Miralax and lactulose

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CarolC
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Miralax and lactulose

Post by CarolC »

Just wanted to record our experience with using both lactulose and Miralax for an 8-yo cat with no known health problems or disabilities, but suddenly a few months ago she became chronically constipated. She was given an enema twice and was cleaned out by the vet twice, and she was prescribed lactulose. She was getting 1 ML of lactulose 2x/day. I also transitioned her to canned food with only a little bit of dry for an afternoon treat. It wasn't helping. This went on for over 2 months. During that time our first bottle expired so we were given a new bottle, but it wasn't helping either.

In desperation I tried milk along with the lactulose, 1/8 c of whole milk with meals. She drank the milk OK, but no real change in the litterbox, so 2 pints of milk later, I gave up on that.

By now it had been 3-4 months (not sure how long, I've lost track) and she's had maybe 2 normal movements that whole time. Most days she was having nothing (often for several days), or a very dry deposit maybe 1 1/4" long, but she continued to eat OK. I got more desperate and tried Miralax. We have been doing this for almost a week, and it is giving some results. She is getting 1/4 tsp morning and night. You dissolve it in water and mix the solution into canned food. Apparently it is tasteless or nearly so.

Common advice is that the cat is not drinking enough water and you should encourage drinking. All I can say is, I was cleaning plenty of urine clumps out of the box, so it seems like her fluid intake must be pretty good.

Right now we are doing better with Miralax.

http://veterinarycalendar.dvm360.com/co ... roceedings
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critters
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Re: Miralax and lactulose

Post by critters »

Hmm. Interesting! I don't know much about Miralax, but I know it's extremely popular with older and disabled humans, so it doesn't seem to have a repulsive taste.
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CarolC
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Re: Miralax and lactulose

Post by CarolC »

I haven't tasted it. Maybe I'll get brave and try it. :)

Here's an update for what it's worth. After about 10 days on Miralax, her litterbox looks about normal. Formed stools the right size and good consistency. This is after months of no luck on lactulose. The first 2-3 days she started having movements, it was clay consistency and super stinky. I don't know if that has anything to do with trying milk previously. I kind of think it was just because the waste was getting sour while she was getting more and more backed up. At about the 4-6 or 4-7 day range, she was not going everyday and I worried it was not working. Then she had a couple of diarrhea puddles in her box. And since about the 10-day point, it looks normal and she looks like she feels good.

You have to dissolve the crystals before mixing it in food. I am taking a little coffee measure which holds 2 Tbsp. I fill it half full with water (so about 1 Tbsp) and measure 1/4 tsp of Miralax. She is an average sized cat, about 8 lbs.

EDIT TO ADD: I shook a little of the crystals into my hand and tasted them. You're right, zero. I can't taste it. Don't know if cats have different taste buds.
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critters
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Re: Miralax and lactulose

Post by critters »

:mrgreen: Cats probably taste differently than we do, but I figure that the fact that you don't taste anything means that it's probably not offensive to them.

PS--I'm glad to know that Miralax and the like are safe and effective to use with critters. Lactulose needing Rx was always such a nuisance, whether it worked or not.
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CarolC
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Re: Miralax and lactulose

Post by CarolC »

Yes, there are several inconveniences with lactulose, but my real objection this time around was, it just wasn't doing the trick for whatever reason.

One problem with lactulose has always been that it's messy. The bottle usually develops drips down the side, which congeal like dried syrup. I always kept my bottle on a plastic lid (from a can of nuts or whatever) so it would not mess up the cupboard. But last time they gave it to me in 2 plastic bottles with a nifty special top on each, designed so you could poke the point of your syringe into it and it was a snug fit, and you could turn it upside down and draw out your dose without any mess. That was nice. I didn't have to store it sitting on a plastic lid to protect the shelf. Howsomever :wink: ...it wasn't working.

This is similar to the bottle adapter.

https://www.ebay.com/itm/Apothecary-Liq ... Sw9tJacG32
adapter.PNG
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critters
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Re: Miralax and lactulose

Post by critters »

Yes, we've had bottles like that on occasion, usually from stuff compounded by regular pharmacies. They're terrific!!
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CarolC
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Re: Miralax and lactulose

Post by CarolC »

Well, I have a kitty who is back on lactulose now. The vet insists it will work. We tried 1ML 2x/day, didn't work. Tried 3ML 2x/day, didn't work. Now she is on 5ML 2x/day. I see no difference, but I do trust this vet to know what he's talking about, so we're still trying.

But the reason I'm posting is the lid. The lactulose bottle came with a childproof cap. When you unscrew it or put it back on, it makes a loud clicking noise. Needless to say, when she hears it, she hides and I have to get her out from inside the cat tree (which is carpeted so she latches on) or under the bunkbeds or whatever. I considered calling the vet and asking for a non-childproof lid, but with the pandemic and everything it seemed like a lot of fuss.

I looked around in the kitchen cupboard and found that the lid on the Heinz vinegar bottle fits the lactulose, so I switched them. Now it is so nice to unscrew the cap and not send my kitty into hiding from hearing that noise. :)
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critters
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Re: Miralax and lactulose

Post by critters »

You might even be able to find a flip top to fit, although I don't know that it wouldn't leak if the bottle turned over. :smart: Yeah, I know what you mean about giving them a cue to something bad coming!
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CarolC
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Re: Miralax and lactulose

Post by CarolC »

So...the continuing story of the lactulose. My cat is on it twice a day. She's on so much that I have to put it into her mouth with 2 squirts, not one, because the dose is too much for one mouthful.

I put her on the kitchen counter and give her one squirt. Wait for her to swallow it. Then give her the second squirt (she is less willing to open her mouth for the second squirt) and turn her loose. She immediately hops from the counter to the chair to the floor and manages to spray it everywhere. Everything gets sticky. The counter. The backsplash. The chair. The wall. The door. The floor. I have a towel over the upholstered seat of the chair (thank goodness) but was not covering the back, which is vertical metal rungs. The wall is protected because after I had to wash syrup off the wall the first time, I put a large piece of plexiglas up to save the paint.

So there I was last night, scrubbing dried syrup off the floor, the backsplash, the chair, the plexiglas, and the door. Then I put lemon oil on the door (all this scrubbing can't be good for the wood). And decided to also cover the back of the chair with another towel, even though it is metal rungs, because they took so long to clean when it was dried on.

I am experimenting with holding her in place for a few seconds after I give her the second squirt, so she hopefully gets more of it swallowed and won't spit it everywhere. That may be working. I noticed the floor wasn't sticky this morning.

All of this, and it doesn't even do a very good job for her. :roll: She had to be started on cisapride anyway.
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critters
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Re: Miralax and lactulose

Post by critters »

Hmmm. I don't know that I have any other suggestions, I'm afraid... :mop:
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CarolC
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Re: Miralax and lactulose

Post by CarolC »

:mop: is right!
:scrub:
P.S. I have the perfect pad for cleaning off dried syrup. It's called Scotch Brite Scrub and Wipe. It's a very thin sponge on one side with Dobie pad fabric on the other for scrubbing, and it's big. They used to sell them at one of the building supply stores but they don't seem to carry them anymore. I had to find someplace that sold them online this time.

P.P.S. Holding her after the second squirt does seem to be helping. At least I want her to get her full dose. When she spits it all over the place, I have no way to tell how much she actually swallowed and how much she managed to spit out.
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critters
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Re: Miralax and lactulose

Post by critters »

:twisted: Uncooperative species!
JodieC
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Re: Miralax and lactulose

Post by JodieC »

Interesting information. I don’t find that lactulose works very well with my dog either. She never used to get backed up before her tail was removed. :(
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CarolC
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Re: Miralax and lactulose

Post by CarolC »

Hi JodieC,

Have you seen information on expressing the bowel? Some dogs will empty their bowel if stimulated. Other dogs can be emptied better by manually squeezing the bottom to massage or pop the stools out. Here is an article about bowel management.

viewtopic.php?f=5&t=18586

Here are some video examples for dogs. Not sure how big your dog is. These are all graphic videos in the sense that they do show the dog actually eliminating. :blush:

https://www.youtube.com/watch?v=-iTCT-ikirs (Squeezing method paralyzed 3-legged dog)

http://www.youtube.com/watch?v=Saf_kZvwClE (Squeezing method dachshund, start at 1:18)

http://www.youtube.com/watch?v=d18yUDdZVUw (Squeezing method - Popeye)

http://www.youtube.com/watch?v=6ueeTJJW9YA (Squeezing method - dog lying on back)

http://www.youtube.com/watch?&v=XiFpsEToOtw (Expressing bladder and bowel of large female dog)

:group:

P.S. The 3-legged dog is mine, and if you're wondering what the reason for picking up the puppy pad was, I was trying to show the stool quality. Even though the fresh stool was being rolled around on the clean white pad, it was not making a mess, so imagine if that was your carpet or your dog's bed. Good stool quality makes a big difference in living with a disabled dog, especially if your dog is inadvertently dropping surprises around the house or doodling in his bed.
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critters
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Re: Miralax and lactulose

Post by critters »

:whale: JodieC!
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