Constipation is defined as the infrequent or difficult evacuation of stool. It is a common problem in cats and may be acute or chronic but does not inherently imply a loss of colonic function. Often the underlying cause is dehydration and is easily managed by supportive hydration, via oral, nutritional or parenteral means. Obstipation refers to intractable constipation that is unresponsive to therapy or cure and implies permanent loss of function.
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The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.
Your ACVS board-certified veterinary surgeon completed a three-year residency program, met specific training and caseload requirements, performed research and had research published. This process was supervised by ACVS Diplomates, ensuring consistency in training and adherence to high standards.
After completing the residency program, the individual passed a rigorous examination. Megacolon is a term used to describe a very dilated, flaccid, incompetent colon. This usually occurs, secondary to chronic constipation and retention of feces , but may be a congenital dysfunction. Megacolon itself is not a specific disease entity, but it will usually result in obstipation inability to defecate , since feces is retained in the colon in a larger diameter than is able to pass through the pelvis.
The feces also become very dry and hard, as the colon absorbs water. Surgery may be required to treat this condition once medical management has been exhausted.
Megacolon is secondary to colonic inertia functional obstruction or outlet obstruction mechanical obstruction. In each category, there are a number of specific causes. The most common cause of colonic inertia is idiopathic meaning unknown cause megacolon.
Idiopathic megacolon is a disease in cats where the colon loses its normal motility and becomes progressively larger. As the disease progresses, cats lose the ability to defecate. The most common cause for outlet obstruction is obstruction due to poorly healed pelvic fractures, which impinge on the outflow tract of the pelvis and prevent the normal passage of feces. Cats affected with idiopathic megacolon are usually between 5—9 years old.
The stool present in the colon is large and firm, and is easily palpable a veterinarian can feel it easily. It is important that your veterinarian perform a rectal exam to check for old collapsed pelvic fractures, obstructive masses, or hernias located either inside or outside of the colon or rectum.
Diagnosis of megacolon is based on history and physical exam , and is confirmed with radiographs x-rays of the abdomen.
The diagnostic work-up should also include blood work to rule out any metabolic abnormalities. Radiographs can confirm the presence of a large colon Figure 1 and can be used to determine if there are any old pelvic fractures Figures 2 and 3 , masses, or spinal deformities. Abdominal ultrasound, contrast studies of the lower gastrointestinal tract, or colonoscopy may also be needed to determine cause of the condition.
For idiopathic megacolon, initial management is medical. These cats should be appropriately hydrated IV fluids if dehydrated , then an enema, and deobstipation manual removal of feces should be performed. This almost always requires general anesthesia, as it is extremely painful for an awake cat. Best medical management includes a low-residue diet your veterinarian can suggest low-residue prescription diets and prescription medications such as lactulose and cisapride.
Lactulose is a mild cathartic helps speed defecation and is a stool softener. Cisapride stimulates colonic motility propulsion. The low residue diet helps to stimulate the colonic cells without increase in bulk. Most cats will initially respond to this therapy, but some will eventually become refractory to treatment.
When medical therapy is no longer effective, surgery to remove the enlarged colon is recommended. Before surgery, your pet may be started on antibiotics, because the colon, containing feces, is the most bacteria-laden part of the intestinal tract.
Antibiotics help to prevent bacterial infection at surgery. In subtotal colectomy, the entire affected colon is resected cut out and the two remaining ends are sutured back together. Failure to remove an affected portion of bowel can cause formation of a new dilated area of bowel, leading to recurrence of clinical signs of constipation and obstipation.
Sub-total colectomy is a challenging surgical procedure. Cats with pelvic obstruction secondary to pelvic trauma can be treated by removal of the abnormal pelvic bones pelvic ostectomy to allow normal passage of feces again. Unfortunately, if the megacolon has been present for greater than four to six months, dilation and loss of function may be irreversible.
The colon is not able to return to normal function after this extended period of time. Therefore, most cats with impinging pelvic fractures are also treated with the same surgery subtotal colectomy. Postoperatively, antibiotics are often continued and cats are closely monitored for infection. Soft stools and occasionally diarrhea can occur for the first few months after surgery. Progressively, the stools become more formed, but rarely ever become normal.
Cats are not incontinent following subtotal colectomy, but may occasionally drop a small piece of soft stool on the way in or out of the litter box as they are adjusting to their new life post-constipation. Postoperative constipation has been reported, but is rare and is usually treated successfully with medical management Rarely, cats require a second surgery if not enough colon was removed the first time.
The vast majorities of cats have excellent quality of life and do not need special diets or medication. Any opinions stated in this article are not necessarily the official position of the American College of Veterinary Surgeons.
The American College of Veterinary Surgeons recommends contacting an ACVS board-certified veterinary surgeon or your general veterinarian for more information about this topic. Your feedback helps us make the Animal Health topics serve you better. Please note that submissions to this form are not monitored by a board-certified surgeon.
For questions about your animal's specific condition, please contact an ACVS board-certified surgeon in your area. Veterinary Surgery Journal. Resident Training Log. Job Board. American Board of Veterinary Specialties. ACVS Merchandise. Connect with us! Skip to main content. Signs and Symptoms:. Cats affected by megacolon may show the following signs: abdominal discomfort decreased appetite lethargy tenesmus straining to defecate The stool present in the colon is large and firm, and is easily palpable a veterinarian can feel it easily.
Medical Treatment For idiopathic megacolon, initial management is medical. Aftercare and Outcome:. Content Theme:. Animal Owners. Also known as:. Was this article helpful to you? Additional comments. Back to small animal health condition topics. Giving to Help Animals Connect with us!
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Megacolon is a condition of extreme and irreversible dilation and poor motility of the colon, usually combined with accumulation of fecal material and the inability to evacuate it. The majority of cases 62 percent have no known cause, however, disorders that lead to recurrent episodes of constipation can also result in megacolon. For years, there was debate as to whether the problem was neurological vs. Constipation is characterized by absent, infrequent or difficult defecation associated with retention of feces within the colon and rectum.
Symptoms, Diagnosis and Treatment Options for Megacolon in Cats
Megacolon is a disease of the colon large intestine , which results in chronic constipation. There are two forms of megacolon: congenital and acquired. The gastrointestinal tract consists of a tube that runs from the mouth to the anus. Its function is to digest food and absorb nutrients into the body. The stomach is a dilated part of the GI tract that produces acids, which help with initial breakdown of proteins. The small intestine extends from the stomach to the colon and serves to further break down food into absorbable nutrients.
Megacolon can be curable when handled the right way
Garfield, a pound, 8-year-old domestic shorthair cat, had become constipated in the past few months. His family veterinarian initially prescribed psyllium fiber Metamucil. Then, a few weeks later, the vet prescribed methylcellulose fiber Citrucel. Then a few weeks later, lactulose. Then a few weeks later, a high-fiber canned diet. Then a few weeks later, mineral oil and petrolatum Laxatone. Then a few weeks later, dioctyl sulfosuccinate docusate or Colace.