My Constipated Cat Cried in the Litter Tray Every Third Day. The Lactulose Stopped Working. This Got Her Going Again.
If your older cat strains in the tray, passes little hard pellets, or only goes every two or three days, this is what a cat-only vet told me that my own vet never did.
With a note from Kayla Brooks, RVN, Registered Veterinary Nurse
The first time I heard it, I thought she'd hurt herself.
It was a low, long cry from the utility room, a sound I'd never heard her make in thirteen years. I ran in and found Toffee crouched in her litter tray, hunched up with her back arched like a croquet hoop, straining. Her tail was shaking.
She stayed like that for what felt like ten minutes. Then she climbed out, walked three steps, turned round and climbed back in to try again.
When she finally gave up, there were two tiny, rock-hard pellets in the tray. Like something a rabbit would leave.
I'm a retired school librarian. I'm not squeamish, but I'll be honest, I sat down on the step and nearly cried myself.
"Some Older Cats Just Get Slow"
That was the start of what I now call our lactulose year.
My vet was kind. She examined Toffee, felt her tummy, and told me she was constipated, which is very common in older cats. She prescribed lactulose, a sweet syrup you mix into food that draws water into the bowel and softens things up.
"Some older cats just get slow," she said. "We'll keep her on this."
And for about a week, it worked. Toffee went more easily. I was so relieved I bought a box of chocolates for the girls on reception.
Then it stopped working quite so well, and the dose went up. Then it went up again.
Here's what nobody tells you about lactulose. It's sticky, it's very sweet, and a lot of cats hate the taste. Toffee started sniffing her food with suspicion. Some nights she'd eat round the bit with the syrup in it. Some nights she wouldn't eat at all, and then of course she'd be even more blocked up.
So I tried everything else I could find.
- Tinned pumpkin. She licked the gravy off the food around it and left the pumpkin like a little orange island.
- Hairball paste. Helped for a day or two. Then nothing.
- A splash of milk, which a neighbour swore by. That gave her the opposite problem, all over the utility room floor.
- Moving her tray, buying a bigger tray, trying three different litters.
- An enema at the vet, twice, under sedation. I won't tell you what that cost.
I was keeping a little diary on the fridge. A tick for every day she went. Most weeks there were two ticks. Some weeks there was one.
A healthy cat, I later read, usually goes once to three times a day.
The Word That Frightened Me
The second time Toffee needed an enema, the vet nurse who handed her back to me said something in passing that kept me awake that night.
"We just want to keep an eye on her so it doesn't turn into megacolon."
I went home and looked it up, which I'd advise anyone not to do at eleven o'clock at night.
Megacolon is what can happen when a cat is constipated over and over for a long time. The bowel keeps getting stretched by hard, packed-in stool, and like an old jumper that's been pulled out of shape, eventually it can lose the ability to spring back and squeeze. The muscle stops doing its job, and things stop moving altogether.
Cats with megacolon can end up needing more and more medicine, regular enemas under sedation, and in the worst cases, surgery to remove part of the bowel.
I'm not telling you that to frighten you. Most constipated cats never get anywhere near that. But it changed how I saw the whole thing. I'd been treating every bad day as a one-off to get through. Those bad days were a pattern, and each time it happened it was a little bit harder on her.
I'd been missing some of the signs too. Reading back through my diary, I could see things I hadn't connected:
- She'd been going in and out of the tray several times for very little
- She'd been licking at her back end more than usual
- She'd gone off her food on the days she hadn't been
- She'd been sleeping in odd, hunched positions
- Once or twice, there was a smear of something liquid around the hard bits, which I'd thought meant the opposite of constipation. It doesn't. It can mean liquid is squeezing past a blockage.
So when my sister-in-law finally put her foot down, I listened.
The Second Opinion
Her cats go to a cats-only clinic in the next town, and she said, "Mo, you've been doing this for a year. Get someone else to look at her."
So I did. And the vet I saw there, a quiet woman with a lot of cat hair on her trousers, asked me a question nobody had asked me before.
"What are we doing about why she's slow?"
I said, "The lactulose."
She smiled and shook her head. "Lactulose moves what's there. It's a good drug and we may still need it. But it doesn't do anything about why things got stuck in the first place. In an older cat, it's usually three things at once."
Then she explained them. I took notes in the car park afterwards so I wouldn't forget.
"Lactulose moves what's there. Nothing was doing anything about why it got stuck."
The Three Things That Slow an Old Cat's Gut
A slightly dry cat's bowel pulls more water back out of the stool, so it turns hard.
Good gut bacteria make substances that feed the bowel muscle. They thin out with age.
Bile helps keep the lower bowel moving. Cats can only make bile salts from taurine.
Water, bacteria, bile. Lactulose only helps with the first one.
1. Water. Older cats are very often a little bit dry, especially if their kidneys aren't what they were. The last part of the bowel pulls water back out of the stool before it leaves. When a cat is short of water, it pulls harder, and what's left turns hard and dry. That's why those pellets were like stones.
2. Bacteria. The gut is full of friendly bacteria, and they do a job most of us never think about. They break down what the cat can't digest on her own, and as they do, they make substances that feed the muscles of the bowel wall and keep things moving along. As cats age, the vet said, that population of good bacteria often thins out. Fewer workers, slower line.
3. Bile. This was the one that made me sit up. Bile isn't only for digesting fat. When it reaches the lower bowel, it helps draw water in and keeps things moving. And cats are unusual. They can only make their bile salts using one thing: taurine. Cats can't make enough taurine themselves, so they rely on getting it from their diet.
She said lactulose was helping with the first of those, by force. Nothing was doing anything about the second or third.
What She Told Me to Do
She was very practical, and I'll pass it all on because some of it cost nothing.
I asked about the probiotic part, because I'd assumed they were all the same as the yoghurt drinks in the supermarket.
She said they're not. A lot of probiotic bacteria are killed by stomach acid before they ever get to where they're needed. The ones worth having for a cat are what are called spore-forming bacteria, which have a tough outer coat, a bit like a seed, that gets them through the stomach in one piece.
She also mentioned a small study in Italy, in cats with long-term constipation, where a daily probiotic led to clear improvement in their symptoms. She was honest that it was a small study, but she said she'd seen enough in her own patients to think it was worth trying before stepping up the medicine.
What I Found
I went looking for something that had both the probiotic and the taurine in it, and that Toffee would actually eat. That last part mattered most, after the lactulose battles.
I found a daily sachet from a company called Fureeze. It's an Australian company (they also ship to the UK and US, and it only takes about 5 days). Mine arrived on a Tuesday, which I thought was quite impressive.
- 1 billion live cultures per sachet, mostly spore-formers with a tough coat that gets them through stomach acid alive (Bacillus subtilis, B. licheniformis, B. coagulans, plus Lactiplantibacillus plantarum)
- 400mg taurine, the one building block a cat needs to make bile salts, plus support for heart and eyes
- Chicken flavoured with goat milk powder. Cats that eat around pumpkin and paste eat this
- Lutein, zinc, iron and vitamin E for eyes, skin and coat
- 28 tear-open sachets in a pull-out drawer box. One a day, no clumping, no mess
Each sachet has a billion live probiotic cultures, mostly the spore-forming kind the vet had described, plus 400mg of taurine. There's also lutein, zinc, iron and vitamin E. It's a fine powder that you tear open and sprinkle over her food, and it's chicken flavoured with goat milk powder.
I'll be honest. After a year of watching her eat around the lactulose, I fully expected her to eat around this too.
She didn't. She ate the lot, then sat by the empty bowl waiting for more.
The Fridge Diary
I kept up my diary with the ticks. I'm going to give you exactly what it showed, because it's the only honest way I know how to tell it.
It's been six months now. Toffee goes most days. She still has the odd slow day, usually in winter when she drinks less, and I keep a little lactulose in the cupboard for those, with my vet's blessing. But the crying from the utility room has stopped. I haven't heard that sound since spring.
The thing I keep coming back to is how long I spent forcing things through when nobody, including me, was asking why they were stuck.
What People Ask Me
"Can I just keep using lactulose?" Plenty of cats need it, and your vet may want her to stay on it. I still use it on slow days. But for us, lactulose on its own was a treadmill. The dose kept creeping up and Toffee hated it. Looking after her gut every day is what got us off it.
"Is it the same as giving her yoghurt?" No. Human yoghurt bacteria mostly don't survive a cat's stomach, and dairy can upset a lot of cats. My neighbour's milk tip proved that.
"Will she eat it?" Toffee eats it without a fuss, and she is a cat who refused pumpkin, refused hairball paste, and ate round the lactulose for a year. Mix it into a food she already loves for the first few days.
"How long before I'll know?" For us it was about two weeks before I saw softer stools and four before it looked normal. I'd give it a good month before judging.
What Other Owners Have Said
These are real reviews from verified buyers of the same sachets.
My cat seems to enjoy this topper and I am noticing less throw up around the house.
Product is improving the 'quality' of kitty's poops!! Yeh!! And he enjoys eating it on his kibble.
My picky eater seems to actually enjoy his food more when I add this!!
My cat absolutely loves this product! She looks forward to it every day, and it's become a firm favourite. Highly recommend!
Love this for my cats. Just need to sprinkle it on and not have to worry about mixing it in their food.
If You're Keeping a Diary Too
If you're counting the days between ticks and dreading that sound from the litter tray, please ask the question I wish I'd asked a year earlier: why is she slow?
Get more water into her. Make the tray easy. Keep your vet involved. And give her gut what it needs to do the job on its own, because every week it stays slow, the bowel gets stretched a little more.
Fureeze has an offer on for new customers at the moment.
There's a 90-day money-back guarantee. Give it 90 days, and if you don't see a difference, send back the empty box for a full refund.
I hope your diary fills up with ticks like ours did.
Maureen
P.S. The day I'd change, if I could go back, is the first night I heard that cry. If your cat strains in the tray and you're on your second or third bottle of lactulose, check the Fureeze offer here. You've got 90 days to see the ticks come back.