I adopted a kitty with hind limb paralysis about 2 years ago. Since day 1, it was evident that he had constipation issues, although he is fully continent and uses a flat tray.
Ben has suspected Megacolon and had to be de-obstipated 3 times so far. I am trying to manage this condition with lactulose, cisapride and soapy water enemas.
Last Thursday, Ben had blood is in urine, so off we went to the vets. He has been prescribed Synulox but now into day 4 of treatment, & his urine (which was looking a more normal colour last night) has gone back to being red.
On Thursday, my vet was more concerned that in less than 6 months, Ben's weight has dropped from 3.3KG down to 2.495KG. I've just wormed him with a milbemax alternative, as per my Vet, to see if it is a parasite issue causing the weight loss. I also had Ben tested and he is FIV+! Poor guy has so many issues to contend with.
My Vets have just called me back and said that they can take a sterile urine sample & give Ben an anti-inflammatory. If there's no improvement when I go home, I will get Ben booked in for tonight (he's due a check up on Thursday).
I guess what I am asking is, how do I approach all of this holistically as opposed to just dealing with individual issues?
Here are what I would say Ben's issues are medically: -
* FIV (immune suppression - possibly needs stronger antibiotics or a more prolonged course of treatment when he has any infections - he often has a snotty nose. I have started giving Ben Mega C Plus to boost his immune system &
historically, have given him a supplement containing l-lysine.)
* Hind limb paralysis (Ben's back legs look weaker due to muscle wastage & he doesn't like me touching them - what can I do to ease any discomfort he has?)
* (Suspected) megacolon (stools seem to build up and get too bulky and firm to pass; Ben has cisapride and lactulose. I only feed wet food and add more water. I give soapy water enemas when needed).
* Ben is drinking like a fish and has been for the last month or so. Blood profile does not indicate any kidney issues or Diabetes. He won't use his water fountain. His appetite is poor, mostly if he hasn't had a bowel movement for a couple
days (he probably has nausea at those times), or, if he has a snotty nose. His coat often looks 'ruffled' and he is losing weight. The poor appetite, weight loss and ruffled coat seem to go hand in hand with Megacolon, but what if we're
Any advice would be much appreciated.
that is a fairly familiar constellation of problems to problems to me.
firstly with the FIV, te only proven therapy for it is Tcyte, which has mixed results and is obscenely expensive. good nutrition, longer courses of antibiotics, staying on top of everything is how I deal with FIV cats (I have had assorted FIV cats in the past). I would consider that the least of the issues right now.
he is drinkign like a fish because of the constipation. I have a spina bifida boy with megacolon who is now six and a half. Incontinent kids are prone to urinary problems and that is the #1 issue usually because it can kill them. It coudl be an infection, it coudl also be cystitis, both of which are pretty common for this crowd. My guy, Butterbean's, bladder is thickened from inflammation and harder to express now after years of it. His megacolon has become enough of an issue after so long that tomorrow we are seeing a specialist to look into surgical options. Hopefully you can avoid that outcome. I can certainly talk about what I have done/do for him.
I see your guy is continent. yay. sorry I missed that on my first read. still, bloody urine is a big concern.
Megacolon has been the focus of my life for so long with these guys I'm not sure what I will do if Bean's condition is improved, I will be very confused. You can try to increase the cisapride dose, Bean is on quite a high dose but that is what he has needed. Here is his recipie for breakfast:
1/3 can EN food (low residue food, high protein, high fat)
enoughw ater to make it soupy (you want as much liquid as possible)
1.75 mls of psyllium husk (i found this worked much better than pumpkin for fiber)
2.5 mls of miralax
2.5 mls veggie oil
1 ml mineral oil
one dose of onsior (a newish anti-inflammatory designed to be easy on the kidneys, this is good for his pain issues and the gut imflammation he gets as well as the bladder inflammation)
one dose bethanacol (helps him pee since he is incontinent)
fluid is extremely important. I have gotten to the point, and you probably will too, where I can look at him and just by how the fur is lying along his spine I can see if he is starting to get dehydrated. Giving 200mls of subcutaneous fludis before he is seriously dehydrated is very helpful. The extra fluid helps him move stool. You really really want your boy pooping every day. The less stool that stays in the colon the better, because you don't want it staying stretched out, also the longer it is in there the harder it gets. Butterbean develops hard plugs that stop him up and then we have to do what I call the "roto rooter" treatment at the vet. As his megacolon has progressed, I have added a nightly warm water enema to his routine, followed by manually expressing his colon, to prevent him from getting stopped up and stretched out (which is a painful thing when it happens).
Since the gut isn't moving stool along, they don't always eat enough and will lose weight. Have to keep that gut moving. I do use lactulose as a seperate dose, Butterbean won't eat food with it added, but if he has a plug lactulose won't do it, he needs a clean out (de-obstipation). A simple thing to try woudl be adding some veggie oil and/or mineral oil and upping the amount of water in his food. If you don't know how to give SQ fluids, ask your vet to teach you. It is easy to do and I think one of the most helpful things you can do at home.
ok, the bloody urine. a sterile sample is a good idea, anytime I am suspicious of a urine problem my vet takes a sterile sample and does a urinalysis. There can be a lot of blood but no bacteria and even no crystals, this is from inflammation. An anti-inflammatory is very helpful, a medication that can also help is Adequan. I also give cosequin daily although I"m honestly not sure how much good it does.
You described another condition I want to address. I have found many paralyzed cats, and cats with hind end deformities also have hypersensitivty to touch which can cause twitching, aggression, or pain. Have you ever seen his skin rolling? It looks like a wave going down teh back. That woudl indicate a more severe form of hypersensitivity. Even if not, a medication called Gabapentin is helpful for managing this. It addresses nerve pain and chronic pain. My little manx syndrome girl, Hopper, has seizures that are set off by being constipated. She also has megacolon although not as bad as Butterbean and if she starts backing up her legs will start jerking and it will actually build into a seizure. In general she does not like her hind legs touched because they are hypersenstivie. Gabapentin has helped her with the sensitivity and the seizures.
I hope this gives you some ideas. It's a hard set of things to manage, but it is possible. Maybe you coudl print this out and take it with you on your next vet appointment and see what your vet thinks. Until a few months ago Butterbean's routine worked very well for him. I have recently switched him to Purina EN food and it has helped quite a bit. He had been on urinary tract food to address his urinary issues.
Please keep us posted!
forever in my heart
i am not the same without you.