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Constipated Cats: A Common Conundrum

By Teresa Garden, DVM

My clients are often surprised to learn that constipation is a common problem in middle aged or older cats just as in people. How would you know if your cat is constipated? Symptoms are straining in the litter box, crying out in the box, or leaving hard pellets in the box or around your house. Constipation can lead to decreased appetite and even vomiting.

The cause of this uncomfortable condition can be behavioral or medical. And we must solve the mystery to solve the problem. Some of the causes of constipation are: dehydration (due to drugs, decreased intake, or kidney disease), metabolic disease (obesity, diabetes, or hyperthyroidism), painful defecation (arthritis, spinal disease, or diseases of rectum or anal glands), megacolon, tumors in the abdominal cavity, or stress in the home.

What are some of the stresses in the home that could lead to constipation? One problem is not having enough litter boxes. The rule is: # litter boxes = # of cats plus one. Make sure the boxes are clean or your cat may try to “hold it” to avoid using a dirty toilet. I’m sure we can all relate to that predicament. Make sure your cat is not being bullied away from the box by other cats. Make sure the litter box is large enough. Storage boxes work well for larger cats. Boxes need to be easily accessible for senior and geriatric cats.

They may have trouble navigating staircases so a litter box on each floor of the house is helpful. It’s important to have the right kind of litter too. Most studies have found cats prefer clumping, non-scented litter with an odor-neutralizer. They prefer their litter boxes to be in quiet, low traffic areas of the home. Feliway diffusers and Rescue Remedy Bach Flower can be helpful in lowering stress in multiple cat households.

Determining the cause of constipation in your cat is very important not only for proper treatment and management but to decrease progression of the problem. Chronic, recurrent constipation can result in megacolon. This is a pathological condition in which the colon loses its normal neuromuscular function and becomes flaccid and extremely distended. This is a life-threatening condition.

If you suspect your cat may be constipated please seek veterinary attention. Your vet can perform a physical exam and take radiographs to confirm constipation and check for megacolon. Blood tests may be ordered to check for underlying diseases that may be associated with constipation. Your vet can check for arthritis, spinal disease, and pain. Cats with recurrent episodes of constipation may need abdominal ultrasound or endoscopy to check for obstructive or infiltrative diseases in the abdomen.

How do we treat constipation in the cat? Rehydration is the first goal. Your vet will give either IV or subcutaneous fluids to your cat. Constipated cats are in a state of dehydration-the level ranges from mild to severe depending on the underlying cause and the duration of the illness. The second goal of treatment is to help facilitate removal of feces. Mild cases of constipation can be relieved with an enema given by your veterinarian. Enemas may be tolerated awake or light sedation may be needed. Manual extraction of feces is required in more extreme cases. This will be performed with sedation or under general anesthesia depending on the particulars of the case.

What can you do at home to help your constipated friend after your vet has treated him? Diet is first and foremost. Canned food is much preferred over dry. This is the easiest way to get more water into the cat to help the colon work better and to prevent future dehydration. Feed small frequent meals to maintain normal hydration in older cats.

Encourage water intake by your feline friend. Multiple water bowls, a dripping tap, or a cat fountain may entice your cat to drink more. You can also add fiber to your cat’s diet. Fiber increases the weight and the water content of feces to help increase the transit of feces in the colon. Fiber also optimizes intestinal bacterial populations. Good sources of fiber include canned pumpkin, beet pulp, flaxseed, or psyllium. At Animal Health & Healing we often use Medibulk by Thorne. It contains oat fiber powder, prune powder, and apple pectin. A very small amount is mixed with canned food to increase the fiber content. A stool softener such as Laxatone may be given daily. A laxative such as Lactulose may be prescribed by your vet if your cat is severely constipated. Pro-motility drugs may be prescribed for magacolon if other therapies have failed.

Early correction and management of constipation will help prevent irreversible problems from developing (megacolon). Each patient must be treated as an individual and a protocol must be developed based on each cat’s environment and underlying physical or behavioral needs. You and your vet will need to work as partners to help your cat have a better quality of life. No one, including your furry feline, likes to be constipated.

Dr. Teresa Garden is chief veterinarian/owner of Animal Health & Healing, a full-service holistic and conventional veterinary practice in the Maplewood/Richmond Heights area. Phone: 314-781-1738. www.AnimalHealthandHealing.com.