Franny is a 10-year-old Siamese cat. She has spent all of her life under the watchful eye of Marsha in a home in Goleta. Marsha is an elderly woman and was planning on moving to an assisted-care facility with Franny, however Franny has developed a constipation problem over the last few months, a solution for which has eluded Marsha and delayed her move.
Fanny started demonstrating her problem with frequent visits to her litter box each time producing small amounts of fecal material in very dry segments. Marsha recognized this as out of the ordinary but it seemed to improve for awhile. That improvement, however, was short-lived as Fanny’s straining to defecate became much more prevalent and her production became almost non-existent. It got to the point where Fanny was not eating well, prompting Marsh to bring Fanny in to see her veterinarian. Fanny was diagnosed with constipation and placed on a stool softener and a wet food diet.
Initially after starting her new diet and stool softener, Franny seemed to do better. Her stool was still very dry appearing, however the volume produced at each visit to the litter box increased. Her appetite did not improve. Back to her veterinarian she went. This time, Franny received some fluid therapy via injection under her skin (subcutaneous fluids) and an enema. She appeared more energetic for the next week or so but her appetite remained sub-par.
The first point I want to make here is that constipation is not a diagnosis, it is a symptom. It can occur for a myriad of reasons ranging from inappropriate diet to cancer. We must find out the underlying cause in order to have a reasonable hope for resolution.
There are two diagnostic steps that will go a long way toward helping us figure out what is causing Franny’s constipation: blood work and abdominal radiographs.
One common cause for constipation in older cats is kidney disease. If the kidney function decreases, affected cats can not concentrate their urine and therefore waste fluid. Over time, this can lead to dehydration, which can lead to constipation as the colon reabsorbs fluid from the stool.
Kidney disease also can decrease a cat’s appetite. Blood work and urinalysis will most often diagnose kidney disease. Treatment for kidney disease is based on severity and usually involves intravenous fluid therapy. With fluid therapy, dehydration can be corrected which then can help relieve the secondary symptom of constipation.
Another cause of constipation involves decreased muscle function in the colon. This can result in a colon that becomes dilated and unable to move stool properly. In a normal cat, waste is passed from the small intestine to the colon (large intestine) where fluid is reabsorbed and the stool becomes more solid. It is then passed out of the body during defecation.
In a cat with a mechanically malfunctioning colon, the waste material from the small intestine packs up in the dilated colon where fluid is continually reabsorbed. This makes the situation worse as the cat is unable to pass the stool and becomes more and more constipated. As one might suspect, this condition can definitely reduce the appetite.
Abdominal radiographs can demonstrate this process. In fact in many of these cases, abdominal palpation during a physical exam can yield a tentative diagnosis. Treatment for this problem, commonly referred to as megacolon, can involve drug therapy to try to increase colon motility as well as special higher fiber diets and stool softeners. In severe cases that do not respond to medical management, surgery can be performed to eliminate a large section of the non-functional colon.
There are certainly more possible diagnoses for Franny’s constipation than the two I have shared here. The key at this point is that Franny needs a much more in depth work-up to definitively diagnose her underlying disease at which point appropriate therapy can be initiated.