You may not be able to relate to this, but some cat owners get very excited when they observe that their kitty has passed a normal bowel movement. There are numerous elimination issues in cats, and knowing the difference between urination and defecation problems is important. Each process has a slightly different posture and outcome, and if you are unsure of what you are observing, you should consult with your veterinarian.
Mookie became my patient about 2 1/2 years ago when I saw her as a second opinion for constipation and lameness. She was 13 years old and had been treated previously at two other veterinary hospitals for these issues. Mookie’s owner reported that the kitty would loudly vocalize when she was having problems with passing stool. I knew right away on exam that she was full of firm stool. I did not initially observe Mookie’s lameness, but as my exam continued she showed discomfort with her left ankle. A review of X-rays taken elsewhere showed a fracture of her left ankle that had improved with splinting of her leg.
She was given some pain reliever and I was able to remove the impacted stool. Once cats develop constipation the condition can progress to a disease called megacolon. Cats with megacolon have damaged muscles in their colons that no longer contract properly to expel stool. I wasn’t sure whether Mookie had megacolon yet.
There are several theories about how to treat chronic constipation, but from experience, I avoid using diets that are high in fiber and produce dry stools. Mookie was currently eating one of these diets, Prescription Diet w/d. I instead recommended an exclusively canned diet that was high in protein and easily digestible. I sent her home with some anti-inflammatory medication to be sure her sensitive ankle was not affecting her ability to posture to defecate, and recommended using overthe-counter human Miralax as a stool softener. We also tried her on a drug called cisapride, which helps stimulate some cats to defecate.
I was disappointed when Mookie’s owner called back a couple of days later to report that Mookie still was not defecating normally on her own. She came in for a recheck and required an enema to clean out her colon. It appeared that Mookie unfortunately had megacolon and would need other treatment. We changed her medication to a compounded drug called tegaserod and increased her stool softener. We continued to encourage her to eat canned food, but her preference was dry.
We didn’t see Mookie for about 10 months. During this time, her owner discontinued her tegaserod. Her constipation recurred about a month later and she ended up in an emergency clinic getting enemas. Mookie was hard to medicate and was eating some dry food, so it was hard for her owner to comply with our recommendations. It took a couple of weeks and an increase of her tegaserod to get her defecation under control. We sent home some individual “pet enemas” – syringes prefilled with dioctyl sodium sulfosuccinate, which stimulates defecation – and told the owner she was to use these if Mookie needed help. We spoke to her owner about keeping Mookie happy and active at home and trying to reduce anything that might be causing stress. Stress can worsen constipation, and Mookie didn’t like the dog in the home.
Mookie did well again for many months until the tegaserod became unavailable, and we had to find another way to manage her megacolon. I had been using some dry veterinary food called Royal Canin Fiber Responsive Diet with some other constipated/ megacolon patients and seeing some amazing responses. We switched Mookie to this and continued her Miralax. So far, she is doing very well on this treatment plan. I’m keeping my fingers crossed that this will help her long-term.
Constipation is seen frequently in cats, and it can be caused by a variety of problems including obesity, pain, stress, arthritis, back problems, kidney disease, dehydration, diet and litter box issues. Many cats can be well managed with diet, but others need stool softeners, other medications and behavior modification. Non-responsive megacolon cats can require a big surgery called a subtotal colectomy that removes most of the colon to help them pass stool.
If constipation is not an isolated event with your cat, be sure to consult with your veterinarian to keep it from becoming a chronic and painful problem.
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