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CriticalCareVet
CriticalCareVet, ER/ICU Specialist
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Hi my cat Billy was diagnosed about 1 month ago with early

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Hi my cat Billy was diagnosed about 1 month ago with early stages of kidney disease. He has a long history of cystitis through stress so was always high risk so I requested full bloods very early after noticing constipation was creeping in and nothing I did was helping.
He has successfully changed over to a prescription renal diet (wet foods) and takes fortekor as well. For his constipation (the main problem right now) he has 1ml of lactulose every second day and 5cm of furlax every other day. Given he's in such early stages I was keen to learn what I could do at home to help keep him feeling good as long as possible. I live in New Zealand so some of the options I've discovered weren't offered to me by my vet. I have obtained and want to start using Miralax (in place of lactulose) because long term it seems to be the safer option. I also want to cut out the Furlax asap because even the manufacturer says that you shuld not use it for any long term solution. I was hoping to perhaps use Slippery Elm Bark Powder instead as a support to the Miralax.

The MAJOR problem is that I have no idea how to transition him onto these (in particular the Miralax). I read loads of information about dosages but I don't really know how bad his constipation is in relation to other cats so I worry I'll either give too much and risk a mess and possible infection.. or not enough and risk him getting backed up to the point he needs a several enemas. PLEASE help me figure this out..
Submitted: 1 year ago.
Category: Veterinary
Expert:  CriticalCareVet replied 1 year ago.
Welcome to JustAnswer! I am a licensed veterinarian and specialist and will do my best to assist you today!

Typically - Miralax is started at 1/8 to 1/4 teaspoon every 12 hours.

It is typically mixed with the food as it is a powder.

Similar to lactulose, it is titrated in dose to the point where the stool is soft and easy to be expelled, but formed (not diarrhea).

Every cat is going to be different - which is why there is a dose range rather than an exact dose for every cat.

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With this communication - we are here to guide you in making the best decision for your pet. This is for informational purposes only. We are not allowed to diagnose and prescribe medications - rather provide a course of action to speak to your veterinarian about - and any medical therapy and treatment should only be performed after an in-person examination with your veterinarian as a professional-client relationship has not been established on the site. While information may be discussed, this is not intended as an encouragement for you to self treat your pet, rather information online, and any treatment provided should only be performed after consulting your veterinarian. This is information ONLY, not advice. More information can be found HERE
Customer: replied 1 year ago.


From what I can tell though there is a sigificant delay in the Miralax taking effect so what I'm unsure of is do I totally stop the lactulose one day and start Miralax the next or slowly transition him using both? Maybe I'm looking at this wrong and it's really easy but to me it's not that simple when you're trying to maintain a passable stool.


 


The only other person I cound find on a support group that made this kind of change said that they reduced the lactulose by half and gave 1/8 tsp for Miralax for two days. Then they reduced lactulose by half again and gave 1/8 tsp twice a day for two days. Finally stopped the lactulose and now uses just over 1/4 a day. She did note that it's probably not recommended to do it that way so that's why I came here. I also don't use the lactulose like that - it's only every second day.

Expert:  CriticalCareVet replied 1 year ago.
Hi There,

When I have typically dont this, I give the lactulose for one of the daily doses and then give the miralax as the evening dose, then weaning the lactulose and changing to miralax only.

Reply any time if more information is needed!

Don't Forget the deposit you placed to ask this question is not used to compensate the professional until you rate my service! Please know, we do everything possible, even when illness is concerned, to give accurate and compassionate information. Please do not rate the website itself or the illness, rather the compassionate and timely information.

Join thousands of satisfied customers by adding me to your bookmarks/favorites: CriticalCareVet.
Just type your future question in the text box to direct it to my personal attention.

With this communication - we are here to guide you in making the best decision for your pet. This is for informational purposes only. We are not allowed to diagnose and prescribe medications - rather provide a course of action to speak to your veterinarian about - and any medical therapy and treatment should only be performed after an in-person examination with your veterinarian as a professional-client relationship has not been established on the site. While information may be discussed, this is not intended as an encouragement for you to self treat your pet, rather information online, and any treatment provided should only be performed after consulting your veterinarian. This is information ONLY, not advice. More information can be found HERE
Customer: replied 1 year ago.


I'm not sure I know what you mean sorry. I only do lactulose x1 every second day usually in the evenings. The only other thing is 5cm of furlax on the other day.

Expert:  CriticalCareVet replied 1 year ago.
If you are only using it once per day, which is used in very mild cases, you can try to do 1/2 dose of each then wean to only miralax.

Don't Forget the deposit you placed to ask this question is not used to compensate the professional until you rate my service! Please know, we do everything possible, even when illness is concerned, to give accurate and compassionate information. Please do not rate the website itself or the illness, rather the compassionate and timely information.

Join thousands of satisfied customers by adding me to your bookmarks/favorites: CriticalCareVet.
Just type your future question in the text box to direct it to my personal attention.

With this communication - we are here to guide you in making the best decision for your pet. This is for informational purposes only. We are not allowed to diagnose and prescribe medications - rather provide a course of action to speak to your veterinarian about - and any medical therapy and treatment should only be performed after an in-person examination with your veterinarian as a professional-client relationship has not been established on the site. While information may be discussed, this is not intended as an encouragement for you to self treat your pet, rather information online, and any treatment provided should only be performed after consulting your veterinarian. This is information ONLY, not advice. More information can be found HERE


CriticalCareVet, ER/ICU Specialist
Category: Veterinary
Satisfied Customers: 63981
Experience: Emergency and Critical Care Specialist
CriticalCareVet and other Veterinary Specialists are ready to help you
Customer: replied 1 year ago.


ok so for example if I start today it's furlax day (no lactulose at all).


 


I would give half the furlax (2.5 cm) and give 1/8tsp of Miralax.


Tomorrow on lactulose day I'd half this and do 1/8 tsp of Miralax and then repeat gradually reducing furlax and lactulose further? is that correct?


 


Then once he's on just Miralax I can adjust according to the stool but it's usually a twice daily dosage rather than single?


 


Also can I mix it straight into food? I thought I had to mix it with water and give orally?

Expert:  CriticalCareVet replied 1 year ago.
Yes - that is correct, mixed either food or water. It doesnt matter.

Don't Forget the deposit you placed to ask this question is not used to compensate the professional until you rate my service! Please know, we do everything possible, even when illness is concerned, to give accurate and compassionate information. Please do not rate the website itself or the illness, rather the compassionate and timely information.

Join thousands of satisfied customers by adding me to your bookmarks/favorites: CriticalCareVet.
Just type your future question in the text box to direct it to my personal attention.

With this communication - we are here to guide you in making the best decision for your pet. This is for informational purposes only. We are not allowed to diagnose and prescribe medications - rather provide a course of action to speak to your veterinarian about - and any medical therapy and treatment should only be performed after an in-person examination with your veterinarian as a professional-client relationship has not been established on the site. While information may be discussed, this is not intended as an encouragement for you to self treat your pet, rather information online, and any treatment provided should only be performed after consulting your veterinarian. This is information ONLY, not advice. More information can be found HERE

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