Constipation

Constipation in cats is not uncommon, and is most commonly caused by dehydration which can be managed by simply adding water to your cat’s meals, subcutaneous fluids administered by your veterinarian or yourself and/or an array of prescription drugs. The signs of constipation are easy to spot if you pay attention: very hard feces (often segmented and found in the litter box or on the floor near and around the box), a reduction in the amount of stool your cat leaves in the box, repeated straining with either no result or small hardened stools, stools covered in part or whole by mucous or bloody mucus, loss of appetite, lethargic behavior, weight loss, crying out while defecating and intermittent diarrhea. "Diarrhea? But my cat his constipated!" you say? Yes, diarrhea. This is cause when liquid behind the blockage escapes around the hardened stool. The signs to spot are a long list, but if you see any one or groups of these signs and for more than a day or two then you should take your cat to the veterinarian right away.

Megacolon

Megacolon is one of those fun problems that have no direct cause and can be fatal. It is usually the end stage condition of chronic colon dysfunction, where the colon is dilated and houses a lot of hardened stool. Megacolon in itself need not be fatal and can often be easily treated and helped to go away, but it can also be chronic and something that will be with your cat for the rest of their life.

The Danger

Constipation, be it caused by megacolon or something else, if left untreated will result in death, and that can happen in a matter of days to a week. Consider that cats hide their illness very well (a product of evolution) and by the time you spot your cat is in discomfort it is already pretty far along.

At the Vet’s Office

If you noticed the warning signs early on then the vet visit may not be overly traumatic (at least in our eyes. Every veterinary visit is traumatic and horrible to my cats, even if the vet only pets them on the head and we leave). If the problem is caused by simple dehydration and early on, the treatment could be simply subcutaneous fluids. If the obstruction is large and not going anywhere the treatment could surgery to remove it. A simple exam consisting of your description of the problem and a good abdominal palpation will usually find the obstruction, though x-rays may be used to confirm the findings if warranted. Once you know how serious the problem is and how often it is happening your veterinarian should go over the therapy options with you.

Therapeutic Options

The therapeutic options can be as easy as once or ongoing treatment.

1. Subcutaneous Fluids (administered at home or in the vet’s office)
2. Removal of feces through enemas. It is very important to note here that even if your vet teaches you how to do this if the condition is ongoing, never ever, and I do mean NEVER use a human enema unless your veterinarian tells you a specific brand and type. Sodium phosphate (Fleet) enema will cause life threatening electrolyte imbalances in your cat and kill them!
3. Removal of feces through manual extraction by the vet. This is dangerous and will require your cat be anesthetized and your vet will take great care doing this as perforation of the colon can kill your cat.
4. Diet changes - Your vet may recommend foods containing fiber to act as a bulk-forming laxative. Other foods that can do this that the vet may recommend include canned pumpkin and wheat bran.
5. Lubricants (laxatives) may be prescribed. This may include over the counter items such as Laxatone or mineral oils; or it may include prescriptions for such things as Lactulose, Lactose, Colte and such. If the prescription route is taken, you can have a compounding pharmacy make it with a flavoring added. (Our cat Leo gets Lactulose compounded with chicken flavor)
6. Motility stimulators may be prescribed, such as Cisapride. Like stated above, most of the motility stimulators can be compounded with flavors. (Our cat Leo gets Cisapride compounded with chicken flavor) There is a number of reports on Propulsid being used as an inner ear compound. I do not know much on this but I believe it is absorbed through the skin. It is debatable if this works, but ask your veterinarian about it if you have questions. (it is important to note that Cisapride has been withdrawn from the drug market because of cardiac toxicity on a small number of human patience. Veterinarians may still request it from compounding pharmacies, and there are many of these throughout the country)
7. Surgery. As a last resort surgery is often the chosen option. Chronic obstipation or megacolon are considered candidates for a colectomy, where the colon is totally removed and the small intestine is connected to the rectum. Your cat will have diarrhea post surgery for up to 3 months and may have soft stools on an ongoing basis. The prognosis is usually very good for a recovery from the surgery. (that said, we have elected to forgo a colectomy for our cat Leo at this time. He has too many other problems and we do not feel it wise to put him through such an invasive procedure. We have elected to continue 2 enemas a week while we play with a cocktail of medications, laxatone and cream.)

Final Words

Please remember that I am NOT a veterinarian or trained cat specialist. My advice and guidance is from person experience, self learning and talks with several vets (this subject, like my guide on seizures is mostly from having to deal with megacolon in our cat Leo). Before you take my advice to heart make sure you consult with your cat's vet and make sure that they agree with my advice. After all, you and your vet know your cat far better than I do.