u/Striking_Magazine_65

Hi everyone, I can already tell this is going to be a long post 😭 I have a 12-ish-year-old rescue cat, neutered male, named Maurice. He had some skin issues and constipation (pooping every 2-3 days) and my longtime vet, who I LOVE, had me put him on z/d. This cleared up the skin issues but didn't do anything for the constipation. We're operating under the assumption this is IBD even though he hasn't had a biopsy. This is actually not my first rodeo with cats and IBD.

We haven't bothered to test other proteins because he honestly seems intolerant to everything. His skin reacts to transdermal meds too. So he's staying on z/d.

Things we have tried: miralax, lactulose, prednisolone, budesonide, fortiflora pro, psyllium, cisapride, pumpkin, sub q fluids. He's had blood work (nothing to write home about), tests for parasites, X-rays, and some other imaging, I believe it was an ultrasound. He has a water fountain and seems to drink enough.

The regimen of meds he is on right now is insane.

Morning:

• Cisapride
• Budesonide
• Wait 20-30 minutes, then give a big syringe with grueled z/d mixed with lactulose and miralax
• Some hydrolyzed treats

Afternoon:

• Cisapride

Evening:

• Same as morning but no budesonide

Cisapride is ideally given 20-30 minutes before a meal, but since he eats like a bird and doesn't really do meals, I give him the big syringe of meds and food and some treats to hopefully stretch his stomach out enough to send the signals to the gut that it should get moving.

Despite all of this, he is now pooping every 5 or so days, and when he does, he has 3-4 bowel movements within a few hours, from hard to mushy.

He's had one episode where he needed to be deobstipated, and one enema. Vet took an X-ray both of those times and said there was no megacolon, he was just backed up with like 12 inches of poop.

The vet is pretty much stumped and said the next step would be to bring him and his chart to an internist to see if anything has been missed.

It looks like chlorambucil is an option for some IBD cats, but that seems to be more for the diarrhea cats. He has the atypical presentation of constipation so I don't know if it would be an option. Pretty sure my vet would've brought it up since I've had another cat on it. He's not really a vomiter, except sometimes after he has one of his mega-poops 😭 Like he poops so hard he barfs.

Can anyone think of anything we have missed? Any like, new drugs my vet may not be aware of? He's way beyond the "add a little pumpkin" stage. We're throwing the whole arsenal of meds at him. He's very not-food-motivated and generally spends his entire day sleeping. His lack of activity doesn't help his situation, but he's an old guy disinterested in playing.

I'll make him the internist appointment, although they book out months in advance, but I'd like to know if there's anything else I should run by my vet.

Thank you ❤️

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