Horse Behavior Problems, Weaving, Windsucking, Cribbing

If you’re a dog or cat person, you may fantasize about horses—thinking they’re perfect and powerful, just pure energy and creatures of beauty. Well, they are energetic, beautiful, and powerful, but they sure aren’t perfect. Horses have as many behavior problems as people have. As many behavior problems as dogs, cats, and birds have.

One of the most frustrating of horse behavior problems is stereotypic behavior. Stereotypic behavior is an action repeated over and over—so, it’s an obsessive, compulsive activity. The most common horse stereotypic behaviors are:
· Weaving and
· Windsucking (also called cribbing)

Weaving
Weaving is like pacing, but horses only move the front two legs. With weaving, the horse stands in place and repeatedly rocks or steps moving one front leg then the other. Equine folks treat weaving by hanging rubber balls in the stall where the head or shoulders will whack into them as the horse leans right and left. Other folks use stall doors with a very narrow place for the head to poke from the door. This narrow opening means the horse must stand still in order to extend its neck and gaze outside the stall.

Windsucking or cribbing
A horse that windsucks grips a door or fence with its teeth and holds on while sucking in air. This maneuver expands the throat and some equine folks treat it by putting a non-expanding band around the horse’s neck. This behavior reminds me of kids that suck their thumbs and get an oral pleasure substitute for breast feeding.

Unnatural life leads to obsessive compulsive behavior
The sad truth is that most horses don’t have a natural life and aren’t free to interact in a herd or to graze for 12 hours a day. Instead, most horses are kept in stalls 23 of 24 hours. Equine folks don’t realize or don’t want to admit that this limited interaction with the environment drives the modern horse slightly nuts. Instead, equine folks commonly say that horses “learn” obsessive behaviors because they are under the bad influence of another horse that weaves or windsucks.

Study results
A study just published in Applied Animal Behavior Science examined whether horses do learn stereotypic behaviors from their neighbors. In the “Possible influence of neighbors on stereotypic behavior in horses,” published June of 2008, Danish researchers from the University Faculty of Science in Hungary (Krisztina Nagy1, Anikó Schrott, Péter Kabai) asked if horses learn to weave or windsuck because they observe other horses engaged in these activities. Researchers looked at almost 300 horses in 9 riding schools and concluded that stereotypic behavior increased when horses were stalled near others who engaged in these misbehaviors. This confirms what many horse folks say. Researchers also found that those horses who were most aggressive toward other horses were most likely to develop stereotypic behaviors.

Study findings may lead to more behavior problems
Unfortunately, this study, may lead to more isolation rather than less. If equine folks believe that their horses will begin weaving or wind sucking because they watch a horse with obsessive compulsive disease (OCD) do it, then barn managers may put horses with OCD in strict isolation. This is the worst possible solution.

Horses are pure energy
Horses, just as humans, dogs, cats, and all animals, should be free to interact with their environment most of the day. It’s not loving to stall horses in order to keep them safe or clean. Humans may be able to sit in cubicles and pretend it doesn’t make us crazy, but horses can’t pretend. Horses act. They are pure energy. And that’s one of the reasons we love them so much.

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Clicker Training for Dogs

New research on clicker dog training
Training dogs is easier than some think and harder than others ever imagine. There is a new study published June, 2008 in Applied Animal Behavior Science by a Danish group that showed training laboratory Beagles once a week was more successful than training them five times a week. What Iben Meyer and Jan Ladewig from the University of Copenhagen showed was that the optimum clicker training schedule for laboratory Beagles was weekly rather than daily for 5 days. Meyer and Ladewig showed that dogs trained once a week learned more quickly and had higher success rates at different steps of the clicker training exercises.

More questions than answers for clicker training
This new study, which is called "The relationship between number of training sessions per week and learning in dogs” left me with these unanswered questions:

• Did the Beagles feel anxious around humans so that the less often the humans trained them the happier the dogs were?
• Do Beagles bred to be quiescent and calm have different learning patterns than dogs bred to be active and mentally alert, such as the Border Collie, field Labrador Retriever, or German Shepherd?
• Were the dogs able to watch and learn from others that were being clicker trained?

Flawed clicker training research
I suspect this research is flawed because the behaviorists began with dogs not bred for intelligence and learning, but for the ability to remain quiet and caged. Their results aren’t applicable to the intelligent, active dogs I enjoy working with.

My approach to clicker dog training
My experience with dog training has shown me that:

1. Frequent, short sessions are ideal.
2. Dogs begin learning as soon as they can smell, see, and hear and can begin training shortly after birth. It’s just that it takes longer for the muscles to develop so the puppy can show us what it knows.
3. Many dogs are mentally active at some times of the day and are distracted at other times, so that time of the day and feeding schedule influence learning.
4. Most dogs let the family know when they want to be active and learn.
5. The size and quality of the reward—whether food or play time—significantly affects learning.

What do you think about dog training?
What do you think is important when clicker training dogs?

I welcome your comments.

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Rabies Disease Is Deadly & Rabies Vaccine Is Dangerous

We’ve discussed in depth in previous Caring for Pets blog entries that rabies vaccine is dangerous, but now let’s look at why this vaccine is still recommended for pets and what we can do to keep pets safe from the vaccine.

What it's like to have rabies
Rabies is a deadly disease causing a cruel cyclone of the mind, erupting into behavior that destroys everything around it in a rage of vicious biting. Vaccines prevent this disease.

The viciousness of rabies is not an academic topic for me. As a vet, unlike many of my colleagues, I’ve taken care of a dog with rabies. I know that rabies drives pets insane. It affects the brain, alters personality, behavior, and affect. Pets with rabies are no longer themselves. They have intense headaches and appear full of both hate and fear.

The farm family that brought in the Australian Heeler, which hid under the chairs they sat on while they were in the clinic, had no understanding of the distress their dog was experiencing. The family did not appreciate that their pet had probably been exposed to the saliva of rabid skunks when it fed on dead hogs that skunks had also fed on. The family had no idea that their dog would progress through a nervous, dumb stage into a satanic frothing stage within the week.

Why the government insists that pets are vaccinated
It is because families don’t appreciate the frequency at which rabies occurs and its severity that local governments now require dogs to be vaccinated. It’s because these families have not seen the effect a single rabid pet can have that governments have mandated frequent, repeated rabies vaccines.

Harm caused by "overkill" rabies vaccine
What a tragedy that those responsible families who do understand the threat of rabies and do vaccinate their have pets that live with the harm caused by this vaccine. Among the possible sequela to “overkill” vaccines are:
• seizures and epilepsy,
• behavior changes
• attention deficit disorders, and
• autoimmune diseases.

Vaccine companies
When a pharmaceutical company creates a rabies vaccine, the company errors on the side of overdoing the vaccine so that no pet will ever develop disease. The pharmaceutical company ramps up its vaccine, creating an “overkill” vaccine because it cannot afford to have a vaccinated pet break with disease.

The following influence a pharmaceutical company’s decision to create an “overkill” vaccine:
• The government won’t license the vaccine if it is only partially effective.
• The expense of treating a pet that develop rabies after being properly vaccinated is astronomical.
• The expense of treating humans exposed to a pet that develop rabies after being properly vaccinated is astronomical.

Effect of "overkill" rabies vaccines
Thus, “overkill” rabies vaccines are developed by every vaccine manufacturer. These “overkill” vaccines are effective in protecting the community and the financial interests of the vaccine company, but they do not serve the interests of individual pets.

The veterinarian's oath
As veterinarians, we are responsible for the wellbeing of both the community and the individual pet. We cannot honor our oath to do no harm if we give all pets the rabies vaccine as mandated by law. Instead, we must consider each pet as an individual and either vaccinate or issue a vaccine waiver as best serves the pet.

Vaccine waivers
Rabies vaccine waivers are based on laboratory titers that prove pets have a protective level of antibodies against the rabies virus. Running the titers is more expensive than giving the vaccine, much more expensive, but the harm that “overkill” vaccines cause is extraordinary.

Holistic veterinarians help protect pets from vaccine harm
To ensure your pet is protected from developing rabies and protected against “overkill” vaccines, work with a holistic veterinarian. Visit the American Holistic Veterinary Medical Association website to find a holistic vet in your area. If you’re in the Santa Rosa area, Dr. Pollen will help you through the Coddingtown Vet Clinic.

Rabies video
To learn more about rabies vaccine, its dangers and what happened to our little friend Jiggy, visit Jan Rasmussen’s website: http://www.dogs4dogs.com/ and view her rabies vaccine video at http://www.Truth4Dogs.org.

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Rabies Vaccines Are Dangerous

While any vaccine has the potential to cause harm, the rabies vaccine may have the greatest potential to cause harm. True, the Feline Leukemia (FeLV) vaccine causes cancer in some cats, but this vaccine is optional while the rabies vaccine is required by law for dogs. Rabies vaccines are not required by law for cats, but these vaccines are universally recommended by conventional veterinarians for all cats in the United States.

Rabies Video
To learn more about the potential danger of the rabies vaccine, visit Jiggy, Jan Rasmusen, and Chiclet at www.Dogs4Dogs.com. Jan, Chiclet, and Jiggy have developed several charming videos and a fantastic book, Scared Poopless, to cover dog topics in a delightful way. Watch their rabies video on YouTube and laugh while you shudder at the potential harm caused by vaccines.

Dr. Pollen's holistic approach to rabies vaccine
Fortunately, a holistic approach to vaccinating can decrease vaccine potential for causing harm. Work with your holistic veterinarian to ensure that your pet is protected from rabies and from the potential harm of the vaccine. If you need a holistic veterinarian and live in the area that Dr. Pollen practices, she’ll do her best to schedule you for an appointment. Call the Coddingtown Veterinary Clinic in Santa Rosa, CA at 707 546 4646.

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Vaccine Safety

Multivalent and monovalent vaccines
Dogs and cats can be vaccinated for one disease or for several diseases with a single injection. Vaccines that cover more than one disease are called multivalent vaccines, and vaccines containing materials that protect against a single disease are called monovalent vaccines. A common vaccine contains parvo, distemper, adenovirus, and parainfluenza (DAPP) so it is a multivalent vaccine.

The AVMA and conventional veterinarians
The American Veterinary Medical Association (AVMA), which sets standards for conventional veterinarians but not for holistic veterinarians, states that multivalent vaccines are safe. The AVMA cautions that when more than one vaccine injection is given, the vaccine should be injected in different locations, such as one on the right side and one on the left.

The AVMA acknowledges that vaccines can cause cancer, but instead of recommending against vaccinating, the AVMA suggest that veterinarians inject the vaccines into the legs, which can be amputated if cancer develops.

The AHVMA and holistic veterinarians
Holistic veterinarians, many of whom belong to the American Holistic Veterinary Medical Association (AHVMA), are more inclined to believe that vaccines can cause harm as well as do good, and that it’s better not to use them than to run the risk of cancer.

The AVMA does advise veterinarians not to use unnecessary multivalent vaccines and warns veterinarians that more dogs are sickened by multivalent vaccines than are sickened by monovalent vaccines that protect against only one disease at a time.

Vaccines mean money
Vaccinating dogs and cats has become a controversial, volatile topic. The realization that vaccines generate 20% of a conventional clinic’s income throws a Molotov cocktail into the discussion. Vaccine proponents may only state that they believe that vaccines make pets safe but they also believe that vaccines can help keep conventional practices solvent.

Problems caused by vaccinating
Holistic veterinarians and opponents to vaccines believe that money should not influence the decision to vaccinate. They believe that vaccines themselves may cause cancer and many of the chronic diseases we see in our pets today—
· allergies,
· epilepsy,
· hypothyroidism,
· immune-mediated thrombocytopenia,
· immune suppression,
· hypertrophic osteodystrophy,
· loss of the ability to smell (anosmia), and
· autoimmune hemolytic anemia.

You make the decision
Ultimately, you make the decision to vaccinate. If you don’t trust your veterinarian’s advice, find a veterinarian you do trust. With your veterinarian, review all the steps you can take to promote your pet’s health so that your pet isn’t relying on vaccines—a very controversial option—to stay healthy.

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Vaccinating Dogs, Who Needs To Vaccinate?

Vaccinating controversy
Vaccinating dogs is such a controversial subject that it belongs—along with politics, sex, and money—on the list of topics we should avoid in polite company. Folks considered “polite company,” like Bertrand Russell’s “nice people” are unable to address gritty topics with honesty.

The claims and the truth
With vaccines, for example, nice, polite people, organizations (AVMA), and companies (vaccine manufacturers) proclaim that vaccine shots save pets’ lives and that vaccines are the accepted standard of care. The reality is that vaccine shots are usually administered to pets in ways that don’t kill outright but harm in the long run. Vaccines are used because we do not trust ourselves to provide the healthy food and environment that enables our pets’ immune systems to recognize and handle whatever they encounter. Instead, we want to feel assured that some force other than food and environment will make our pets safe. Vaccines have been promoted as a force that provides this safety. In healthy, well-fed, well-adjusted pets, vaccines are unnecessary. In genetically unhealthy, poorly fed, psychologically stressed pets, vaccines are better than nothing.

Which vaccines?
So, which vaccines should be given to dogs that aren’t healthy, well-fed, or well adjusted? All dogs that bite should receive a rabies vaccine. And, behavioral counseling. Dogs with genetically poor gastrointestinal (GI) systems, such as the Rotty, should receive parvo vaccine. Dogs that will walk where feces liters the soil, as it does in our dog parks, should receive parvo vaccines. Dogs that inhale the breath of sick dogs, as in our veterinary clinics, doggy day cares, kennels, and humane society shelters, should receive distemper vaccine. Families with farm dogs that live with leptospirosis-infected cattle, hogs, raccoons, and rats should use lepto vaccine. Families with dogs with collapsing tracheas, cardiac disease, and uncontrolled coughing who will be kenneled in a veterinary clinic, animal shelter, or unclean environment should use kennel cough vaccine. Families with veterinarians who promote grain-laden kibble rather than raw and whole foods, who sell supplements without understanding which are helpful and which are harmful, and who euthanize pets with liver disease, should use the adenovirus vaccine for hepatitis.

Vaccine decisions based on goals for health
If our goal for our pets is optimum health, we should focus on providing good, fresh foods and a clean, loving environment . This focus supports a fully functioning immune system so vaccines are unnecessary. If our goal for our pets is reasonable health, and we know we will not be providing good, fresh foods, the opportunity to exercise, and a healthy emotional environment, then we should vaccinate only for diseases our pets will encounter and we should vaccinate only once or twice in a lifetime. If our goal is not to think about our pets' health so that someone else must think of it, then we should vaccinate and run titers to determine when re-vaccination is necessary.

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Vaccinating Cats

We used to think vaccinating was like praying—the more the better, but now we know this is not true. Cats develop a fatal cancer called a fibrosarcoma especially if vaccinated for several diseases at the same time. Vaccines for feline leukemia and rabies cause the greatest problem. In addition to causing cancer, vaccines cause other more subtle illnesses. For example, many veterinarians believe there is a correlation with being vaccinated and developing the following feline diseases:

• allergies,
• autoimmune disease,
• epilepsy,
• loss of the ability to smell (anosmia), and
• hyperthyroid disease.

To help prevent unnecessary vaccine-induced illness, limit the number of vaccines your cat receives.

Diseases for which cats must be vaccinated:
Rabies

Diseases for which most cats should be vaccinated:
Rhinotracheitis (Feline Herpes)
Calici virus
Panleukopenia (Feline parvovirus)

Vaccines to use infrequently, if at all:
Bordetella (Kennel cough)
FeLV (Feline Leukemia Virus)
FIV (Feline Immunodeficiency Virus)
FIP (Feline Infectious Peritonitis)

Core and Noncore Vaccines
Another way to look at cat vaccines is to divide them into core and noncore groups. Core vaccines are for diseases that cause serious illness and may be fatal: Rhinotracheitis (Feline Herpes), Calici virus, Panleukopenia (Feline parvovirus), and Rabies. These vaccines should be used in most cats. Noncore vaccines protect against diseases that are not normally serious, infect only a limited number of cats, or are not highly effective. Examples of noncore vaccines, which should not be used routinely, are FeLV (Feline Leukemia Virus), FIV (Feline Immunodeficiency Virus), FIP (Feline Infectious Peritonitis), and Bordetella (Kennel cough).

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Vaccinating Dogs

We used to think vaccinating was like praying—the more the better, but now we know this is not true. Veterinarians suspect the following health problems can be caused by over vaccination:

• allergies,
• autoimmune hemolytic anemia,
• immune-mediated thrombocytopenia,
• immune suppression,
• epilepsy,
• hypertrophic osteodystrophy,
• loss of the ability to smell (anosmia), and
• hypothyroidism.

Dogs already suffering from allergies have increased allergic response to allergens after being vaccinated, which may make their allergies worse. For these reasons, it is in your dog’s best interest to receive a limited number of vaccines.

Diseases for which dogs must be vaccinated:
Rabies

Diseases for which most dogs should be vaccinated:
Adenovirus
Distemper
Parvo

Diseases for which some dogs should be vaccinated:
Bordetella
Corona
Leptospirosis
Lyme disease
Parainfluenza

Core and Noncore Vaccines for Dogs
Another way to consider vaccines is to divide them into core and noncore groups. Core vaccines are for diseases that cause serious illness and may be fatal: rabies, distemper, parvo, and adenovirus. These vaccines should be used in most dogs. Noncore vaccines protect against diseases that are not normally serious or that infect only a limited number of dogs. Noncore vaccines should not be used routinely but can be given to dogs who may be exposed the disease and significantly affected by it. Noncore Vaccines are for bordetella, parainfluenza, corona, leptospirosis and lyme disease.

We'll look at which vaccines are recommended for cats in an upcoming Caring for Pets blog entry.

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Vaccinating Dogs, A Controversy With Options

The topic of vaccinating dogs and cats is so controversial that veterinarians and veterinary organizations throughout the US and Canada cannot agree on what is best. The lack of agreement makes it difficult for pet families to make decisions; the following is to help clarify the controversial issues and discuss the vaccine options available for pets.

Vaccine options developed out of necessicity. We’ve made animals sick with traditional vaccine methods, and now that we’re aware of this, we’re looking for ways to customize vaccines to individual pets.

Bad vaccine practices
Traditionally, we veterinarians have given several vaccines on the same day. We have given vaccines when pets are stressed by surgery or other hospital procedures. We have given the same amount of vaccine to a Chow as to a Chihuahua. There is no doubt among holistic veterinarians that these practices can destabilize the immune system rather than strengthen it. The amount of destabilization and damage that vaccines do ranges from inconsequential and transient to significant and permanent.

To increase the probability that vaccines will be a blessing rather than a harm, pet families should be aware of vaccine options, then decide—with the veterinarian’s support—which would be best for your pet.

Vaccine Options
These are vaccine options veterinarians have begun to offer:
1. which diseases are vaccinated for
2. how many diseases at one time
3. how often vaccines are repeated
4. how much is injected
5. when vaccines are given—with surgery or not
6. the age at which vaccines start

Over the next few days, let’s discuss these options in greater detail, beginning with the first. We'll begin by clarify which vaccines are essential or core vaccines, and which are not necessary or are "noncore".

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Vaccine Dose and Vaccine Boosters

My friend, Jan Rasmusen at www.Dogs4Dogs.com , asked these two questions, and I sense that many other pet families are also asking them:
1. Do puppies and adult dogs get the same dose of a vaccine?
2. Is a "booster" the same dose as the initial shot?

Let’s answer these questions below, and we’ll cover more vaccine topics through the week, If you’d like information on waiting to socialize your puppy until after it has been vaccinated, search the blog for “puppy safety and vaccines.” If you’re interested in cats, search the blog for “cat vaccines.”

Vaccine dosages
Vaccines are licensed so that the same dosage goes to all dogs. Vets who give vaccines according to accepted protocols are legally covered by the manufacturer and by the AVMA if anything goes awry. This practice may not be safe.

Holistic vets recognize that the same dosage is not appropriate for dogs of different sizes and many holistic vets will obtain owner consent to:
• use titer tests rather than vaccinate,
• give less than the standard 1 ml dosage,
• give the vaccine less often than recommended, or
• give the vaccine with a homeopathic that helps modulate immune response.

The holistic veterinarians' practices may be healthiest for your pet but these practices are not yet accepted by vaccine manufacturers, the FDA, EPA, AVMA, and many veterinarians.

Vaccines and boosters
Vaccines and boosters use the same product.
Whether we are giving an initial vaccine or are giving a booster, we use the same product. The vaccine is merely called a booster to indicate that a previous vaccine has been given. That being said, we may use one company product one week, and another company's product later so the initial vaccine and the booster are not in fact the same. The clinic record will indicate what product was used.

Switching vaccine products
There are several reasons for changing vaccines: price, availability, desire to avoid adjuvants, desire to use vaccines that protect against more or against fewer diseases in one injection, desire to give the vaccine by a different route (intramuscular (IM) versus intranasal (IN)).

Vets typically do not explain that vaccine manufacturers have been changed or that a pet is being vaccinated with another product than used previously. Instead, we say, "This vaccine protects your pet from X disease." Thus, a pet can receive an injected Lyme’s disease vaccine followed by an intranasal Lyme vaccine (or visa versa), and the family may only realize that the animal has had a Lyme vaccine, not that one is different than that used previously.

Switching vaccine manufacturers and using different products is considered by vaccine manufacturers, veterinarians, and the AVMA to be an acceptable practice. In theory, this is a safe practice because all vaccines are licensed as protecting against disease, but in truth some vaccines are probably better and safer for pets than other vaccines.

A holistic veterinarian's vaccine concerns
Although switching vaccine manufacturers should not be done lightly, I believe most holistic veterinarians are less concerned about this issue than they are concerned with the issues that Jan has raised. I believe our three biggest vaccine concerns are:
• how much vaccine volume is used,
• how many vaccines are given at the same time, and
• how often are the vaccines given.

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Constipation in Cats, A Complex Problem

Complexities of constipaton
We’ve covered feline constipation as though it were easy to diagnose and treat, but it is not. There are many factors that will fool a pet family and a veterinarian when trying to diagnose or treat a constipated cat.

Misdiagnosing constipaton
First of all, it’s possible to misdiagnose constipation unless we take X-rays. For example, some little kittens, especially Manx kittens, can be constipated because they don’t have normal nerves and bone structure in their back end. Other little kitties can be constipated if they’re dehydrated, but often when we see a kitten that’s straining to pass stool so that it looks constipated, it actually has a coccidia infection. Without X-rays and stool smears and cultures, we’re not sure.

Adult cats can fool us too. Constipated cats often strain and don’t pass stool, but cats with severe diarrhea also strain and don’t pass any stool. Again, we may need X-rays, stool smears and cultures to be sure.

OOH the cost of constipation
When families bring in a constipated cat, they’re usually convinced this is a simple matter to fix: toss in a rectal bomb and it’s outa there. Often, a simple enema or suppositories will do the trick, but some constipated cats are much SICKER than the family recognizes. Some cats become constipated because they have a serious underlying disorder such as diabetes, kidney failure, or cancer. If your cat is seriously ill, your veterinarian will help you get to the bottom of the matter—don’t be overwhelmed by how expensive the diagnosis and treatment can be for “simple” constipation.

Your cat constipation resource
Over the past few days, we’ve filled the Caring for Pets blog with everything we know about constipated cats, and it’s been a s---load: predisposing factors, fluids, soluble and insoluble fibers, Chinese herbs, laxatives, suppositories, enemas, and medications. You can use the search function at the top of the page to help locate the topics you’re interested in and to see how much holistic veterinary health information is free, right at your fingertips. Work with your veterinarian to choose the best therapy for your cat.

Preventing constipation
If you have a geriatriac cat, a cat with arthritis or renal disease, or a Manx cat, bring up the topic of constipation with your vet before your cat has a problem so that you're preventing the problem rather than treating it. This approach will save you money and your cat will love you for keeping it healthy.

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Treating Constipation in Cats: Medications

Constipation is a serious medical problem for cats and a distressing problem for their families. Unfortunately, it’s not rare. When you remember every cat enema you’ve ever given, constipation seems as common as two eyes.

Constipation occurs frequently in geriatric cats and in cats with arthritis, diabetes, or kidney disease. Constipation is also common in the Manx cats that inherited abnormal bone and nerves in their back ends. Cats on anti-depressants or anti-psychotic medications are also inclined to become constipated. See previous blogs for all the factors that lead to cat constipation.

We’ve been discussing methods to treat constipation (fluids, soluble and insoluble fiber, prebiotics & probiotics, Chinese herbs, laxatives, suppositories, and enemas) and now it’s time to summarize all the western medications we prescribe for constipated cats.

Cisapride (Propulsid or Prepulsid)
2.5 -5 mg/10 lb cat two or three times a day. Best if given 15 minutes before meals. (Higher doses are used by some vets.)
Cisapride increases neurotransmitter acetylcholine in the gut so that food moves more quickly through. Human pharmacies have stopped carrying Cisapride (caused arrhythmia) but special compounding pharmacies will make it up for veterinary use. Humans that developed arrhythmias were taking drugs that increased the amount of Cisapride in the body. These drugs included antibiotics, antifungal, and antiviral agents: clarithromycin, erythromycin, troleandomycin, nefazodone, fluconazole, itraconazole, ketoconazole, indinavir, and ritonavir. Cats on these drugs shouldn’t be given Cisapride.

Metoclopramide (Reglan)
.8-2.0 mg orally for 9 lb cat ½ hour before means and at bedtime.
Metoclopramide stimulates the first part of the digestive tract (stomach, and small intestine) but doesn’t change the rate that food moves through the distal portion (large intestine or colon). It is not usually as effective as Cisapride, which works in a similar fashion but does stimulate the distal colon.

Docusate (Surfak, DSS, Colace)
Docusate calcium (Surfak), Docusate sodium (DSS, Colace)
50 mg/ cat once or twice a day orally
Docusate medications are stool softeners that increase the water in the stool. Make sure the product you buy doesn’t have phenolphthalein, a stimulant laxative, because it can harm cats.

Lactulose
1-3 ml/9 lb cat (up to 3/4 teaspoon) orally, two-three times a day.
Lactulose is a sweet liquid. Cats hate the taste of this sugary medication, and many refuse to eat food that has lactulose mixed into it. Lactulose works as an osmotic laxative, so it stimulates activity and it pulls water into the stool.

Kristalose
¾ teaspoon twice a day with food.
Kristalose is a powdered form of Lactulose that can be mixed in canned food. Kristalose works as an osmotic laxative, just as Lactulose does, but many cats that won’t accept lactulose because of the flavor will accept Kristalose.

MiraLax (polyethylene glycol powder)
Wide dosage range 1/8-1/4 teaspoon orally twice a day with food. Some cats need a heaping tablespoon.)
MiraLax is a prescription-only laxative that doesn’t affect blood sugar or electrolyte balance.

Cyproheptadine
2-4 mg/cat orally once or twice a day. Taper off as soon as possible.
Cyproheptadine is an appetite stimulant that helps anorexic cats eat enough food to fill the gut and stimulate regular bowel movements. Cyproheptadine can cause dry mouth and sedation.

Misoprostol (Cytotec)
25 mcg/cat
Misoprostol is usually given because it helps prevent ulcers by inhibiting gastric acid secretion. Because one of the side effects is diarrhea, Misoprostol is used in constipated kitties with the goal of softening the firm stool enough that normal stools are passed. Misoprostol is approved for dogs, and used off label in cats

Amitiza
24 mcg/cat (½ to 1 capsule) orally each day as necessary
Amitiza hasn’t been approved for use in pets, but veterinarians are prescribing it because it works so well in humans to treat constipation. Amitiza works like Misoprostol does, and it helps keep the stool moist. Can be used with Cisapride because they act differently, but should be added at low dosages and monitored for adverse effects.

Ranitidine (Zantac) and Nizatidine (Axid)
Ranitidine is 4-8 mg/9 lb cat orally twice a day. Nizatidine is 10-20 mg/9 lb cat twice a day
Ranitidine and nizatidine are normally considered antacids, but they also stimulate gut muscles so help with constipation. Antiulcer medications cimetidine (Tagamet) and famotidine (Pepsid) don’t help with constipation. Can be used with cisapride.

Drugs that will be available soon
Prucalopride and tegaserod (Zelnorm) are two new drugs that will help constipated cats because they stimulate intestinal movement. They are not on the market yet.

Drugs that help constipated dogs but don’t help cats.
Although many drugs that benefit dogs are also helpful for cats, there are drugs that are either harm cats or are of no benefit. Two drugs that stimulate GI motility and have been used to treat canine constipation that are not helpful for cats are erythromycin and motilin.

Constipation in Cats, Don’t Get Fooled
We’ve covered feline constipation as though it were easy to diagnose and treat, but it is not. There are many factors that will fool a pet family and a veterinarian when trying to diagnose or treat a constipated cat.

First of all, it’s possible to misdiagnose constipation unless we take X-rays. For example, some little kittens, especially Manx kittens, can be constipated because they don’t have normal nerves and bone structure in their back end. Other little kitties can be constipated if they’re dehydrated, but often when we see a kitten that’s straining to pass stool so that it looks constipated, it actually has a coccidia infection. Without X-rays and stool smears and cultures, we’re not sure.

Adult cats can fool us too. Constipated cats often strain and don’t pass stool, but cats with severe diarrhea also strain and don’t pass any stool. Again, we may need X-rays, stool smears and cultures to be sure.

When families bring in a constipated cat, they’re usually convinced this is a simple matter to fix: toss in a rectal bomb and it’s outa there. Often, a simple enema or suppositories will do the trick, but some constipated cats are much SICKER than the family recognizes. Some cats become constipated because they have a serious underlying disorder such as diabetes, kidney failure, or cancer. If your cat is seriously ill, your veterinarian will help you get to the bottom of the matter—don’t be overwhelmed by how expensive the diagnosis and treatment can be for “simple” constipation.

Your Cat Constipation Resource
Over the past three weeks, we’ve filled the Caring for Pets blog with everything we know about constipated cats, and it’s been a s---load: predisposing factors, fluids, soluble and insoluble fibers, Chinese herbs, laxatives, suppositories, enemas, and medications. You can use the search function at the top of the page to help locate the topics you’re interested in and to see how much holistic veterinary health information is free, right at your fingertips.

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Treating Constipation in Cats: Enemas

We’re discussing treatments for feline constipation, and we covered treatments we put into the mouth of the cat, and suppositories that we put into the rectum. Now, let’s consider the big guns: enemas.

Good enemas and OsamBenEnema or Bad enemas
From your cat’s point of view, all enemas are bad, but here are some enemas that are at least safe. Safe enemas for cats include warmed:
• water
• dilute salt water
• water with docusate sodium (DSS), such as “Pet-Ema,”
• mineral oil

Mineral oil is not given with DSS because the DSS increases the absorption of oil.

Unfortunately, some enemas are not safe for cats. Unsafe enemas are those containing phosphate; for example some Fleet enemas. (Some Fleet enemas do not contain phosphate and are safe.) Cats absorb sodium and phosphate molecules from these enemas into their blood and tissues, becoming hypertonic. As a cat’s body seeks to dilute the area and correct the hypertonicity, it pulls water from the tissues, including from the brain and muscles. The result is a potentially fatal hypertonicity electrolyte imbalance.

How to give an enema to a constipated cat
If you can work in a knight’s chainmail outfit so your cat won’t know it’s you it hates and is about to kill, you can give a cat an enema. Otherwise, have your vet do it. You cannot pay your vet enough to handle this chore because this will prevent your cat from hating you, or running away to hide and dribble fecal contents in the closet.

Hospitalize cats for enemas
When your cat’s problem with constipation is severe enough that an enema is needed, your pet needs to be hospitalized for at least a few hours. During hospitalization, your cat will be given a thorough exam, blood work, X-rays, and fluids. After the diagnostic work is done, your cat will be rehydrated with IV or subcutaneous (SQ) fluids. Once rehydrated, it will probably be anesthetized for the enema.

The enema technique used by veterinarians is to fill a stainless pitcher with warm enema fluid, connect the fluid to a rubber feeding tube or a urinary catheter, allow enema fluid to flow down to the end of the tubing so there is no air in the setup, lubricate the tip of the tube with K-Y jelly, and insert the tip into the rectum. The tubing is then slid above the fecal obstruction and the clamp is slowly opened to allow enema solution to disperse around the fecal mass.

Enemas take patience
It can take hours for enema solution to soften fecal material. In many cases, it takes multiple enemas. Depending upon the cat, some vets will give more than one enema a day, but other vets wait and give a second enema the following day, and a third on the third day.

Fluids and forceps
If enema fluid does not soften the concrete in your cat’s colon, the next step is to slip a sponge forceps, which has small round, flat tips, into the rectum and into the fecal mass. The forceps are used to help break the stool into smaller chunks so that enema fluid can penetrate the material.

Enemas can cause vomiting
An enema or the use of forceps can cause vomiting. Vomiting is dangerous in anesthetized cats because fluid can enter the lungs. We position these cats so that their mouths drain any fluid, and we inflate the cuff around the tube that carries anesthesia solution and air into the lungs so that very little vomitus can slide past. Still, vomiting when anesthetized can kill cats.

Soap Enemas
Soap enemas stimulate bowel movements because they irritate the colon. For most cats, it’s healthier to soothe the colon than to irritate it, so soap enemas—even those made with gentle castile soap—aren’t recommended.

Coming Up
We’ve covered every treatment for constipation except medications. They’re next.

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Treating Constipation in Cats: Suppositories

Constipation is a serious problem in cats, and over the last two weeks we’ve taken an in-depth look at the factors that predispose cats to become constipated and some of the treatments. We’ve covered fluids, soluble and insoluble fiber, prebiotics & probiotics, Chinese herbs, and laxatives. Now, let’s consider suppositories.

How suppositories work
We resort to using suppositories when everything we’ve put down the throat hasn’t worked. Suppositories are wax or glycerine bullets that we slip into the rectum where they melt and stimulate defecation. Suppositories work in three different ways:

1. Lubricating—petroleum jelly
2. Hyperosmolar softening—glycerin, lactulose, and polyethylene glycol
3. Irritating—Dulcolax

Lubricating suppositories create a sliding surface inside the colon and over the feces so that stool slides out more easily. These suppositories are very gentle and can be used in almost all cats. Hyperosmolar suppositories pull water from the body to keep the stool moist. If cats are dehydrated, the hyperosmolar suppository will still pull water, and this increases the dehydration. Thus, hyperosmolar suppositories such as glycerine and lactulose lubricate the feces and the lining of the distal colon and others work by irritating the intestines and stimulating defecation.

Suppositories used for cats:

• glycerol,
• bisacodyl,
• docusate sodium.

Inserting suppositories
Cats have two circular sphincters, an outer sphincter called the anus, and an internal sphincter about 1 inch inside the anus. Suppositories are placed deep inside the internal sphincter not just deep to the anus.

Coming Up
We’ve covered 7 different treatments for constipation: fluids, soluble and insoluble fiber, prebiotics & probiotics, Chinese herbs, laxatives, and suppositories. We’ve been saving the big, nasty: enemas. We’ll cover giving enemas to cats next, and then we’ll cover medication.

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Treating Constipation in Cats: Laxatives

We’re discussing treatments for feline constipation. We’ve covered fluids, soluble and insoluble fiber, prebiotics & probiotics, and Chinese herbs. Now, let’s consider laxatives.

What are laxatives?
Laxatives are oral medications that promote defecation. We use laxatives only in cats that can be unplugged, but not in cats with mechanical or physiological blockages. To ensure the cat is not blocked, blood tests and X-rays may be required. When some pet families hear how much it costs to treat a “simple” constipation, they’re shocked, but we can we can kill obstructed cats by giving them laxatives, and that’s a really shitty shock.

What is obstipation?
Constipation is having difficulty defecating, but when the difficulty becomes an impossibility, the cat is obstipated rather than constipated. Constipation=stuck. Obstipation=blocked.

Types of laxatives
All laxatives have the same goal—get fecal material out—but they have different methods of working. Five different laxative approaches are:
1. Bulk forming—ground flax seed, psyllium (metamucil), bran
2. Softening emollient--DSS (Colace),dioctyl calcium sulfosuccinate (Surfax)
3. Lubricant--fish oil, flax oil, mineral oil, petroleum jelly,
4. Hyperosmotic—glycerine, lactulose, polyethylene glycol, magnesium salts
5. Stimulant –Dulcolax, senna, aloe, castor oil, bisacodyl, cascara

1. Bulk forming laxatives
Bulk forming laxatives are finely ground plant materials that bulk up the feces. These bulk formers absorb fluids and create a mass that signals the intestines to contract. Intestinal contractions move stool down the intestines and out the rectum.

Because bulk formers are “natural” treatments for constipation, many cats tolerate them better than they tolerate some other treatments, however, bulk formers cannot be used in all cats. Bulk forming laxatives shouldn’t be used in dehydrated cats. For these cats, give 1-4 tablespoons of pumpkin, sweet potatoes or squash. These vegetables proivide bulk but because they’re moist, they don’t pull fluid from the cat.

Cats with megacolon should not be given bulk formers as the goal is to have as small amount of fecal material in their distal colon as possible.

2. Softening emollient laxatives
The chemical emollient laxatives, such as Colace, have an slick method of action. They help the body absorb more lipid molecules so the feces slides better. Emollients also help hold water in the stool so the feces is softer. Emollients lose their effectiveness if they are used long term, so no cat should be on them for an extended period. Nor should dehydrated cats be given emollients.

3. Lubricant laxatives
Lubricant laxatives can be given orally, such as fish oil and flax oil; they can be rubbed on paws, such as the hairball medications that contain petroleum jelly; or they can be used as enemas, such as mineral oil. Lubricants work by holding lipids inside the stool rather than allowing them to be absorbed into the body. This gives the stool volume and slickness.

The negative aspect of lubricant laxatives is that some of them also attract and hold onto fat soluble vitamins A, D, E, and K, causing these vitamins to slide out of the body with the feces. We can prevent vitamin loss, by using lubricant laxatives that are themselves rich in fat soluble vitamins, such as fish and flax oils. Lubricant laxatives such as mineral oil or petroleum jelly in hairball medications don’t provide vitamins and should not be used very often.

Please don’t give your cat mineral oil by mouth. Because mineral oil is odorless and tasteless, some cats accidentally inhale it into their lungs. If using mineral oil, give it as an enema.

4. Hyperosmotic laxatives
The gut wall is not a solid barrier like the old Berlin wall, it’s more like the US-Mexican border that water and molecules cross as easily as citizens. Movement of water and molecules creates an osmotic balance inside and outside the gut. We can disrupt the balance by feeding molecules that are so large they cannot pass the gut wall. This pulls water into the gut.

Lactulose and the other hyperosmotic laxatives are large molecules that stay within the gut. They force water to move toward them and into the feces, which helps soften the feces.

then a balance is achieved by having water move from the body into the feces. Laxatives containing large molecules that pull water into the feces are called hyperosmotic laxatives. Examples of hyperosmotic laxatives are polysaccharides (lactulose and lactose) magnesium salts (magnesium sulfate, magnesium citrate; and polyethylene glycols (GoLYTELY and Colyte). The safest of these hyperosmotic laxatives for cats is lactulose. The magnesium laxatives are ok in some cats, but not cats with kidney disease and many constipated cats have kidney disease. Polyethylene glycol is unsafe for cats whose nerves aren’t working so they have a “functional” obstruction or for cats with a blockage and a “mechanical” obstruction. Hyperosmotic laxatives shouldn’t be given to dehydrated cats.

5. Stimulant laxatives
Stimulant laxatives cause gut movement. Some cause movement because they irritate the nerves to the gut. For example Dulcolax (bisacodyl) stimulates the nerves to fire. If stimulants such as Dulcolax are used long tern, they lose their effectiveness either because the nerves are damaged or they’re habituated to the signals. Cats that have an occasional problem with constipation are best candidates for stimulant laxatives, such as 5 mg of Dulcolax once a day. Geriatric cats, Manx cats, and cats with chronic kidney disease should not routinely use stimulant laxatives.

Coming up
With all the treatments we’ve discussed for constipated cats (five types of laxatives, fluids, soluble and insoluble fiber, prebiotics & probiotics, and Chinese herbs) you’d think we’d have exhausted the topic, but not even close. We’ve still got suppositories, enemas, and drugs to cover. Suppositories are up next.

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Treating Constipation in Cats: Chinese Herbs

We’re discussing treatments for feline constipation, which we’ve divided into fluids, soluble and insoluble fiber, prebiotics & probiotics. Now, let’s consider using Traditional Chinese Medicine (TCM). TCM includes many forms of therapy: energy work, nutrition, herbs, acupuncture, and moxa. Let’s focus mostly on herbs, and slightly mention Western herbs, acupuncture and moxa.

TCM Diagnosis
Traditional Chinese Medicine (TCM) diagnoses constipation differently than western medicine does. To make the diagnosis, we assess the history, signs and symptoms, tongue, pulse, and sensitivity along acupuncture meridians. Using this information, a TCM diagnoses for constipation could include organ or meridian dysfunction, blocked energy flow, fluid deficiency and excess heat. Names given to some of these problems include:
• Liver Qi stagnation
• Spleen Qi stagnation
• Spleen Qi deficiency
• Liver-Spleen disharmony
• Yin deficiency
• Phlegm stagnation

Chinese herbs for constipation
The following herbal formulas are some of those used to treat constipation and are dosed in very small amounts, usually 1/8 teaspoon per 8-lb cat per day. The dose is divided and given as 1/16 of a teaspoon twice a day.
• Bupleurum Disperse Liver (Chai Hu Shu Gan San)
• Ledebouriella Powder that Sagely Unblocks or Ledebouriella with Magical Therapeutic Effects (Fang Feng Tong Sheng San)
• Free & Easy Wanderer Plus or Bupleurum & Peony (Jia Wei Xiao Yao San)
• Augmented Four Materials Decoction or Tang Kuei & Salvia (Jia Wei Si Wu Tang)
• Poria 15 (Shi Wu Wei Fu Ling Pian)
• Ma Zi Ren Wan

Constipated cats that are anxious or depressed and tend to be anorexic with nausea and vomiting because of liver disease would be prescribed Bupleurum Disperse Liver. Constipated cats that appear hot, have fevers, skin sores, hives, and voracious appetites are prescribed Ledebouriella Powder that Sagely Unblocks. Constipated cats that are old, weak, wobbly, anemic, and have brittle nails and dry skin are prescribed Augmented Four Materials Decoction.
Constipated cats that are irritable, angry, aggressive and have red eyes are prescribed Free & Easy Wanderer. Obese, edematous cats that have problems with food stagnation as well as constipation are prescribed Poria 15. Cats that have developed a large dilated colon (megacolon) are prescribed Ma Zi Ren Wan, which, unlike some formulas, can be given for the life of the cat.

Safety of Chinese herbs
Chinese herbal formulas are prescribed by veterinarians after carefully assessing the cat. Used correctly, they tend to be safe, but some herbs are not safe if they are used for a long period. Just as cats treated with western medicine require periodic vet visits, cats taking herbs need periodic vet visits.

Acupuncture benefits constipated cats
Acupuncture points are chosen to stimulate Qi, address deficiencies, and relieve heat and damp, according to the TCM diagnosis. Commonly treated acupuncture points include: BL25, LV 2, CV04, CV06, CV08, CV12, SP06, SP09, ST25, ST36, and TH06. If you’re curious about the location of these points, ask your veterinarian to paint them on your cat’s fur so that you can massage them at home. Or, look at the book 4 Paws 5 Directions by Dr. Cheryl Schwartz, which has good drawings and explanations of where to find the points.

Moxa
Moxa is an herb that is rolled up like a cigar. We light one end of the moxa cigar and hold the warm end near acupuncture points to warm the skin. Moxa therapy is ideal for treating constipation in weak, cold, or geriatric cats. Inhaling the burning moxa is beneficial for cats, just as the warmth is, but some asthmatic cats may react poorly to moxa.

Western herbs
Western herbs used for constipated cats are chosen as carefully as Chinese herbs. Western herbs for constipation may include chickweed, marshmallow, licorice, barberry root, dandelion root, anise, and aloe.

Coming Up
We’ll cover enemas, laxatives, suppositories, and drugs used to treat feline constipation in the coming days.

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Treating Constipation in Cats: Prebiotics

We’re discussing treatments for feline constipation, which we’ve divided into fluids, fiber, prebiotics & probiotics, Chinese herbs, enemas, laxatives, suppositories, and drugs that enhance gut motility. We’ve covered fluids, soluble and insoluble fibers, and probiotics and now, let’s consider prebiotics.

What are prebiotics?
Prebiotics are food for the probiotic organisms. Prebiotics are molecules from fruits, vegetables, and beans. These molecules are so large and complex that they can pass through the first section of the gut without being broken down and absorbed as most other nutrients are. These large molecules reach the lower gut, which is populated with probiotic organisms, and become the food source for these probiotic yeasts and bacteria. As a result, the yeasts and bacteria produce vitamins and fatty acids that keep cats healthy.

Examples of prebiotic molecules:
• fructooligosaccharides (FOS), named for the source (fruit), size (oligo = few) and type of molecule (saccharide or carbohydrate sugar),
• galactooligosaccharides (GOS)
• mannosoligosaccharides (MOS),
• xylooligosaccharides (XOS),
• inulin, and
• arabinogalactans (AG).

Benefits of prebiotics
Among the benefits attributed to prebiotics are:
• a boost to the immune system,
• an increase in calcium and magnesium absorption,
• a decrease in colon cancer,
• a decrease in irritable bowel syndrome,
• a decrease in bad gut bacteria and infection,
• a decrease in fecal odor,
• better control of blood sugar and a decreased tendency to develop diabetes,
• lower cholesterol and blood lipids.

Sources of prebiotics
High concentrations of prebiotic molecules are found in fruits, vegetables, beans and whole, unrefined grains:
• artichoke
• asparagus
• bananas
• black beans
• burdock
• carrots
• chicory
• garlic
• tomatoes
• barley
• maize
• wheat

Onions and leeks also contain prebiotic molecules, but onions, and possibly leeks, make cats sick by causing Heinz body anemia.

How much prebiotic do cats need?
Cats probably need the same concentration of prebiotics that people do to be healthy, which is about 1% of the weight of what is eaten.

Coming Up
We’ll cover Chinese herbs, laxatives, suppositories, enemas and other treatments for feline constipation over the next few days.

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Treating Constipation in Cats: Probiotics

We’re discussing treatments for feline constipation, which we’ve divided into fluids, fiber, prebiotics & probiotics, Chinese herbs, enemas, laxatives, suppositories, and drugs that enhance gut motility. We’ve covered fluids, soluble and insoluble fibers, and now, let’s consider probiotics.

What are Probiotics?
Probiotics are the bacteria and yeast that populate your cat’s gut when it’s healthy. In a healthy gut, there are so many bacteria and yeast organisms (prokaryotic cells) that they equal more than the total number of regular cells (eukaryotic) in your cat’s entire body.

Probiotics make vitamins and nutrients, actively promoting your cat’s health; and probiotics support the feline immune system to prevent disease. Cats without healthy probiotic organisms have irritable bowel syndrome, diarrhea, and increased susceptibility to disease. Cats with healthy guts are most likely to have normal bowel movements and not be constipated.

Examples of normal cat probiotic bacteria and yeast
There are more than a dozen different probiotic organisms in the health cat gut, including these bacteria and yeasts:
• Lactobacillus (L. acidophilus, L. bulgaricus, and L. thermophilus),
• Streptococcus bulgaricus,
• Enterococcus faecium,
• Bifidoacterium bifidus, and
• Saccharomyces boulardii.

What wipes out your cat’s probiotic organisms?
Probiotics began to populate the feline gut immediately after birth, but they aren’t permanent. These living cells can be wiped out and will need to be replaced if cats:
• eat the wrong foods (high carbohydrate diets),
• become infected with pathogenic gut bacteria (salmonella or clostridia)
• become infected with parasites (giardia or coccidia), or
• are placed on antibiotics.

Replacing probiotic organisms
Yogurt and kefir contain small amounts of these probiotics and are sufficient for healthy cats, but supplements with a high concentration of probiotics are necessary for cats with diarrhea, debilitation or those taking antibiotics. Antibiotics kill the healthy bacteria and organisms in your cat’s intestines as surely as they kill bad bacteria.

Many products are marketed as probiotics, but they don’t contain any viable organisms. Your cat needs from 20-500 million probiotic organisms per day and receives no benefit from useless products. Refrigerated probiotics that include a food source for the probiotic organisms, such as apple pectin or the milk in yogurt, may be better than powdered supplements. Some cats that cannot tolerate milk can tolerate yogurt.

Some veterinarians suggest that probiotics are absorbed better if they take advantage of the body’s natural pH change through the day. For example, acidophilus is best given in the morning and bifidus at night. All veterinarians recommend that probiotics not be given with antibiotics, but a couple hours later than the antibiotic. Probiotic doses are doubled or tripled for cats taking antibiotics.

Coming Up
We’ll cover prebiotics, herbs, and other treatments over the next few days.

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Treating Constipation in Cats: Fiber

We’re discussing treatments for feline constipation, which is a common problem in senior cats, and also occurs in Manx cats that inherit abnormal bone or nerves to their back ends. We divided treatment into 8 categories: fluids, fiber, prebiotics & probiotics, Chinese herbs, enemas, laxatives, suppositories, and drugs that enhance gut motility.

We’ve covered fluids, and now, let’s consider the second category, fiber.

2. Fiber
There are two types of fiber, those that dissolve in water (soluble) and those that don’t dissolve (insoluble). Some foods contain mostly soluble fiber, some mostly insoluble, and some, both. Insoluble fiber probides bulk to stimulate defecation. Soluble fiber doesn't provide bulk, but it supports a healthy intestine, which is essential for normal defecation.

Examples of soluble fiber

• oats


• peas


• beans


• sweet potatoes


• starchy vegetables

Examples of insoluble fiber

• celery


• broccoli stalks


• green beans


• bran


• psyllium

Examples of foods with both soluble & insoluble fiber

• grapes


• apples


• blueberries


• strawberries


• blackberries


• cranberries

Fruits have both soluble and insoluble fiber: the flesh inside the fruit is easily dissolved, but the fibrous peel remains as roughage.

The differences between soluble and insoluble fiber
Insoluble fiber is the type that promotes bulk and stimulates intestinal contractions. Soluble fibers don’t remain bulky, but they are slow to dissolve so that they pass through the small intestine and into the large intestine before they’re broken down. Within the large intestine, soluble fibers provide nutrients for bacteria that make vitamins and fatty acids that are absorbed and promote health. Soluble fibers also absorb fat, so for those with triglyceride or cholesterol problems, soluble fibers are beneficial. Soluble fibers also benefit those with inflammatory bowel disease (SIBO) and liver disease. The downside of soluble fibers is that they can cause gas, especially if introduced suddenly and in large amounts. For dogs especially, soluble fibers are farts waiting to happen.

The best fibers for cats
The best way to give your cat soluble fiber is to feed mashed, cooked pumpkin, squash, or sweet potatoes. To provide soluble and insoluble fiber feed ground flax seed, such as found in Missing Link, rhubarb, broccoli heads and stalks.

Coming up
We’ll cover prebiotics, probiotics, herbs, and other treatments over the next few days.

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Treating Constipation in Cats: Fluids

Constipation, which is difficulty passing stool (defecating), is a painfully common problem for cats, especially older cats and those with abnormal nerve or bone structures, typical of some Manx cats.

We’ve looked at a dozen factors that predispose cats to developing constipation. These factors can be temporary so that we only need address them once or twice in a cat’s life, or they may be chronic and require ongoing attention. It’s much safer to use nutritional therapies, including, fiber, prebiotics and probiotics for all our chronic cases, as these approaches are the most natural, least harmful, and least expensive.

Herbs that treat constipation should be considered a form of medicine, but they are less likely to cause harm than are drugs , enemas, laxatives, or suppositories.

Treatment for constipation can include
1. Fluids
2. Fiber
3. Prebiotics & Probiotics
4. Chinese herbs
5. Enemas
6. Laxatives
7. Suppositories
8. Drugs that enhance gut motility


1. Fluids
Giving fluids IV or SC are the most important first therapy for all cats with constipation for three reasons:
• Constipated cats are often dehydrated.
• Fluids may help moisten the dry, hard stool.
• Toxic materials are being reabsorbed from the bowel when stool remains longer than normal, and fluids help flush these toxins from the system.

Maintenance fluid is about 50-60ml/kg or 25-30 ml/lb. For an 8 lb cat, that’s about 8ounces (30 ml to an ounce). Because cats evolved as desert creatures and got their water from prey more than from drinking, cats being fed dry food are often chronically dehydrated. To prevent chronic dehydration, feed cats moist or canned food rather than kibble.

We’ll cover fiber sources, prebiotics, probiotics, herbs, and other treatments over the next few days.

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Constipation in Cats, Dealing With Obstruction, Rectal Pain, and Medications

Cats are prone to develop constipation when they’re older and when they have irregular nerve and bone development as some Manx cats do. We’ve been looking at a dozen factors that predispose cats, especially the Manx, to develop constipation, and now, we’ll cover the last three:

1. Poor teeth
2. Poor appetite
3. Diet low in fiber
4. Dehydration
5. Arthritis so cannot assume a squatting position
6. Lack of exercise
7. Dislike area used for defecation
8. Kidney disease
9. Hairballs
10. Obstruction
11. Rectal pain
12. Medications

10. Obstruction
An obstruction presses on the colon and prevents food from passing through to the rectum so that it dries into fecal bricks. Common causes of obstruction are cancerous tumors, enlarged prostates, and pelvic fractures that heal with a narrowed pelvic canal.

When cats become constipated, blood tests, X-rays, and ultrasound studies help us determine what—if anything—is compressing the colon. Some tumors can be surgically removed or treated with chemotherapy or radiation. Other tumors can shrink or be prevented from enlarging with Chinese herbs and homeopathy. Of course the goal is to prevent cats from ever developing tumors, and good diets with Omega 3 fatty acids; natural antioxidants in fresh, darkly pigmented food; healthy fiber; and exercise are some of the best methods of maintaining cancer-free cats.

11. Rectal pain
Rectal pain can lead to constipation because cats avoid defecating when it hurts. A common cause of rectal pain is abscessed or impacted anal glands. Cats have anal sacs just as dogs do, but are much less likely than dogs are to develop impaction or abscess. Because of this, we can get in the habit of ignoring these sacs. Normally, glands inside the anal sac produce a thin grey-brown paste material that is squeezed out when a cat defecates and a normal stool distends the anus and pushes against the sacs, which are buried beneath the skin at 4 and 8 o’clock. When cats develop diarrhea and have thin, runny or pasty stool, there is insufficient mass to push against the glands during defecation so that the sacs aren’t emptied. To make matters worse, diarrhea-carried bacteria can dribble down the skin, moisten it, and create abscess in, or around, the anal sacs. So, if cats have red anal areas, or vocalize when defecating, use a baby wipe and clean the bottom. Gently spritz the bottom with cool herbal washes containing calendula and Hypericum or tea, then visit the veterinarian.

Cats that are exceptionally painful will be anesthetized so the area can be cleaned, anal glands emptied, and the anus inspected. Some cats may need antibiotics, homeopathics or herbs, as well as a change in diet to keep the stools of the right consistency until the bottom has healed.

In addition to anal sac problems, pain-causing tumors can develop in the skin, glands, prostate or fibrous tissue around the bottom; and diarrhea can cause pain because the stool scorches the skin. Symptoms of swelling, weight loss, and anal pain are serious, so these cats need veterinary attention.

12. Medications that cause constipation
Medications cause constipation in cats, especially anti-depressant or anti-anxiety medications called SSRIs or selective serotonin reuptake inhibitors. SSRIs prescribed for cats include some of the same drugs used for humans, such as Prozac (fluoxetine) and Paxil (paroxetine). MAO (monoamine oxidase) inhibitors such as Amitriptyline, given for depression and behavior problems, also cause constipation.

In an effort to prevent constipation, sometimes these meds are prescribed to be given every other or every third day. If this dosage schedule doesn’t keep the cat happy and prevent constipation, ask your vet for an alternative medication, such as Buspirone, or for an entirely different approach to anxiety and depression.

If your cat is taking any SSRI, MAO inhibitor or anti-depressant, don’t stop the medication suddenly; get your veterinarian’s help to wean your cat off slowly.

Hundreds of other medications have the potential to cause constipation in cats, including antihistamines, muscle relaxants, antacids, anti-seizure medications, calcium supplements, iron supplements, pain medications, blood pressure medications, heart medications, diuretics, and drugs given during surgery to dry up secretions and maintain the heart rate.

If your cat has a problem with constipation and is prescribed any of these medications, discuss the possibility of constipation with your vet. It’s always better to prevent constipation by increasing oil in the diet, or by using some of the other therapies we’ll be covering over the next few days than it is to treat it once it’s a problem. There is no creature on earth that dislikes enemas as much as the cat.

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ProLo Therapy and Wobblers

We're interrupting the series on feline constipation to address a quesiton a reader sent regarding ProLo therapy:

Hi Robbie,
Thanks for being interested in alternative therapies for dogs with wobblers. Unfortunately, the term "wobblers" includes many problems that cause nerve damage and limb instability, so it's case by case with treatments.

No conventional surgeons, who are the vets that typically repair wobblers, that I've spoken with are familiar with ProLo therapy.

I suggest you contact a veterinarian who teaches ProLo, has had it, and happens to be the head of the AHVMA:
Carvel G. Tiekert, DVM, Executive Director
2218 Old Emmorton Road ~ Bel Air, MD 21015
e-mail: office@ahvma.org

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Susan Pollen, DVM

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Constipation in Cats, Prevention of Problems Caused By Dislike of the Area Used for Defecation, Kidney Disease, and Hairballs

We’re examining the factors that can cause cats to become constipated so they have difficulty passing stool. We’ve looked at poor teeth, poor appetite, diets low in fiber, dehydration, arthritis, and lack of exercise. Now, let’s look at three more significant problems that cause constipation, with our focus being how to prevent them.

7. Dislike of the Area Used for Defecation
Constipated cats learn to associate pain with defecation, and if they are using the litter box, they automatically associate the litter box with pain as well. Cats that have made the association of the box and pain try to defecate in other places around the house.

Cats also avoid the litter box if they have arthritis and it hurts them to climb into it, or if they are attacked on their way to the litter box or while in the litter box. To prevent this, use litter boxes with ramps, use NSAIDs to control arthritis pain, and allow cats to escape from aggressive housemates to a quiet area for defecation. Keep stools moist with fluids and stool softeners—from pumpkin and rhubarb to ground flaxseed and psyllium—so that defecation isn’t a painful chore.

8. Kidney Disease
Cats with kidney disease become constipated because they’ve lost the ability to conserve water. These cats become dehydrated. As their bodily fluids dry up, the water in the stool is sucked out by the high osmotic content of the blood. The drier the stool becomes, the more difficult it is for intestinal muscles to contract around it and propel it forward. The longer the dry stool remains in the intestine, the larger the intestine is stretched. As intestinal nerves and muscles stretch beyond their normal capacity, the gut permanently loses its ability to contract. This is what causes megacolon, the condition in which cats are entirely unable to defecate.

It helps many cats with kidney disease to receive herbs, such as Rehmannia, and Omega 3 fatty acids from fish or flax seed. Acupuncture and constitutional homeopathic medications also help. The single most important remedy, though, is water, and these cats may need subcutaneous fluids every couple of days to counter the loss of fluids through the urine. I like to give these cats a special treat of one salted potato chip every few days because a little salt is also beneficial for the kidney. And we all understand what ‘little’ means, don’t we.

9. Hairballs
The most beautiful feline coats turn into ugly wads of intestinal gunk if we don’t help our cats groom themselves. Hairball gunk can accumulate in the stomach where it causes vomiting, or it can flow into the intestines where it resists all enzyme degradation and remains a thick wad for its passage down the entire intestinal tract.

We can do a lot to prevent hairballs by removing hair, and by feeding fish oil, flax oil, sesame, olive, or nut oils to promote passage. Avoid feeding mineral oil because it has no flavor and can be inhaled into the lungs more readily than oils that cats smell easily. Also, mineral oil combines with fat soluble vitamins and carries them out of the intestines while the oils mentioned above all contribute more nutritional value than they carry off.

To help remove hair so that it isn’t swallowed, try dampening your hands and rubbing them over the coat so that dead hairs stick and are easily lifted off. It also helps to gently groom cats with old fashioned boar hair hairbrushes and newfangled stripping tools, such as the Defurminator.

The older cats become, the less able they are to groom themselves and the more likely they are to develop hairballs, so be sure to increase grooming frequency to at least one minute a day for every year of age.

It also helps to prevent cats from chewing out their hair by keeping them free of fleas. Clean healthy bodies have fewer fleas than sick, dirty bodies, so wash and groom your pet often. To control fleas, vacuum the floor, wash the bedding, and remove litter around the house that fleas can hide in. Apply calendula or herbal teas if your cat’s skin becomes irritated.

Cats also chew out their hair if they have pain—over their hips with arthritis, over the belly with stomach pains, anywhere if they’re anxious. If your cat is chewing, get medical help to diagnose and address the problem.

We’ll continue with our last discussion of how to prevent constipation in the next Caring for Pets entry, then we’ll discuss foods, herbs, homeopathy, acupuncture and drugs that help treat it.

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