ABSTRACT OF THE WEEK

Journal of feline medicine and surgery
Volume 13 | Issue 10 (October 2011)

Safety and palatability of polyethylene glycol 3350 as an oral laxative in cats.

J Feline Med Surg. October 2011;13(10):694 - 697.

Fiona M Tam¹, Anthony P Carr, Sherry L Myers

¹ Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. fiona.tam@usask.ca

Abstract

Recurrent constipation is a common problem in cats. Laxatives often are the cornerstone for management of recurrent constipation; however, there is a paucity of published research on laxative use in cats. This study investigated the safety and palatability of polyethylene glycol (PEG3350) in normal cats. All cats consumed the PEG3350 laxative for 4 weeks without changes in weight or food intake. In all cats soft stools were achieved. Effective doses varied widely in experimental cats, so individualized dosing is important. Mild, non-clinical hyperkalemia was noted although the cause is unknown.

Companion Notes

Report on the safety and palatability of polyethylene glycol 3350 as an oral laxative in normal cats

Study design

- introduction on the treatment of constipation in cats

- laxatives commonly used as part of management

- polyethylene glycol (PEG3350) is a bulking and softening agent

- large molecular weight, water-soluble polymer

- in human medicine widely used as an osmotic laxative

- not metabolized by intestinal bacterial

- minimally absorbed

- each molecule hydrogen bonds with 100 molecules of water

- this results in high osmotic pressures in bowel lumen

- this acts against the absorption of water out of the lumen

- in multiple meta-analyses

- PEG3350 a more effective laxative than lactulose

- as well as many other oral laxatives

- adverse events are self-limiting and include the following:

- distended abdomen with pain

- nausea

- excessive diarrhea

- clinical hyponatremia not documented with daily low-dose use

- lactulose is a commonly used osmotic laxative

- in human medicine

- moderate evidence of efficacy and safety for chronic constipation

- in veterinary medicine: no evidence to support use

- soluble and insoluble dietary fibers

- in human medicine

- weak evidence of efficacy and safety for chronic constipation

- in feline medicine: no evidence to support use

- study population: 6 healthy cats from 1-4 years of age in a closed colony

- there was no history of diarrhea or constipation in the colony

- procedure:

- pilot trial on 2 of the cats to determine an effective initial dose

- treatment trial for 4 weeks

- PEG3350 with electrolytes (Colyte oral solution; Schwarz Pharma)

- 1.9 g per meal with the powder mixed with food

- cats were fed twice daily

(Iams, ProActive Adult formula, canned and dry)

- standard weight of canned and dry food offered each meal

- unconsumed amount weighed

- dosage titrated in each cat to achieve soft, formed stool (grade II-III)

- initial dose doubled if no effect seen within 48 hours

- assessment methods:

- fecal scores assessed daily; standardized fecal grading scale used

- grade I: over 66% of feces are liquid

- grade II: intermediate consistency between soft and liquid

- equal amounts of feces are soft and liquid

- grade III: over 66% of feces is soft

- firm enough to form a pile (no cylindrical appearance)

- grade IV: intermediate between firm and soft

- equal amounts of feces are firm and soft

- grade V: over 66% of feces in a defecation are firm

- cylindrical shape with little flattening

- CBC and chemistry before and 2 and 4 weeks after starting PEG3350

- palatability assessed by food intake and weight

- treatment stopped after 4 weeks

- cats monitored until stool consistency was normal for 2 defecations

Results

- grade I-III stool consistency achieved in all cats

- target consistency achieved in a median of 21.5 days

- median daily dose of powder to achieve target fecal grade: 3.0 ± 1.1 g

- median daily doses of the 6 cats to achieve target fecal grade

- 0.8, 1.5, 3.0, 3.0, 3.8 and 3.8 g

- dosage may be highly variable between cats

- diarrhea occasionally noted during treatment, 4 cats

- PEG3350 dosage decreased

- median time to return to normal consistency after stopping: 5.5 ± 3.4 days

- adverse event: no significant side effects noted in any cat

- sporadic vomiting, 1 cat during the treatment

- mild hyperkalemia, 3 cats at 5.6-6.0 mmol/l with reference at 3.9-5.5 mmol/l

- not associated with clinical signs in any of the cats

- food intake and body weight not significantly changed by PEG3350

“Our study demonstrated that PEG3350 with electrolytes is a safe and palatable oral laxative in healthy cats when used for 4 weeks. Potential side-effects include hyperkalemia; however, the changes we noted were not clinically or statistically significant.”

Article Tools:

Medline

Full Text on the Web

Email to me

Archives Highlights:

Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals.
Most prevalent diseases were sepsis (43.9%), enteritis (14.0%), and omphalitis (9.0%). Case fatality rate was 33.3%. Neonatal sepsis significantly increased the risk of death.

Investigating the relationship between canine training classes and post-adoption return rates in North American shelters
Of all the returned dogs, those who attended training were more likely to be returned for owner-related reasons (58.8?%), whereas dogs who did not attend training were more likely to be returned for animal-related reasons (78.9?%). While attending training classes at animal shelters may help to reduce behavioral returns, as shown by the shift in return reasons, they do not appear to reduce return rates significantly for the general shelter population.

Effective treatment with afoxolaner (NexGard) of Trixacarus caviae in a pet guinea pig.
The animal was treated with a single oral dose of 2.50 mg/kg afoxolaner, and the lesions, presence/absence of mites, and intensity of pruritus were evaluated periodically until 2 months post-treatment. A week after the medication, the lesions were milder, but pruritus was still present and was attributed to the healing process. Further examinations showed significant improvement with the complete remission of clinical signs and no mites at the microscopic examination after 4 weeks.

'Transmission Tracker - Dirofilaria'- a public dashboard to assess in real-time the temperature-bounded transmissibility of canine heartworm across Australia.
'Transmission Tracker - Dirofilaria' processes near real-time temperature records across Australia and allows users to enquire about historical and current weather suitability for canine heartworm transmission at any Australian postcode of their interest. This information allows veterinarians to access when, and for how long, heartworm may be transmitted at a specific location, assess the associated risk of infection, and advise on a patient-dependent dirofilariosis prevention plan for their canine patients and guardians.

Endoparasites of rabbits and hares.
Accurate gross and microscopic identification of endoparasites in rabbits and hares is an important element of the diagnostic work of veterinary anatomic pathologists. Given the zoonotic nature of rabbit and hare endoparasites, such as C. hepatica, E. cuniculi, and others, veterinary pathologists are ideally poised to make valuable contributions to the understanding of the disease ecology of these pathogens in the context of a One Health research program.