DIAGNOSIS & MANAGEMENT OF CONSTIPATION IN CATS SUSAN LITTLE, DVM, DABVP (FELINE) @catvetsusan, catvet@vin.com
In the VETgirl Real-Life Rounds webinar, “Management of Constipation in Cats,” Dr. Susan Little, DABVP reviewed the diagnostic workup and approach for treatment of constipation in cats. Learn tips from the feline pro!
KEY HIGHLIGHTS
Constipation is the infrequent and difficult evacuation of feces with retention of feces within the colon and rectum. Obstipation is intractable constipation. Some of the more common underlying causes of constipation include certain drugs, stressors, litter box aversion, difficulty in defecating (pain, neurologic problems), excessive fecal bulk, dehydration (e.g., associated with chronic kidney disease), intra- or extra- luminal colon masses, narrowed pelvic canal, and idiopathic megacolon. 1 CLINICAL SIGNS AND DIAGNOSIS The clinical signs of constipation are typically obvious to the owner, such as tenesmus, and scant hard dry feces, sometimes with blood. However, cats will also strain in the litter box due to lower urinary tract obstruction and owners may misinterpret this as due to constipation. Other clinical signs are non-specific, such as vomiting, inappetence, and lethargy. Physical examination confirms the presence of large amounts of feces in the colon sometimes accompanied by abdominal pain. The colon often palpates as a long firm tube or feces may be palpated as discrete concretions. A careful evaluation (e.g., musculoskeletal system, caudal spinal cord function, anorectal area) should be made for underlying causes. A rectal exam under sedation may
diagnostics such as a barium enema or colonoscopy may be warranted. 2 ACUTE MANAGEMENT The first step in acute management is correction of dehydration with fluid therapy followed by removal of obstructing feces. Obstipated cats will require warm water or isotonic saline enemas (5-10 mL/kg) administered slowly with a lubricated 10-12 French feeding tube. (continued)
be necessary in some patients to evaluate for masses, pelvic fracture malunion, or anal gland abnormalities. A minimum database (complete blood count, serum chemistries/electrolytes, urinalysis) should be assessed, especially to determine hydration and electrolyte status and identify underlying diseases. Survey abdominal radiographs are useful to confirm the diagnosis and assess severity as well as to evaluate for potential underlying causes, such as previous pelvic trauma and arthritis. In some cases, further
4
vetgirlontherun.com
Made with FlippingBook - Online Brochure Maker