Help, My Cat Won’t Poop!

Here’s a question I received by way of Catster headquarters.

I just adopted a 6-year-old cat. He seems to be settling in, and we are keeping him separated from our other two cats. He has been eating wet and dry food, but he barely poops, although he does pee regularly. One night he crapped in our bed and buried it under the covers. We figured he associated the litter box with pain, which our vet agreed with. We put out an extra box with different litter, but he still only pees in both.

We have taken him to the vet twice in four weeks. He has been on twice-daily doses of lactulose, and last week he had an enema. He pooped as soon as he came home, and then nothing for five more days. I’ve added non-spiced pumpkin to his food, but he turns his nose up. I’ve made his wet food soupier by adding water, but he doesn’t like it. The vet thinks he may just be a bit more sluggish about pooping than most cats, but are there any health risks from long-term constipation? And is there anything we can do for him at home? (Seriously, can we give the cat an enema? There can’t be much to it, surely.)

The world is roughly divided (if you’ll allow me to very loosely paraphrase Gabriel Garcia Marquez) into two types of cats: those who can poop, and those who cannot. Pity the poor individuals who cannot.

First, take consolation from the fact that things could be worse — for you, if not necessarily the cat. Cats who defecate outside the litter box cause nowhere near as much damage and heartache as those who urinate inappropriately.

Most young cats (and 6 is still young for a cat) are relatively regular individuals. Some poop twice daily. Others go every other day. Others fall in between. But I have deep sympathy for any individual, regardless of species, who routinely goes five days between poops. Your cat sounds like he’s suffering from chronic constipation.

Everyone knows what constipation is. Unfortunately, nobody has a perfect solution for it. However, I have a few thoughts.

Constipated cats frequently defecate outside of the box. Some people surmise that’s because the box is associated with pain. Others think cats simply become exhausted from the repeated effort and become disinclined to make recurrent trips to the box. Beds are generally more comfortable than litter boxes, and some cats might prefer to engage in their toils where they are comfortable.

To help keep your bed clean, consider keeping multiple litter boxes around the house (possibly in several sizes with different types of litter). Keep them all spotlessly clean, and make sure your cat has privacy in them. Basically, you want to make it as easy and inviting as possible for your cat when he feels the magic about to happen.

I’d recommend that you talk to your vet about your cat’s overall health. Some problems that cause chronic dehydration, such as kidney disease or diabetes, may contribute to constipation.

If your vet finds no underlying health problems, then the best bet is to add fiber to your cat’s diet. Canned pumpkin is a natural source of fiber, but not all cats accept it. Over-the-counter fiber supplements for cats can be purchased at pet stores or through veterinarians. Vetasyl is made from natural psyllium, and many cats will readily consume it when it’s mixed with wet food or sprinkled on dry food. High-fiber diets also are available through veterinarians. Some of these are designed for weight loss, so they must be used cautiously in thin cats.

Hairball remedies like Petromalt and Laxatone contain lubricants that help to grease the pipes, so to speak, and help hairballs (or feces) pass. Hairball formula diets also exist, and they can be purchased over the counter.

Since dehydration sometimes plays a role in constipation, fluids often help. The simplest way to get more fluids into a cat is to feed wet food or to add water to wet (which hasn’t worked for you) or dry food. I also recommend having multiple fresh water sources, including recirculating cat fountains.

Finally, there are the last resorts. Experienced owners can inject fluids under the skin at home to keep your cat well-hydrated. Heavier laxatives such as lactulose may treat constipation when administered regularly, but can take several doses before they’re effective. Promotility agents such as cisapride can stimulate the colon to get the trains running more regularly.

Enemas can be administered at home, and do not require degrees in rocket science. Specially made cat enemas are available through vets. There is a slight risk of complications (distention of the colon or excessive straining can cause issues), but usually it’s not hard to administer them to cooperative cats. However, enemas (or rather, cats who receive enemas) usually are stinky and messy. Most people don’t want to deal with the mess, but if you’ve got the fortitude, then home enemas are not out of the question.

If I were you, I’d start by adding a fiber supplement (such as Vetasyl) and possibly switch to a hairball diet, with Laxatone or Petromalt as a top-off. Consider lactulose as your next line of action.

You should hope for the best, but also be prepared for the possibility of a long haul in the future. There is a chance that the recent changes in your cat’s life are contributing to a temporary problem. However, in some cats (especially younger ones) with chronic constipation, bigger problems develop in the future. The worst of these, called megacolon, can lead to such severe constipation that surgery (to remove a section of the colon) or euthanasia becomes necessary. I hope your cat never reaches that point.

Got a question for Dr. Barchas? Ask our vet in the comments below and you might be featured in an upcoming column. (Note that if you have an emergency situation, please see your own vet immediately!)