like cat soup sometimes but he eats it. We know we are giving him too much miralax if he starts leaving little turd presents around so we dial it back. Every so often he takes a massive dump which makes us all feel better. I have also on occasion given him a few licks of coconut oil. No idea if that is good or bad but it seems to have helped. I don't do that regularly.
posted by mokeydraws at 4:21 PM on December 8, 2020 [2 favorites]

Our vet told us straight-up metamucil was fine, in cat-sized quantities: we'd mix a scant 1/8 teaspoon in with a can of wet food for a few days when she was having trouble going. It worked!
posted by BuddhaInABucket at 4:38 PM on December 8, 2020

My kitty has had constipation issues. My vet recommends 1/4-1/2 tsp daily of Restoralax (PEG), mixed into wet food (kitty is ~15lbs). She said not to give him dry food, or if we do, to soak it in water until its super mushy. I think this accords with a lot of the advice given here.

My cats loooooove coconut oil, so if that isn't a treatment I am sure yours would love it either way.
posted by dazedandconfused at 5:04 PM on December 8, 2020

1 tsp - 1 tbsp plain canned pumpkin (not the pumpkin pie stuff, obviously) 1-2x/day mixed with wet and/or dry food keeps things moving. I'm not sure PEG is supposed to be used long term, but pumpkin is very safe and can be a daily supplement forever.

Water fountains (especially metal or ceramic ones) work great for encouraging cats to drink water. I also mix my cats' wet food with extra water. Enough to make it sloppy, not enough to make it liquid.
posted by Anonymous at 5:51 PM on December 8, 2020

Nthing pumpkin, good luck!
posted by getawaysticks at 6:00 PM on December 8, 2020 [2 favorites]

Our vet said 1/4 tsp of mirilax is fine (and our car is 7 lbs soaking wet). We also raised the dose a bit too far at one point, until, as monkeydraws described, we got soft little presents. Kitty did not seem to notice!

Our kitty was eventually diagnosed with "triadic syndrome" which is basically GI irritation, and constipation seems to be part of it. So she gets mirilax every day now, and the vet is fine with that. She would not eat pumpkin. We mix mirilax into her daily bit of wet food.

I'll also add from human experience of recurring constipation, a doc once told me to do a solid 2 weeks on mirilax just to get everything cleaned out, and that was good advice.

Hope your kitty improves and stays that way!
posted by Dashy at 7:09 PM on December 8, 2020

I also had a cat with this issue. Like kitchen witch, he had a mega colon, which meant that his colon had stretched out and so he would sometimes get impacted and had to get an enema at the vet. He was on prozac for anxiety as well.

I would know he was in trouble if I picked him up and his middle was swollen and full, a bit like a football. What helped keep him out of the vet hospital was:

-Special high fiber prescription food, I had great success with royal canin. It had to be prescribed by the vet and it wasn't cheap, but it was very effective and less expensive than regular enemas!
-Miralax sprinkled on his food if he was seeming a bit backed up.
-Water fountain as others have mentioned
- There was a tuna-flavored paste that helped keep his BMs from getting too hard, you put it on their little forepaws and they from it off. Our daily routine was pill and then that as a reward. Ask your vet about it!

Good luck. This is a common issue with cats, particularly looking haired anxious ones. It is progressive, so finding the right food and routine will make a big difference!
posted by pazazygeek at 2:34 AM on December 9, 2020

Here to echo the canned pumpkin recommendations. My cat actually developed a taste for it after a while.
posted by orrnyereg at 8:24 AM on December 9, 2020

My cat hates pumpkin, but my fat longhaired cat doesn't mind when I sprinkle this dried pumpkin in his food. He ignored it just fine. I also think they are drinking more water now that I've added a fountain to the house. I also add a little water to their food every day, and I've stopped feeding dry food.
posted by answergrape at 9:40 AM on December 9, 2020

Response by poster: Basically good update: One more episode of straining and vomiting the night before last, so I worried. I have upped the miralax to 1/8 tsp per day. Early this morning, ample poop with no vomiting (I didn't see her so in theory she could have been straining, but I suspect not.)

Yesterday she was a little less playful and active than usual but that might easily have been because the humans were acting so weird - she was climbing stairs and jumping without difficulty.

This morning I went to check on the litter box because, in fact, she bounced up the stairs, demanded treats (which she did not get, it was not treat time) and then leaped up onto her special viewing shelf in the window, all of which seemed in line with her hilarious habit of rocketing upstairs from the basement after a particularly successful use of the litter box.

Sadly she adores, adores, adores her kibble (Taste of the Wild Salmon-Venison with the picture of the lynx ("that's me!!!"); we get store brands, she gets none but the finest) and won't up her wet food intake beyond a certain point. I'm reducing the kibble as much as possible and increasing the wet food.

My plan right now is to continue with the increased miralax and schedule a vet visit, but that probably won't happen for a couple of weeks (vet's website says there's a substantial wait for non-emergencies because of COVID precautions.) Given that they did imaging and bloodwork last time and it's been a year, my guess is that this is a motility issue rather than something immediately critical.
posted by Frowner at 5:24 AM on December 10, 2020 [3 favorites]

If your cat would tolerate it, abdominal massage? (That link also suggests raising the food bowl a few inches to make eating wet food easier. We've done that with our cats and it seems to help!) Cat grass (which is super easy to grow from seed and so much cheaper than the plants sold at pet stores) seems to help as well.

I've also heard that wiping the butthole with a wet cloth can help move things along.
posted by spamandkimchi at 9:02 AM on December 10, 2020 [1 favorite]

Sorry you are going thru this. My cat, Torison, has had similar issues since 2016. Guess What spelled out Tor's story and treatment almost exactly and it may be important to go thru the steps, as what works for one cat will not work for all. I will say that Tor has been almost completely medicine free except for mirulax for the past 2 years. He is not cured - his normal is now to poop every 2-3 days. But his situation is managed and he appears to be as relaxed/happy as he was pre-2016.
He hates most wet cat food and would refuse to eat it at all if there was medicine mixed in. What he does accept is always mixed or pureed with water to make broth (he has his own blender bowl) as he will not eat any chunks in the wet food.

Doses for a Maine Coon look-alike 16 pound cat.
2016: Vet's prescription started with high fiber cat food (various Royal Canin/Science Diet formulas for long hair cats /specific high fiber formulations) + 12-15 mls of Enulose (prescription stool softener) + Metamucal + Mirulax .
2017: he was still going to the vet every 5-7 days for treatment, the vet suggested a major change to very low fiber cat food (less than 5 grams fiber) + Enulose + Mirulax + Cisapride (my term:convulsant) The addition of cisipride worked and the constant vet visits came to an end, but he was miserable. Note. Ask for the cisipride pill. Originally got this as a liquid and my walls & windows were sprayed with the result.
2018: What eventually worked to wean off the cisapride (and enulose) was a combination of the low fiber dry food (Royal Canin Digestive Care) + Mirulax (1/2 teaspoon/2 ML) and something I tried to help cheer him up -- Hairball Control Greenies. (not Dental)
All years-current: Daily wet food - 1/2 to 1/3 (3-5 oz) of a can of something mixed or blended with water. If cold, warmed to room temp or higher.

I currently combine the dry food and 8-12 greenies in a cup and shake the half teaspoon of miralax into the dry mix. He is brushed and/or combed during most meals because he does not like to eat if I'm not watching/petting him. If he is stopped up for 3+ days, I add more greenies - up to replacing the dry food completely until he, um, goes. The only wet food he now accepts fancy feast cod/sole/shrimp or regular tuna (as of 2018). For those of you yelling at me for this - he tries to bury all other wet foods and I start to see skin issues with only fancy feast. The Vet is seems to be mused by addition of the greenies (and the tuna), but he is 15 or 16 now, generally healthy, and not dead yet.

To sum up - we were going to the vet every 5-10 days for ~2 years until the current shift and he has not had to go back for constipation issues in the past 2 years. 1-2 times a year, if he is stopped up for 5 days, I also give him doses of cisipride until it works.

++Water fountains. Bought my first in 2007, after he jumped in the sink to drink from the tap the day I brought him home from the shelter. Note. my other cat completely ignored the water fountain. Some cats will just not use them.
posted by gardenkatz at 8:37 AM on December 11, 2020

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