Lactulose for cats - long explanation

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Lactulose for cats - long explanation

Postby Toni Martin » Tue Jun 22, 2004 7:00 pm

I've not visited for a while, so here's my story, in brief. Sheba, my cat is incontinent (both urine and stool) due to nerve damage from a car accident. Thanks to this site and the wonderful help here, we are all adjusted to this special need. But, one lingering problem that comes and goes is that Sheba seems to have lost the nerves to a portion of her bowels and stool moves very slowly through. I envision that the stool in the 'dead' portion is probably pushed by stool behind it to move it through. Her stool ends up being hard, dry and large in diameter. This causes her distress in trying to push it out, causing splitting and bleeding of the anus. The most successful solution so far has been Metamucil each meal (2x day) in an amount that doesn't make the stool too stringy because she can't seem to cut it off when she tries to expel it. In other words, she needs a definiive piece of poop that can pop out, vs. a long string that she can't seem to cut off and stop pooping. (Her schphincter (sp?) muscles aren't strong enough to 'cut'.) The Metamucil works the best, but is not as effective as Sheba and I would like. We've tried pumpkin and prunes (too alkaline - she gets crystals.) The vet has recommended trying Lactulose. Has anyone tried this on their kitty? Other ideas are also welcome.
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Re: Lactulose for cats - long explanation

Postby critters » Tue Jun 22, 2004 7:00 pm

It's VERY commonly used. See "kittie with possible megacoclon" on the next page; I'm not sure if Alisa G's Trixie uses it, but I'll try to get her here.
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Re: ps

Postby CarolC » Tue Jun 22, 2004 7:00 pm

Yes, you're right, Alisa does use it with Trixie. Here is a repost of her April 4 update:


Posted by Alisa G on 17:25:14 4/4/2004 from 12.73.234.10:
Thanks so very much for all of the prayers for Trixie. I'm happy to report that she is still with us----and pooping again. We have to watch her like a hawk. She had some damage to her lower colon from the severe constipation that she had. The vet was able to manually "unplug" her. She didn't think she was going to be able to and mentioned euthanasia. Surgery doesn;t have a good prognosis for her.

Well it worked!! She's on can food only,lactulose and cisapride. So far so good. Thanks for the well wishes please keep them coming. =)

--end repost--

My dog's physical therapist says lactulose can be compounded at the pharmacy to make it taste better, ie. they can add flavoring such as liver, tuna, grape, or cherry.

If you can't reach Alisa, she posted on the Yahoo Handicats Support Group 6/22. You might be able to reach her and others using lactulose there.





click here to go to Yahoo Handicat Support Group
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ps

Postby critters » Tue Jun 22, 2004 7:00 pm

You might also ask about DSS (docusate sodium, as in Colace), which is available OTC, although it might be easier as a basic liquid RX instead of a gel cap.
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Re: Lactulose for cats - long explanation

Postby Debbie-Spain » Wed Jun 23, 2004 7:00 pm

Hi Toni

My cat, Kat, has almost exactly the same problem as Sheba from being hit by a car. Getting the poop right has always been a bit of a problem. I live in Spain and we don't have things like pumpkin pie here!

Just after I first took Kat in, having had no success in getting her to poop, she had to be emptied under anaesthetic using some special equipment because she had a fecal impaction. So since then it has been really important to try and keep her going smoothly! She took prepulsid for a short time to start things "moving" again but I got her off it as soon as possible...Kat's anal sphincter is permamently open so she has no "cut off" either...
Things that have helped Kat keep "moving" are malt supplement (the kind that comes in a tube, like a jelly, usually it's recommended for hairballs) and above all giving her the kind of tinned cat food that comes with lots of jelly around the sides. Here we have a brand called "Felix" but I know that there are other similar brands. I maybe would not feed her that out of choice but it certainly keeps her poop coming out (she doesn't really eat the lumps of meat, just the jelly around them), I also feed her Hills C/D dried food which seems to prevent her getting too runny and is also good because she too has a problem with crystals...

I'm not sure whether you have to express Sheba for her urine, but if you do, once her bladder is empty you can actually feel your way up to where the stool is (without getting your hands dirty!) and kind of "squash it" into shape to make it come out easier, you can even try squashing and moving it towards the exit, LOL. I have often done this with Kat, the vets showed me how to do it and it is really useful, you can feel whether there is too much stool accumulated and try and help it out.

Also, just in case, not sure if Sheba is like Kat, prone to urinary tract infections, but after Kat's last, I have started giving her Cystaid (it's from the UK, not sure if there is a US alternative), and I am really pleased with the results so far. Previously there would be days when I wasn't at all happy with the colour of her urine, but since I have been giving her the Cystaid (one capsule a day) her urine started looking considerably healthier after about a week and has stayed so for the last 3 or 4 weeks...

Your post made me wonder, I have used in the past Hill's Light food for dogs that were overweight. I imagine it is high in fibre and the effect on their poop is that there is more volume, which could be a problem, but the density and texture would probably be perfect for cats like Kat and Sheba. Just not sure whether the same would happen with a "Light" food for cats...

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"light" food

Postby critters » Wed Jun 23, 2004 7:00 pm

Some have higher fiber; some have lower fat. Just a few minutes ago I wondered about the possibility of using hairball-formula food; it almost always has psyllium (Metamucil, etc) or something for extra fiber. Extra fiber without extra water to be absorbed can be constipating, though, so I guess it's a fine line...
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Ditto here

Postby CarolC » Wed Jun 23, 2004 7:00 pm

I use Laxatone for my dog. It can be used with cats too. The product Debbie refers to is probably what they call Petromalt here, a hairball remedy. My dog will also eat straight vaseline. Petromalt and Laxatone taste good. With Vaseline, you may need to smear it on a paw to be groomed off.

The food with jelly sounds like what they call aspic here. Fancy Feast and others have flavors with aspic.

I do the squashing thing with my dog too, though it is harder because a dog's abdomen is much shorter and firmer. Sometimes if I can get the leading end of the stool to pass, stools further inside move toward the exit. My dog's injury is mid-back, about where the ribs end. There is a procedure you can do with dogs where you put on latex gloves, dip your finger in vaseline, and insert your finger into the rectum. In some cases this will stimulate them to evacuate the bowel reflexively. With my dog that does not happen. I have very long slender fingers, and I can sweep out stools without bothering her, which can help. My dog is a 7 lb. chihuahua, and like your kitty, her stool diameter becomes way too big. I usually compare it to what my Golden Retriever leaves in the yard, and it would be too big for my Golden if I didn't help her. With my dog, I press on the soft tissue to either side of the anus and pinch to see if I can feel any stool inside. You feel something firm inside the soft tissue. As Debbie says, I sometimes mold the leading end of the stool, which is often clay-ey in consistency, so it has a more pointed end instead of a large blunt end. When I pinch on the stool and/or spread open the anus slightly, the stool will usually crown and begin to pass of its own. Then other stools may move into place and continue to pass. I often pinch as they pass, which both narrows the diameter and breaks them off as they fall. If you can hold her in an upright position, you get the advantage of gravity and the weight of internal organs to press the stool toward the exit. I find it convenient to place an incontinent pad, paper towel, or kleenex in the bathroom lavatory and potty my dog into the lavatory. Cleanup is easy, and I can see what I'm doing in the bathroom mirror.
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Can lactulose be a long term solution for a constipated kitt

Postby rubyraquelita » Tue Jan 31, 2012 12:20 pm

Hello from Peru! First, this page is a miracle for people with handicapped pets! THANKS! My cat has exactly the same problem described above for Sheba (incontinent in both pee and poop)! My cat´s name is Mimi. I pee express her everyday each 4-6 hrs but she gets constipated so frequently now! I try to push it and help it when I touch her stomach and feel a long tube of poop inside. However, I feel I am just putting it all together and making a huge ball of poop that is impossible to get out. She had had in the past a doctor unplugging her, but she needs to be sedated, etc. too painful and traumatic!
I just talked to my vet...he says lactulose can help. I have been under laxatone and olive oil but nothing does the miracle. Is there is any side effect?? HE told me to give her 3ml each 8 to 12 hrs....is that ok??? Can I have her with this her whole life? She is only 2 years old. PLEASE HELP! Since yesterday she hasn´t poop. I will do today what the vet does: inyecting glycerine on her little but, after some hrs, it normally comes all out...but I wonder how healthy is to do that...
THANKS!!!
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Re: Can lactulose be a long term solution for a constipated

Postby CarolC » Thu Feb 02, 2012 11:00 pm

rubyraquelita wrote:Hello from Peru! First, this page is a miracle for people with handicapped pets! THANKS! My cat has exactly the same problem described above for Sheba (incontinent in both pee and poop)! My cat´s name is Mimi. I pee express her everyday each 4-6 hrs but she gets constipated so frequently now! I try to push it and help it when I touch her stomach and feel a long tube of poop inside. However, I feel I am just putting it all together and making a huge ball of poop that is impossible to get out. She had had in the past a doctor unplugging her, but she needs to be sedated, etc. too painful and traumatic!
I just talked to my vet...he says lactulose can help. I have been under laxatone and olive oil but nothing does the miracle. Is there is any side effect?? HE told me to give her 3ml each 8 to 12 hrs....is that ok??? Can I have her with this her whole life? She is only 2 years old. PLEASE HELP! Since yesterday she hasn´t poop. I will do today what the vet does: inyecting glycerine on her little but, after some hrs, it normally comes all out...but I wonder how healthy is to do that...
THANKS!!!


Hi rubyraquelita,
When I saw your post I wanted to answer, but need to look up the dosage for lactulose.

According to The Pill Book Guide to Medication for Your Dog and Cat The usual dosage is:

The Pill Book Guide to Medication for Your Dog and Cat wrote:Cats: For hepaticencephalopathy --0.25 - 5 ml/cat and adjust until soft stools are produced.
For constipation--1 ml/10 lb 3 times a day, then adjust as needed.
Drug form: liquid containing 667mg/ml


According to the Veterinary Drug Handbook, Fourth Edition
Veterinary Drug Handbook, Fourth Edition wrote:Cats:
For hepatic encephalopathy:
a) 0.25 - 1 ml PO; individualize dosage until semi-formed stools are produced. (Center, Hornbuckle, and Scavelli, 1986)
For constipation:
a) 1 ml per 4.5 kg of body weight PO q8h initially, then adjust prn (Kirk 1986)
b) 0.5 ml/kg q8-12h PO (Sherding 1989); (Washabau ad Holt 2000)
Lactulose Solution 10g lactulose per 15 ml


Under the cisapride entry in the Veterinary Drug Handbook, Fourth Edition
when cisapride is used
Veterinary Drug Handbook, Fourth Edition wrote:Cats:
in combination with a stool softener (author recommends lactulose at a starting dose of 2 - 3 ml PO tid; then adjust prn)


PO means "by mouth" or "orally"
a 12 lb cat is 5.4 kg
a 10 lb cat is 4.5 kg
an 8 lb cat is 3.6 kg
a 6 lb cat is 2.7 kg

Lactulose is not habit forming and as far as I know it is safe to use for the whole lifetime of the cat.

When you are attempting to express the bowel, and you can feel the tube of poop inside, are you able to pinch the tube and break the poop into smaller pieces? That can help it come out. Also, can you sometimes feel a little lump of poop right in her anus, ready to come out? Are you able to squeeze her bottom so it pops out? If you don't want to touch it you can use a Kleenex. :wink:

Did you see the videos showing people expressing the bowel of their cat? They are wonderful!

http://www.youtube.com/watch?v=LbVxdFyGKjs (Expressing bladder and bowel of cat in standing position)

http://www.youtube.com/watch?v=iuMZ4hrijuY (Expressing bladder and bowel of small cat in midair)

http://v.youku.com/v_show/id_XMTczNjAzOTk2.html (Vet expressing cat's bladder and bowel)

http://www.youtube.com/watch?v=HVdJI-qsOus (Expressing large male Persian (Sasha) in standing position - Part 1)

http://www.youtube.com/watch?v=KIFTKuR9-uc (Expressing large male Persian (Sasha) in standing position - Part 2)

There was a message by happyfeet that said Miralax may be even better than lactulose. Here is the link:

viewtopic.php?f=5&t=15358&p=82063&hilit=miralax#p82063

Hope this helps. :D
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Re: Lactulose for cats - long explanation

Postby rubyraquelita » Sun Feb 05, 2012 11:12 am

Yesterday she was manually unplugged after the vet did a Coca Cola enema! It destroyed the poop which was sooo dry and hard. But the procedure is traumatic. She needs to get sedated.

Thank you so much for all of the videos and the lactulose dosage. I watched but I have been traying to do that. I press when I feel stool around the anus, it comes out. Normally a hard ball that sometimes makes her anus to bleed :( but sometimes, I can feel the whole intestine full from up top. i try to move it and to push and nothing. I can actually feel I am making a larger size poop instead. I will try lactulose twice a day. I read other postings and recommended miralax but I am not sure I can find it in Lima.

I wonder if I could feed her Hills food for gastroinstestinal issues. Maybe it has too much fiber and poop will enlarge even more? Or could it be large but easy to brake? Or what if I dont feed her Fancy feast anymore and give her just human foods like cans of tuna or boiled chicken.

My drama is that after few weeks, I feel we will be back on the coca cola :(

If someone has any further tip, I will appreciate it so much! Thanks!
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Re: Lactulose for cats - long explanation

Postby CarolC » Tue Feb 07, 2012 11:13 pm

rubyraquelita wrote:Yesterday she was manually unplugged after the vet did a Coca Cola enema! It destroyed the poop which was sooo dry and hard. But the procedure is traumatic. She needs to get sedated.

Thank you so much for all of the videos and the lactulose dosage. I watched but I have been traying to do that. I press when I feel stool around the anus, it comes out. Normally a hard ball that sometimes makes her anus to bleed :( but sometimes, I can feel the whole intestine full from up top. i try to move it and to push and nothing. I can actually feel I am making a larger size poop instead. I will try lactulose twice a day. I read other postings and recommended miralax but I am not sure I can find it in Lima.

I wonder if I could feed her Hills food for gastroinstestinal issues. Maybe it has too much fiber and poop will enlarge even more? Or could it be large but easy to brake? Or what if I dont feed her Fancy feast anymore and give her just human foods like cans of tuna or boiled chicken.

My drama is that after few weeks, I feel we will be back on the coca cola :(

If someone has any further tip, I will appreciate it so much! Thanks!


That is so interesting about the Coca Cola! :shock: I do not know for sure, but I think if there is more fiber it might be easier to break. But you don't want too much bulk, either. Here is a good post about that question. It mentions low residue food.

viewtopic.php?f=5&t=16018&hilit=+low+residue+#p85160

On the question of wet or dry, I always heard to use wet. I think it would be good to experiment a little because you already know the food she is eating now is not working very well, so maybe you will find something better. Are you having any results from the lactulose?

The best idea might be to join the Feline Megacolon Yahoo Group, I am pretty sure the people there will know the best food for this problem. Hill's makes so many different formulas, maybe they will know which one works best. There are other companies that make special veterinary diets, too.

http://groups.yahoo.com/group/Feline_Megacolon/
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