Constipation and Your Cat
Constipation is relatively common in cats. While middle-aged
and older cats (cats over 8 years) are more susceptible, cats of any age can become
constipated. Although there is no absolute rule on the number of bowel movements
a cat should have each day, most healthy adult cats have one or two. Veterinarians
suspect constipation when a cat has no (or very infrequent) bowel movements, when
it strains while attempting to defecate, and when it has a significantly decreased
amount of stool.
Constipation, in and of itself, is not a disease. It
is, however, a sign that all is not well within the catís gastrointestinal tract.
And if not attended to promptly, constipation can become a debilitating and serious
condition. If you suspect your cat has not had a bowel movement for several days,
itís time to consult your veterinarian.
Often owners donít realize anything is amiss until constipation
is considerably advanced with obvious signs of distress such as frequent
trips to the litter box, straining to defecate (tenesmus), and painful defecation
(dyschezia). Behaviors include crying and licking the genital-anal area. These
signs, too, can be misleading.
When a client calls our office and states that
my catís been in and out of the box three or four times in the last hour, the
client is always assuming itís constipation, whereas 90 percent of the time itís
a urinary obstruction, especially if itís a male cat. And a urinary obstruction,
unlike constipation, is an emergency.
As constipation progresses, the signs become more pronounced.
The cat may lose its appetite, become lethargic, look unkempt, begin to crouch
and hunch up because of abdominal discomfort, and possibly even vomit. Contrary
to what you would expect, the cat may even pass a small amount of runny, blood-tinged
Constipation, Obstipation, and Megacolon
We tend to use the term constipation generically to
describe not one but three distinct conditions: constipation, obstipation, and
megacolon. And although the three conditions have much in common, they also have
significant differences. So veterinarians treat them differently.
Constipation and obstipation are the most closely related
conditions and can be viewed as different points on a continuum. Constipation
is the stage when the cat has obvious difficulty passing a stool. Obstipation
is when the cat is very blocked (severely impacted) and unable to have any bowel
movement at all.
The causes of constipation and obstipation are many, including
diet (ingested hair, foreign bodies, bones); environment (a dirty litter box,
lack of exercise, hospitalization); painful defecation (anal abscesses from cat-fight
bites or feces- matted hair [long-haired cats are particularly susceptible]);
obstructions (tumors and improperly healed pelvic fractures that restrict movement
through the intestines); and medications (for other conditions). And watch your
catís weight. Obese cats can become constipated.
Chronic constipation and obstipation from specific causes
can result in a distended colon that has poor movement (megacolon). Sometimes,
though, megacolon occurs when the muscular movement of the colon wall, which
propels fecal material through the colon, diminishes for some unknown reason.
As a result, fecal matter comes remains in the colon where it becomes drier and
harder. Over time, the enlarged, impacted colon loses most of its muscular ability
(motility) and becomes a loose pouch filled with dry, concrete like material.
Unfortunately, veterinary science has yet to discover the causes of this condition
known as idiopathic megacolon.
Treatment for constipation is two pronged: first, relieve
the constipation from recurring either by removing the cause of the constipation
or by medically managing the cat. Relief for the constipated cat can occur naturally
through induced defecation with enemas and glycerin infused into the colon, or,
if the cat is severely impacted, through manual removal of the hardened feces
Any cat that has been constipated for several days may
also be very dehydrated. So before staring any procedure, your veterinarian may
give your cat subcutaneous or intravenous replacement fluids. Rehydration with
intravenous fluid may also be necessary to help renurish the colon with electrolytes
Removing the stool of a severely impacted cat takes
time and patience. Once a cat has been cleaned out, most veterinarians immediately
put the cat on a program of medical management.
Medical management for cats with chronic
constipation typically has both a dietary and medical component.
The dietary component usually
involves putting the cat on a higher fiber diet. Fiber absorbs water thereby creating
looser, bulkier stools. That shortens the transit time in the gastrointestinal
tract and keeps things moving. While you want to increase the amount of fiber
in your catís diet, you donít want to overdo it. Initially, donít be tempted to
switch to the highest-fiber diet you can find. And you should introduce the dietary
change gradually, over five to seven days. If you switch your cat too quickly
onto a high-fiber diet, your poor feline chum will likely become very uncomfortable
with gas pains.
Sources of supplementary fiber include bran, psyllium
(Metamucil), and canned pumpkin. Some cats will eat these products, others wonít.
If your cat will eat them, mix the fiber-rich supplement in with quality canned
cat food. However, before you implement any dietary changes, consult your veterinarian
to make sure the changes you propose meet your catís dietary and health needs.
Increased dietary fiber doesnít help every cat.
Another newer approach along with the above has met
with some success. This includes use of two prescription medications lactulose,
a medications that softens the stool, and propulcid, a motility modifier. Another
medication now used is ranitidine, again with some success.
Water consumption is also very important, for the constipation-prone
cat. Find out what your catís water preferences are and accommodate them. Know
that canned food has a higher water content than dried food and that milk can
have a laxative effect in some (but not all) cats.
If medical management is ineffective, there is another
Surgery for the treatment of megacolon is a highly successful
surgery that returns most cats to a normal life-style. This major surgery is a
subtotal colectomy. This involves the removal of most of the colon, then reconnects
the remaining ends, allowing the cat to defecate normally. The downside to the
surgery is the very small risk of leakage at the point where the ends are rejoined,
which can result in life-threatening infection within the abdominal cavity. (Should
this occur, your veterinarian can do corrective surgery and treat the infection.)
As with any major abdominal surgery, there is always the small risk of other complications.
But for most cats, the outcome is very successful.
Finally, how Concerned should Owners be about Constipation?
Owners whose cats have a single bout probably do not have to worry. For chronically
constipated cats, this condition will require constant attention.