Overview of Feline Hematochezia (Blood in Stool)
Hematochezia is the presence of bright red, fresh blood in the feces in cats. Hematochezia usually occurs with bleeding in the lower intestines (colon, rectum). Hematochezia should not be confused with melena , which is the passage of dark, tarry, black feces. Melena represents the passage of old, digested blood that has occurred with bleeding higher up in the intestinal tract.
Below is an overview of Hematochezia (Blood in Stool) in Cats followed in-depth information about the causes, diagnosis and treatment of this condition.
In cats, the presence of hematochezia may be a symptom of either a minor problem, or a potentially more serious problem in the animal. One occurrence of hematochezia may be a minor and transient event. Repeated or persistent hematochezia is more serious and should not be ignored. There are several possible causes. The most common cause in older pets is cancer and in younger pets are parasites.
General causes include:
General Causes of Blood in the Stool of Cats
- Infectious agents, such as bacteria, protozoa, viruses, and intestinal parasites
- Dietary intolerance/allergy/indiscretion
- Cancer (neoplasia) of the lower bowel
- Polyps (benign masses) in the colon or rectum
- Inflammatory bowel diseases, such as colitis
- Trauma to the lower bowel or anal area
- Clotting disorders (coagulopathy)
- Intussusception (the telescoping of one part of the bowel into another)
- Miscellaneous diseases of the anus, rectum and colon
What to Watch For
- Bright red blood in the feces
- Straining to defecate
- Increased number of bowel movements produced
- Possibly no other clinical signs
- Possibly other systemic signs of illness, such as excessive drinking, urinating, vomiting and diarrhea, lethargy, poor appetite, weight loss
Diagnostic Tests for Hematochezia in Cats
- Rectal examination
- Complete blood count (CBC)
- Biochemical profile
- Fecal examination
- Coagulation profile
- Abdominal X-rays (radiographs)
- Abdominal ultrasound
Treatment of Hematochezia in Cats
There are several things your veterinarian might prescribe to treat your pet’ symptoms. These include:
- Changes in the animal’s diet
- Fluid therapy
- Deworming medications for intestinal parasites
- Antibiotics for bacterial infections
- Motility modifying drugs that change the rate of movement of food through the intestines
At home administer any prescribed medications as directed by your veterinarian and follow any dietary recommendations closely.
You should also observe your pet’s general activity and appetite, and watch closely for the presence of blood in the stool, or a worsening of signs. If any changes occur, notify your veterinarian.
In-depth Information on Hematochezia (Blood in Stool) in Cats
Hematochezia refers to the presence of red or fresh blood in the stools, and must be differentiated from melena, which is the presence of black, tarry stools. The causes, diagnostic tests, and treatment protocols for hematochezia often differ from those for melena.
Hematochezia is often a sign of lower gastrointestinal disease. In some cases it is an indication of a minor, transient problem. In other cases it is indicative of a serious underlying disease that can become an emergency requiring intensive therapy. Hematochezia may be the only clinical sign seen, or it may be accompanied by other signs, especially straining to defecate. Obtaining a detailed history and through physical examination are essential when evaluating these patients.
Causes of Hematochezia in Cats
There are many potential causes of hematochezia. The most common causes are usually associated with the gastrointestinal tract, although in some cases, the cause is completely unrelated (e.g. clotting disorders or coagulopathies). It is important to determine the cause of hematochezia, as specific treatment is often necessary for these patients.
- Numerous infectious agents may result in hematochezia. These include viral infections such as panleukopenia, bacterial infections such as Salmonella, protozoal agents such as coccidiosis, and intestinal parasites such as hookworms and roundworms.
- Dietary intolerance and indiscretion from eating spoiled food, overeating, ingesting foreign material (especially bones), a sudden change in diet, or eating people food may cause inflammation of the lower bowel and hematochezia.
- Dietary allergy to certain food substances, such as to particular proteins, lactose, high fat content, and certain food additives may also cause colitis with hematochezia.
- Masses of the colon, rectum or anus may cause bleeding and produce hematochezia. Such masses include benign (polyps) and malignant (cancer) tumors.
- Persistent hematochezia is a common sign of inflammation of the colon, sometimes referred to as colitis. Many of the causes of hematochezia listed above also cause colitis. Colitis can also occur for unknown, immune-related, or poorly defined reasons, and may require a colonic biopsy to identify the type of inflammation present.
- Trauma of any sort can cause hematochezia. Examples include bite wounds to the anal area, fractures of the pelvis that disrupt the colon or rectum, the passage of sharp ingested objects (e.g. bones, needles, tacks, etc.), and the insertion of instruments or materials into the rectum (e.g. examination scopes, enema syringes, etc.).
- Bleeding disorders (coagulopathies) of the body may result in bleeding from the lining of the lower bowel. There are numerous types of bleeding disorders that may occur in animals. Examples include ingestion of rat poison that contains anticoagulants, inherited clotting disorders (rare in the cat), decreased numbers of platelets (uncommon in the cat), disseminated intravascular coagulation (DIC) from massive infections or organ failure, and severe liver disorders.
- Intussusception (the telescoping of one part of the bowel into another) secondary to foreign bodies, tumors, or parasites can cause hematochezia.
- Stricture (narrowing) of the anus or colon, secondary to previous trauma, inflammation, cancer or a foreign body may result in bleeding, especially as stools are passed.
- Chronic or intermittent constipation and attempted passages of dry, hard stools may result in hematochezia.
- Anal sacculitis (inflammation of the anal sacs) or anal sac abscessation can change the consistency of the fluid in the anal sacs to a bloody liquid. This liquid may coat the stools as they are defecated. Anal sac diseases are uncommon in the cat.
- Proctitis is inflammation of the rectum and is often associated with colitis.
Obtaining a complete medical history, and performing a thorough physical examination are necessary in order to create an appropriate diagnostic plan for the patient with hematochezia. The physical examination often includes a digital rectal examination. In addition, the following tests may be recommended:
- A complete blood count (CBC) to evaluate for the presence of infection, inflammation, anemia, and altered numbers of platelets
- A biochemical profile to assess the overall health and function of various abdominal organs, and to help rule out other disorders
- A urinalysis to evaluate the kidneys, the hydration status of the patient, and the presence of blood in the urine
- Multiple fecal examinations for parasites, bacteria, protozoa, and the presence of occult blood (blood that is not visible with the naked eye)
- A coagulation profile to assess the ability of the blood to clot
- Abdominal radiographs (X-rays) to evaluate the abdominal organs and assess for the presence of a foreign body or tumor