You didn’t realize that you haven’t noticed any stool in Fluffy’s litter box until the veterinarian asked. By the way the vet was holding Fluffy’s belly you’re suddenly putting it all together. Fluffy has been yowling in the litter box for a few days now. You knew that he could urinate and he was passing those small, wet, slimy stools and you figured he had some diarrhea. Then he stopped eating, started vomiting and you got really worried and forgot all about what you had thought was diarrhea. Then in this room with this strange person squeezing your cat’s abdomen it all comes back to you.
There are plenty of reasons a cat could become constipated. It happens to dogs as well but cats really seem to know how to do it right. In fact, cats are much more commonly represented in the small population of pets that suffer from megacolon as a result of chronic blockage and subsequent loss of function of the colonic muscles.
Straining to defecate is the most commonly seen symptom with constipated cats. This seems straight forward enough but straining to defecate can be confused with straining to urinate. Feline Urinary Obstruction Straining to defecate is also the most commonly noted sign in pets with large intestinal diarrhea so even if we know they are trying to poop but aren’t getting anything out we can’t really be sure it’s constipation. A physical exam will give me some clues about whether or not your pet is constipated but to rule out obstipation or the serious megacolon we need an x ray. X rays of obstipated cats are pretty easy to read, you look at the x ray and instantly your mind says, “That cat can not poop that out.”
Here is a small fact about veterinary medicine; cats do not enjoy enemas. How constipated a cat is determines how extensive the enema needs to be. Some cats only need a little bit of help and a simple warm water or lubrication enema will do the trick. I say simple because I don’t have to do a lot of math or monitoring. I do not mean simple as in, you should try this at home if you think your cat is constipated. For more advanced cases a lot of enema fluid is going to be introduced and this typically requires a bit of sedation as it is going to be very uncomfortable. These cases generally haven’t been eating for a few days and will require some hydration as well. We like to keep these guys overnight if we can to be sure they are going to eat and are done vomiting once the obstruction is removed. The most difficult cases require not only an enema but a good deal of manual evacuation as well. These guys go under general anesthesia and a good amount of effort is put into cleaning them out. The cat who receives an enema requiring general anesthesia is definitely going to be groggy and definitely going to leak. It may want to have a sleep over. These poor patients tend to not want to eat right away and may take several days even a week to start having bowel movements again.
That last point leads into a bit of a tangent. The colon’s main job is to store feces. It can store weeks of fecal material at a time, this is why we may not seem terribly excited when your dog or cat hasn’t had a bowel movement for a day or two.
After we have removed the offending fecal material we will want to think about ways we can avoid this in the future. If this was the first time your cat has been constipated and it was fixed with a simple enema we might tell you to add a little more canned food or pick up a fountain to try to increase water intake.
Even if it was the first time, if your cat was really constipated we will probably recommend you change his diet around a bit. There are two ways we can go with this. We can try a diet that is high in fiber and will make more bulky stools that are easier to pass because they contain more water. This can be achieved with a commercially prepared diet or by adding fiber to the diet your cat normally eats. The other direction we can take this is to feed what is called a low residue diet, this means that the diet is highly digestible and may actually produce less stool which in turn means less work for the colon.
If your cat is a chronic offender we may add in certain medications to help the colon work a little harder or to lubricate the stool and make it pass easier or both. These cats are also going to be on special diets as well.
In extreme cases we might recommend that a small section of the colon be removed so that there is not room to store large amounts of feces. These are called subtotal colectomy surgeries. In these cases you can expect your cat to always have slightly loose stool. While cats tend to do very well after surgery and the loose stool is not typically an issue we do like to save surgery as a last resort.
Thank you for reading.