My 17 year old cat has had a bowel problem for quite some time. He is constipated and has lactulose added to his food on a daily basis. Without this, his movements become similar to concrete and are impossible to pass. At times he does allow me to help him pass movements which otherwise would become blocked. The vet had checked his kidneys etc and everything seemed fine. It looks to be simply old age.

However these past 2 weeks he has on-and-off diarrhea. He breaks wind all the time which is extremely smelly and he sleeps all day, which has been the case for the past few months. He also appears to be loosing his balance; whenever he wakes, if on the window ledge or top of the couch, he will fall off. I'm reluctant to put him to sleep as he seems otherwise fine, although I have to say he is a little on the slim side. I don't know whether I'm now being kind or cruel.

I hope you can please offer advice.


I don't believe you are being cruel to your kitty. Even considering his age, there are many possible treatable conditions that could be causing his constipation problems, diarrhea, and loss of balance.

How recently were your cat's kidneys checked by a veterinarian? And was full bloodwork done to check all of your kitty's organ functions? Also, it should be noted that a urinalysis will often provide the first indication of kidney disease, even before the values are elevated in the bloodwork, so a urinalysis should be done as well.

There are many things that could be causing your cat's recent poor balance. Kidney disease, low potassium, feline hyperthyroidism, and diabetes can all cause loss of balance in cats in different ways, causing problems with the hind legs, either through weakness or neurological changes. However, all of these feline illnesses are easily treatable if diagnosed early.

Regarding your concern with constipation and diarrhea, sometimes what appears to be cat diarrhea is actually still constipation. When the cat is straining to pass hardened stool, fluid can escape around the stool and can appear to be diarrhea. Additionally, kidney disease can play a big part in bowel problems in older cats.

Lactulose can be a trial-and-error type of treatment. Sometimes the perfect dose is just the slightest bit different than what you are currently giving. A bit too much and your cat may have diarrhea, while just a bit too little can cause terrible constipation. Especially since it is being given in your cat's food, there is a possibility that the amount your cat ingests changes just enough from day to day to cause diarrhea or more constipation. If constipation continues to be an issue even with giving Lactulose on a regular basis, you should talk to your veterinarian about adding Cisapride as an additional course of treatment.

So, again, I do not believe you are being cruel to your cat. I do think that he would benefit from full bloodwork and a urinalysis as soon as possible, however, to diagnose the cause of his symptoms. Even though your kitty is 17 years old, you could still have a few good years left with him!

All the best,
Dr. Neely