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 cat’s 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, it’s time to consult your veterinarian.

The Symptoms

Often owners don’t 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 cat’s been in and out of the box three or four times in the last hour, the client is always assuming it’s constipation, whereas 90 percent of the time it’s a urinary obstruction, especially if it’s 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 diarrhea.

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

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 cat’s 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.

The Treatment

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 under anesthesia.

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 and fluids.

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

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 cat’s diet, you don’t want to overdo it. Initially, don’t 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 won’t. 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 cat’s dietary and health needs. Increased dietary fiber doesn’t 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 cat’s 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 approach – surgery.

Surgery

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.