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Caring for a Three Legged Dog or Cat

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thoughts on long-term effects of Miralax and Gabapentin
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Kirsten Thompson
1
15 September 2021 - 11:17 am
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Hi everyone – This is my first time posting but I did read the tripod book for cats prior to Monster’s surgery, and it helped prepare me so much that I can’t express my gratitude for you all. Monster is 16 and had rapid growing soft tissue sarcomas that took over his right back leg in a matter of months. He was a young 16 so we amputated a few months ago (Summer 2021) and he has done really well. He has had some constipation since surgery that I have taken care of with Miralax. I’m not sure if the amputation caused his internal bits to change positioning a bit. And not sure if others have had this experience? He does seem to vomit more while taking Miralax, but that could also be bc he ended up constipated. idk. He is an IBD cat so food options are very limited. And coming out of surgery, he was slow to pee, very slow to poop, and even got syringe fed. But it seems like all of those memories disappear once you are past them.

A few weeks in, he got stressed, and completely forgot how to walk and started having a lot of phantom movement of his muscles on the right side. I gave one dose of gabapentin from his post surgery meds and he woke up normal.

Fast forward another month, he started having a little constipation so Miralax was reintroduced and then I replaced my HVAC and he got stressed again. This time the inability to walk and yowling lasted a little over 24 hours. He got another dose of gabapentin and no longer cared that he couldn’t remember how to walk and still managed to use the litterbox and eat. He seemed unable to sleep that day, kept jerking awake. After he fell asleep and got a few hours of good sleep, he woke up able to walk again and normal. A week later, he’s eating his regrowth of hair right over his hip joint. And he’s never been an over-groomer.

As his name might indicate, Monster does not like the vet and most vets have rejected him over the years. His surgeon and the staff at Blue Pearl in Louisville have been great with him though. I have a little concern about him going on gabapentin long-term because he hates meds and it is messy giving him a liquid, but it does seem to work to shut off that phantom pain receptor in the brain. He’s old and I’m always aware that kidney issues in old cats can pop up at any point. Any advice is appreciated.

thank you!

Kirsten and Monster 

The Rainbow Bridge



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15 September 2021 - 11:48 am
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Kirsten I’m so happy you posted here! Thanks for starting a discussion all about Monster!

To keep things on topic, here’s what I mentioned in my previous response:

So the over-grooming is listed as one of many subtle pain signals that cats give. Check out today’s Tripawds pain management post for more info on signs. Remember that treating pain is not a one-and-done usually. Oftentimes it takes multiple approaches, so pain medication in addition to something like acupuncture and manual therapy (massage).

Let your vet know what’s going on and request a visit to the clinic’s rehab therapy team (I see they have one). The Tripawds Foundation can pay for your first rehab visit and this will hopefully be what it takes to help Monster with his pain. I’m so happy you found a clinic that works well with his purrsonality!

Also, some things I forgot to mention:

Gabapentin is a pretty benign medication according to pain experts like Dr. Robin Downing (she runs a Feline Friendly practice too, so she gets your concern). Her thoughts about Gabapentin are in that link.

Also, here are some Forums search results about Miralax. Folks like Holly have shared how they use it to help their cats. I hope she will see this post so she can comment but here’s what she said in that post:

Those doses are tiny doses! Purrkins brother has had bouts with constipation & backed up like your Andy, I use miralax on him daily and it keeps him going nicely. You don’t need a script and it works better then Latulose a script from the Vet. Both our Vets know and approve, our Vets now suggests the Miralax over Latulose to his patients 😉

Miralax- Over the counter – does not affect blood sugar
Latulose – can raise calcium levels in the blood , can affect blood sugar, need a Script, can rot teeth
(it’s sticky icky mess and the cats don’t like it )
Megacolon kitties use it with success!
Wide dosage range 1/8-1/4 teaspoon orally twice a day with food. Some cats need a heaping tablespoon plus)
Start small like I did with Purrkins, I don’t think you will need much! Saxton I use 1/2 tablespoon 2X daily

I’d want to find out the reasons for the constipation in the meantime. Has the vet checked for a condition like mega-colon? 

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Kirsten Thompson
3
15 September 2021 - 12:59 pm
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Prior to the soft tissue sarcoma discovery, he had only been to the vet once in several years because he has to be fully sedated to have a minor visit. He had a senior cat exam about a year ago and most things were looking good. He just had an IBD flare up and she wanted to keep an eye on liver levels. A few months later the tumors showed up though. So I’m not sure what his blood levels are post surgery. 

So the cancer was when he had several procedures done (spring/early summer 2021), including an ultrasound and xrays to make sure the cancer was only on the one leg. Internally, the vets saw nothing of concern. Noted he had 15 year old kidneys, but he was 15. So that wasn’t too concerning to anyone. It took a special feline anesthesiologist two attempts to get him out for his amputation surgery.

He’s a lovely cat, just not at the vet. So most of his vet visits are me explaining things until something really needs to be looked at. I assume during the ultrasound etc this summer, they would have seen mega-colon? He also never had an issue with constipation until surgery. His first dose of Miralax was a few days post-surgery when he wasn’t pooping. I have read it can lead to dehydration/worsen dehydration so that was my only concern with using it regularly. I give 1/4 tsp once per day and he has a healthy movement once per day. He is a rare water drinker though despite several bowls and a fountain. And he has IBD related to chicken, turkey, tuna, beef, salmon… No Fancy Feast for him. He eats lamb and sardine foods.

His activity level has decreased since surgery so that could also be a reason for the constipation. He doesn’t appear to be in pain 90% of the time. He’s old, so he might have a little arthritis in the remaining rear left leg and he doesn’t like to / can’t stand well on only that leg. But he runs up and down stairs and hops onto lower level things. Prior to surgery he was jumping on counters and even the top of doors on occasion. So the jumping has been cut out of his life the past few months.

The phantom limb issues seem to be largely confusion with him. He forgets how to walk, you can see the missing limb surrounding muscles moving. He flops all over with some backwards walking. And then after the second episode, he also chewed some hair off the area with the missing leg (a few days ago). I had been told by his vets that the gabapentin “blocked” the phantom issues and if they occurred to give him a dose. But I think you all have more experience collectively, so I wanted more advice.

thanks again!

Kirsten and Monster

The Rainbow Bridge



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15 September 2021 - 1:58 pm
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Hey Kristen, a few thoughts:

Have you ever taken him to a Cat Friendly vet practice? These vets have extra training in cat handling procedures, and their practices are even doing things like not using certain cleaning products that can cause animals to go “nose blind” and lose their sense of smell inside (a big factor in why so many animals are stressed at the vet). 

I’m not sure they would have spotted mega-colon unless they were specifically looking for it. 

Between the decreased activity and the constipation, and the occasional phantom leg pain , it does sound like he’s feeling some kind of pain that should be treated. Any chance there is a mobile vet / cat specialist and preferably a rehab therapist, in your area? If you want to PM me your location I’d be happy to look for you, but you’d have to register as a member to use our messaging system.

It's better to hop on three legs than to limp on four.™
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Forum Posts: 4
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30 August 2021
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5
15 September 2021 - 5:27 pm
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Hi Kristen,

I’m probably not the greatest person to comment But I am a Registered Dietitian (of humans of course so don’t know how much of this carries over to animals). But for sure in humans the things we recommend for constipation are fluids, fiber, and physical activity (so less activity could likely have something to do with it) I also lost one of my cats a few years back due to advanced kidney failure and she was getting constipating from that, they suggested pumpkin as a laxative so that might  be something you could ask your vet about if you are concerned with the Miralax.

i also hope this is ok to ask. But I’m considering amputation on my 15 year cat and have surgery scheduled for next Tuesday with some time to really decide if this is the best choice. Can I ask …do you have any regrets or things that surprised you or difficulties? I’m scared due to her age and thought with you cat being of similar age you might be a good person to talk to. 

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