My cat has megacolon. What are Cisapride medication alternatives?

From Plumb's Veterinary Drug Handbook "For chronic Constipation (e.g. megacolon): In combination with a stool softener (author recommends lactulose at a starting dose of 2-3 mL PO three times per day; then adjust as needed) and a bulk agent (e.g. psyllium or pumpkin pie filling) cisapride is given initially at 2.5mg (for cats up to 10 lbs) or 5mg (for cats 11 pounds or heavier) three times daily, 30 minutes before food. Cats weighing greater than 16 pounds may require 7.5mg" So in short, Merlin may require a 5-7.5mg dose three times per day. Before changing the dose, I would talk to the prescribing veterinarian about Merlin. I would discuss whether or not he needs a stool softener and whether he needs to be on canned pumpkin daily. Depending on how regulated he is or how constipated he is, he may need different things. If he hasn't had a bowel movement for awhile, he will likely need an enema. I have also found that cats with megacolon respond REALLY well to the prescription diet Royal Canin GI fiber response. Talk to your vet as they can likely order it for you or write a written prescription for you. I hope this helps!

Hello, thank you for using Petco Pet Education Center, formerly Petcoach. There are no known contraindications with using mirtazapine and cisapride together but remember, all cats react differently to medications so if you notice any abnormal issues then stop the medications immediately and call your vet. Hope this helps. Best wishes.

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! Poor Galaxy! I recommend cisapride, lactulose and Royal canine fiber response for constipated cats. Sometimes with the prescription diet it eliminates the need for most medications. If she isn't eating I would have her seen today and deobstipated (sedate and remove all feces) before the weekend. Then get the cisaride and food started. Sometimes refractory cases need partial removal of their colons. I wish you the best!

I am afraid more information would be required as to the underlying cause of the megacolon and any previous injuries or surgeries he has undergone in order to assess fully. Diet manipulation, acupuncture and chiropractic care may all help in improving lower bowel function and the addition of laxatives can all ease symptoms

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. Feeding high fibre food is the key in managing megacolon. Please, try Royal Canin Fibre Response - it is a very good diet that hopefully will be more tasty for Yzma than Hill's.

Hello, and thanks for your question on Petco Pet Education Center, formerly Petcoach. For now, I wouldn't stress about knowing exactly which medication has helped Kiki - in truth, it's probably been a combination of all the different interventions. Cats who are prone to constipation often need constant adjustments in their management, so for now, if she's doing well, continue the miralax as your vet advised and touch base with them if her stools become hard or less frequent again. Sometimes cats may need to be on both meds for a time, or even switch foods entirely to a diet formulated for cats with constipation issues. So, there's probably not one "right" medication for her, and a therapy that worked this time might still need to be adjusted in the future. I have found the Royal Canin GI Fiber Response food to help immensely - you could ask your vet if that's an appropriate option if Kiki continues having bouts of constipation. Hope this helps!

I would not be overly worried about her not producing stools just yet. The metronidazole and the buprenorphine can both cause a decrease in gastric motility but moreso the buprenorphine. If she is still on the buprenorphine I would discontinue it unless you feel like she is still in a lot of pain. If she will eat it, you can offer her some canned pumpkin as that may help stimulate her GI tract. Pure canned pumpkin, not pie filling. About one teaspoon 2-3 times per day. I would also recommend you start her on a probiotic - one made for cats, not humans. I like this one but any one made for cats is fine. ( https://www.amazon.com/Purina-Veterinary-Fortiflora-Nutritional-Supplement/dp/B001650OE0 ) Hope this helps. Best wishes.