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Monday, November 20, 2006

Constipation in Cats

Constipation is a sign of disease, and is relatively common in cats. It is characterized by infrequent or absent defecation, and the passage of hard, dry feces. There is also increased straining to defecate and decreased fecal volume.

Constipation is different from obstipation, which is complete fecal obstruction. When cats have obstipation, it impossible for them to defecate. The colon becomes filled with rock-hard feces. Constipation generally has a good prognosis, but cats with obstipation usually develop irreversible changes in the muscle of their colon.

Constipation is also different from megacolon, which refers to the condition of extreme colonic dilation, and is a disorder of the structure and function of the colon. Cats with megacolon are always constipated, however constipated cats don't necessarily have megacolon.

Megacolon can be primary or secondary. It can be caused by a primary defect in the nerve supply of the colon, or it can become secondary to any lesion or disease that prevents normal defecation over a long period of time.



Causes of Constipation

Constipation can be caused by any disorder that prevents the normal passage of feces. The major causes of constipation can be divided into the following categories:

Dietary and environmental (hair, bones)
Painful defecation (anal/rectal disease)
Obstructive (old pelvic fracture, tumors)
Neurological (paralysis, spinal cord disease, megacolon)
Metabolic and hormonal (low potassium)
Drug induced
The most common causes are obstructive (secondary to hair ingestion) and neurological.

A cat with signs of constipation should be seen by a veterinarian to determine the underlying cause. If signs have not been observed, but a cat has a history of lethargy, decreased appetite, or intermittent vomiting, the cat should be seen by a veterinarian.

Cats with constipation typically have a history of reduced frequency or total failure of defecation for a period of days to weeks. You may observe your cat making frequent attempts to defecate without success.

Some cats pass liquid stool around the obstruction. The diarrhea may contain blood or mucus. Often, cats can become significantly dehydrated. Abdominal palpation usually reveals a hard, full colon, while a rectal examination shows an empty rectum. Performing x-rays will confirm a full colon and rule out any tumors.

Treatment

The treatment of constipation involves four basic steps:

Restore electrolyte and fluid balance.
Remove or alleviate any underlying causes.
Administer laxatives or cathartics.
Give enemas.

In general, constipated cats can be divided into two types of clinical groups:

A. Cats with severe impaction or obstipation.

B. Cats with long histories of moderate constipation.

Both types may require long-term therapy to control their disease. However, the cats in the first category may require more effort to remove the impacted feces.

Cats with severe impaction or obstipation must be admitted to a veterinary hospital for treatment with oral laxatives, enemas, or manual evacuation under anesthesia. The specific approach depends on the severity of the obstipation. In extremely affected cats, the breakdown and removal of the fecal mass may have to be done over two or three days. During hospitalization, the cat should also receive good, supportive care.

On an outpatient basis, moderate impaction can be relieved with simple water enemas. For maintenance therapy, you can do the following:

Supplement the cat's diet with bran, metamucil, or a similar bulk-forming material. However, there are some cats that do not improve, or even get worse after fiber content is increased.
Add laxatives as needed.
Groom the cat regularly to remove dead hair from the coat.
Keep the cat's litter box extremely clean to promote regular defecation.
Do not change litter box brands abruptly.
Remove covers from the litter box to prevent odor.
There are many different types of laxative and cathartic drugs that you can use to treat constipation. Laxatives are usually milder and cause the elimination of formed feces. In most cases, cathartic drugs will induce diarrhea. Consult with your veterinarian before giving your cat any medication.

The prognosis for cats with impaction depends on the underlying cause and duration of the impaction. Mild cases usually have a good prognosis, but severe cases may lead to a secondary megacolon. You should be aware of the possibility of continued preventative and maintenance therapy.

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