Q: I have a 2-year-old male cat that has had two bouts of impacted bowels in two years and has had to have enemas both times. I have changed his food many times trying to regulate him, and he is currently on dry and wet food daily. After this last bowel issue, I changed him to a prescription diet with high fiber and probiotics, as advised by our veterinarian.
She has given me lactulose to administer if he does not have a bowel movement, also suggested that I might start adding 1/8 tsp of MiraLax to his wet food.
Do you have any suggestions?
A: Thanks for getting in touch, and I am very sorry to hear of your kitty’s problem. Constipation is, unfortunately, a common problem in cats, and perhaps a brief review of its diagnosis and treatment would be helpful.
Constipation is defined as a less than normal frequency of defecation, often combined with difficulty passing stool, dry stools, and/or painful defecation.
It can be caused by a variety of problems, including ingestion of undigestible material (i.e., hairballs/foreign body), tumors or narrowing of the gastrointestinal (GI) tract, electrolyte disturbances/dehydration, some neuromuscular disorders, and by certain drugs. In many, if not most cases, the definite cause of constipation is not identified in cats, a condition referred to as idiopathic constipation.
The average cat defecates once to twice daily, and if an owner notices that their cat has not defecated in 48 hours and/or if he shows signs of discomfort upon attempts to defecate, a veterinary consultation is in order.
The veterinarian will usually perform a physical examination and may feel large amounts of stool in a cat’s GI tract if he is suffering from constipation.
This may be followed up by imaging (abdominal ultrasound and/or radiographs) to verify the suspicion of constipation and to rule out any other abnormalities in the cat’s abdomen. Bloodwork may also be recommended to rule out any secondary negative metabolic impacts of constipation.
The initial treatment of cats with constipation may vary depending upon its severity and often includes the administration of either intravenous or subcutaneous fluids to assure adequate hydration, and enemas if the degree of constipation is deemed to be advanced.
Importantly, while owners can, in theory, be trained to give veterinarian-approved enemas at home, this can be technically difficult due to the cat’s compliance (many cats require sedation for enemas). Because certain types of enemas can be harmful to cats, owners should never give enemas to their cats without discussing this with their veterinarian first.
If affected cats are relatively stable, at-home treatment usually involves several recommendations. The first is assuring adequate hydration by prompting cats to drink by offering adequate water bowls and/or water fountains and adding water to food.
The second usually involves the addition of soluble and/or insoluble fiber to the food in the form of pumpkin puree, psyllium husks, or a similar dietary supplement. Laxatives, which work by drawing water into the stool and/or by making it more “slippery,” facilitating easier passage through the GI tract (like the MiraLax and lactulose you mention), may also be recommended.
In more advanced cases, drugs that increase the motility of the GI tract may be prescribed to promote increased peristalsis (rhythmic contraction of the intestines) to facilitate the movement of feces through the GI tract.
Feline constipation should be treated aggressively, as if it is not controlled, it can progress to obstipation (a more severe form of constipation) and, ultimately, megacolon (characterized by severe colonic dilation/impaction and a permanent loss of function of the affected colon), which can become a life-threatening emergency. Cats with megacolon often require surgical resection. Early intervention on this condition is key for a favorable outcome.
Please continue to regularly monitor your kitty’s defecation habits and to work closely with your veterinary team to assure that their recommended treatments are effective.
Best of luck, and please send an update when you can.
