Constipation in Cats
Diagnosis In-depth Obtaining a complete medical history (including diet, eating habits, environment) and performing a thorough physical examination including a thorough digital rectal examination are necessary in order to create an appropriate diagnostic plan for the constipated patient. A complete blood count (CBC) will evaluate for the presence of systemic infection or inflammation. A biochemical profile evaluates kidney, liver, electrolytes (specifically, potassium and calcium), total protein, and blood sugar status. All of these parameters are important to establish in the chronically constipated patient, and to rule out the possibility of concurrent diseases. A urinalysis helps evaluate the kidneys and hydration status of the patient. Abdominal radiographs (X-rays) may reveal colonic or rectal foreign bodies or tumors, old pelvic fractures, hip dysplasia and will reveal the degree of constipation. Multiple fecal examinations are important to rule out gastrointestinal parasites, which can cause pain and straining associated with constipation.
Your veterinarian may recommend additional tests to insure optimal medical care. These are selected on a case-by-case basis. A parathyroid level may be recommended in the hypercalcemic (elevated calcium) constipated patient, as hyperparathyroidism has been associated with constipation. An abdominal ultrasound evaluates the abdominal organs and helps assess for the presence of tumors. It is a very sensitive test in evaluating the prostate. The procedure is relatively safe, although it may require a mild sedative. It is often recommended that a specialist perform the procedure. Colonoscopy (lower GI endoscopy) may be of benefit in the patient with constipation. It is a rather noninvasive way to evaluate the colon, and identify the presence of a tumor, stricture, or other lesion. Your veterinarian may also want to sample tissue for the presence of inflammation or cancer.
Since it is necessary to “clean out” your cat to allow for proper visualization of the colon, oral solutions are administered the evening and morning before the procedure, in addition to several enemas. Hospitalization is brief, and healing is generally quick and uneventful. It does, however, necessitate general anesthesia, and therefore is associated with minor risks. It is often necessary to refer the patient to a specialist, and is only performed when other diagnostics are either inconclusive or the patient is not responding well to therapy.
One or more of the diagnostic tests described above may be recommended by your veterinarian. In the meantime, treatment of the symptoms might be needed, especially if the problem is severe. The following nonspecific (symptomatic) treatments may be applicable to some cats with constipation. These treatments may reduce severity of symptoms or provide relief for your cat. However, nonspecific therapy is not a substitute for definitive treatment of the underlying disease responsible for your cat’s condition. Medical and dietary therapy may be lifelong and often frustrating. If an underlying cause has been identified, treat it or remove it if possible. Discontinue any medications that may cause constipation. Alter the diet to be altered to include bulking agents such as methylcellulose, bran or pumpkin. Stool softeners such as docusate sodium(DSS, Colace) may be used as instructed by your veterinarian. Promote frequent exercise, as this helps promote regular bowel movements. If a cat is severely impacted and/or dehydrated, it may be necessary to hospitalize him for fluids, enemas, and possible manual removal of feces, which often necessitates general anesthesia. In a small percentage of patients where constipation continually progresses to obstipation, a colectomy (surgical removal of the colon) may be necessary if medical management is not of benefit.
Follow-up Care for Cats with Constipation
Optimal treatment for your cat requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your cat does not improve rapidly. It is important to note that chronic or recurrent constipation can lead to obstipation and acquired megacolon, at which point prognosis is guarded for normal function.
It is important to monitor the frequency of defecation and the consistency of feces. Administer all prescribed medication as directed. Alert your veterinarian if you are experiencing problems treating your cat. Overuse of laxatives and enemas can cause diarrhea.
Discontinue/avoid any medication or substance that may be causing or exacerbating (worsening) constipation.