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Feline Megacolon
Cat Megacolon is a bowel disorder.The colon of the cat is chronically dilated or enlarged because the nerves in the colon do not function properly. The causes of feline megacolon can be acquired through trauma for instance, congenital, or idiopathic(unknown). Clinical signs of feline megacolon in the cat can be simply chronic constipation. Other signs could be distended abdomen, not eating, weight loss, vomiting, nausea, straining to defecate(tenesmus), painful defecation (dyschezia), and rectal prolapse from constant straining. Megacolon usually shows up in middle aged and older cats but can appear in cats as young as three and four years old

. An excellent write up can be found at All Animal Veterinary Hospital."If the nerves to the colon do not function properly, the muscles of the colonic wall will not contract properly. If this happens, the muscles stretch and the colon enlarges in diameter. In addition, the fecal material is not moved out of the body and severe constipation may result. This massive enlargement of the colon and the resulting constipation is called megacolon. The colon may have a diameter 3-4 times that of a normal cat. "Another site that describes treatment is here "More vets are now recommending a highly digestible, low residue diet for megacolon cats. A low residue diet can be beneficial because most of it is used by the cat's body, and as a result, less waste is produced. Less waste equals less stool, and less stool equals less frequent blockage problems.
A holistic approach can be found at at this site..the wellvet. They recommend:
Apricot Seed and Linum - Chinese herbs, very helpful
Colon Formula - Western herbal combination, very helpful
Herbal Bulk - Always a good place to begin
Similase - Digestive enzyme support

Another brief article for treatment can be found here which suggests Insoluble fiber fiber under certain conditions and Adding Lactulose (a soluble fiber)."Cisapride is sometimes used in the early stages of constipated patients when the smooth muscle can still contract. Now that cisapride is less attainable and we know it can have serious side effects, ranitidine can be used. Ranitidine is an H2 blocker but also stimulates colonic smooth muscle contraction. Neither of these products is useful when the colon has lost its ability to contract as seen late in the disease. If patients still have constipation problems because of an atonic colon, surgery should be pursued "



Constipation and Megacolon
excellent article..also discusses medications..."SUBTOTAL COLECTOMY A permanent resolution of this problem can be achieved by surgically removing the diseased colon. This generally eliminates the need for any stools softeners, pills, enemas etc. and the patient can resume a “low maintenance” lifestyle. The constipation is replaced by a looser consistency stool and, though sometimes this firms up into a more normal consistency stool after a couple of months, it is important for an owner expect this change to be permanent. Patients appear much more comfortable with this new arrangement and most owners are so satisfied with results as to wish they had pursued surgical treatment sooner"
Feline Constipation, Obstipation, and Megacolon: Prevention, Diagnosis, and Treatment
Robert Washabau United States

What is megacolon in a cat and how is it treated?
"Feline megacolon is a syndrome rather than a specific disease. Consequently, identifying the underlying cause of the megacolon, if feasible, and treating that cause, if possible, is important. Treatment of megacolon per se may include conservative medical therapy or surgery. Sometimes medical treatment alone is sufficient; however, in many cases medical treatment fails and surgery will be required to save the cat’s life. In some cases surgery is the treatment of choice,,,,Surgery involves removing most of the colon (lower bowel). This procedure is called subtotal colectomy. Most otherwise healthy cats tolerate the surgery well."
What is megacolon?
"If the nerves to the colon do not function properly, the muscles of the colonic wall will not contract properly. If this happens, the muscles stretch and the colon enlarges in diameter. In addition, the fecal material is not moved out of the body and severe constipation may result. This massive enlargement of the colon and the resulting constipation is called megacolon. The colon may have a diameter 3-4 times that of a normal cat. " "
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Megacolon in cats article mentions aids for cats such as Supplemental fluid Rebound " Oral Electrolyte replaces electrolytes , vitamins and minerals which plain water does not contain. Chicken flavored to entice your cat to drink more. Great for long term usage for kidney failure also". Laxatives such as Laxatives. "(Adjust the dosage of laxatives so your cat has a bowel movement at least once every other day. If diarrhea occurs, reduce the dosage or the frequency of administration.) Defurr-Um tasty treats contain all the essential ingredients to prevent and avert fur ball when given on a daily basis. Defurr-UM Treats contain Malt Syrup and have a Natural Chicken Flavor."

They also mention tips for prevention Prevention
" Owners can follow these preventive measures:
1. Keep litter boxes clean to encourage frequent elimination
2. Comb the cat (especially longhaired cats) to remove excessive hair
3. Use laxatives (“hairball medication” ) on a regular basis.
4. DO NOT use any enema products. Always leave this to veterinarians, as some products are toxic to cats
"

  • Vet Clin North Am Small Anim Pract 2002 Jul;32(4):901-15 :ks Megacolon in the cat.
    Bertoy RW.
    Veterinary Surgical Service, El Dorado Hills, CA 95762, USA.
    bertoydvm@aol.com

    Megacolon is a condition that is not uncommon in the cat. Most cases are idiopathic (a cause cannot be determined), and these seem to be a result of colonic inertia. Pelvic fracture malunions are the next most common cause and result in a pelvic outlet obstruction. Total or subtotal colectomy offers good long-term results in cases of idiopathic megacolon and chronic cases of pelvic fracture malunion, and the technique is described in detail
    Clin Tech Small Anim Pract 2002 Nov;17(4):178-83 : Gastrointestinal obstruction.
    MacPhail C.
    Department of Clinical Sciences, 300 W. Drake, Colorado State University, Fort Collins, CO 80523-1620, USA.


    For cats that present with signs of gastrointestinal disease, obstruction is a primary differential. There are numerous reasons of gastrointestinal obstruction in small animals, yet there are several specific causes that are more commonly associated with the cat. These include linear foreign bodies, trichobezoars, focal intestinal neoplasia, feline infectious peritonitis, and megacolon. Clinical signs related to gastrointestinal obstruction consist of vomiting, diarrhea, constipation, tenesmus, anorexia, or weight loss. The course and onset of disease depends on the rate at which the obstruction develops and whether the obstruction is partial and complete. The diagnosis of obstruction is typically suspected based on clinical presentation and palpation of an abdominal mass. Diagnostics tools are used for definite diagnosis and determination of location within the gastrointestinal tract. Surgical treatment is dependent on the etiology of the obstruction and various techniques are employed to remove the obstruction and prevent recurrence.
    J Feline Med Surg 2002 Sep;4(3):129-38 : Surgical management of constipation.
    White RN.
    Davies White Veterinary Specialists, Higham Gobion, Hitchin, Hertfordshire.

    There are many recognised causes of constipation in the cat and the management of the condition depends on the clinician's ability to recognise the appropriate aetiology in each case. Most surgery therapies for constipation in the cat are related to the management of idiopathic megacolon, although causes such as pelvic outlet obstruction, complications of neutering surgery, perineal herniation, and malunion pelvic fractures may also require surgical intervention. Currently, the surgical management of megacolon consists of subtotal colectomy with the recommendation that the ileocolic junction be preserved. The procedure, in general, is associated with few life-threatening complications although the majority of individuals will experience a transient period of loose stool formation in the immediate post-operative period. In the majority of cases, the long-term outcome following subtotal colectomy is considered excellent. Copyright 2002 ESFM and AAFP
    Vet Clin North Am Small Anim Pract 2002 Jul;32(4):949-62, vii-viii : Lumbosacral and pelvic injuries.
    Lanz OI.
    Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Duckpond Drive, Blacksburg, VA 24061, USA.
    olanz@vt.edu

    Pelvic fractures are commonly observed in cats after automobile-induced trauma and frequently affect other organ systems. An organized systematic approach should be followed in the evaluation of pelvic fractures. Common pelvic fracture patterns observed in cats include pubic fractures in combination with unilateral ilial fractures, unilateral sacroiliac luxations, bilateral sacroiliac luxations, and contralateral ilial body fractures. Narrowing of the pelvic canal may preclude normal passage of feces and result in megacolon. Timely and precise surgical intervention is necessary so as to impart a favorable prognosis
    Vet Clin North Am Small Anim Pract 1999 Mar;29(2):589-603 : Pathogenesis, diagnosis, and therapy of feline idiopathic megacolon.
    Washabau RJ, Holt D.
    Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, USA.
    washabau@vet.upenn.edu

    Many cats have one or two episodes of constipation without further recurrence, although others progress to complete colonic failure. Middle-aged male cats are particularly at risk for the clinical continuum of constipation, obstipation, and dilated megacolon. Pelvic canal stenosis and nerve injury are minor causes in the development of this syndrome. In most affected cats, the underlying pathogenesis appears to involve colonic smooth muscle dysfunction. In this group of cats, it is not yet clear whether this disorder represents a primary or secondary (resulting from long-standing constipation and colonic distension) abnormality. Many cats with mild to moderate constipation respond to conservative medical management (e.g., dietary fiber supplementation, emollient or hyperosmotic laxatives, colonic prokinetic agents). Indeed, early use of colonic prokinetic agents is likely to prevent the progression of constipation of obstipation and dilated megacolon in many cats. Some cats may become refractory to these therapies, however, as they progress through moderate or recurrent constipation to obstipation and dilated megacolon. These cats eventually require colectomy. Cats have a generally favorable prognosis for recovery following colectomy, although mild to moderate diarrhea may persist for 4 to 6 weeks postoperatively in some cases.
    Surgical management of constipation R. N. White
    J Feline Medicine and Surgery 4, 3, September 2002 129-138

    There are many recognised causes of constipation in the cat and the management of the condition depends on the clinician's ability to recognise the appropriate aetiology in each case. Most surgery therapies for constipation in the cat are related to the management of idiopathic megacolon, although causes such as pelvic outlet obstruction, complications of neutering surgery, perineal herniation, and malunion pelvic fractures may also require surgical intervention. Currently, the surgical management of megacolon consists of subtotal colectomy with the recommendation that the ileocolic junction be preserved. The procedure, in general, is associated with few life-threatening complications although the majority of individuals will experience a transient period of loose stool formation in the immediate post-operative period. In the majority of cases, the long-term outcome following subtotal colectomy is considered excellent.



    A writeup on cisapride propulsid from wedgewood pharmacy
    "Cisapride has been widely used in the treatment of gastric emptying disorders, intestinal transit and other motility disorders in both dogs and cats. It accelerates the emptying of the stomach and propulsion of food through the intestines by increasing peristalsis. It is used in cats in the management of chronic constipation and megacolon. Work in humans has shown that cisapride is better absorbed when given with food. In small animal practice it is usually recommended that cisapride be given orally 15 minutes before feeding. "It is no longer used for people
    Vetinfo
    ""It is still possible to get cisapride (Propulsid Rx) from compounding pharmacies and many vets feel that it is helpful for megacolon problems. An alternative medication is ranitidine (Xantac Rx), which seems to have similar effects in some cats. The usual dosage of cisapride is 1.25 to 2.5mg given 15 to 30 minutes prior to eating and the dosage of ranitidine is 1 to 2mg/kg every 12 hours. "
    J Vet Intern Med 1997 Nov-Dec;11(6):313-8 : Cisapride stimulates contraction of idiopathic megacolonic smooth muscle in cats.
    Hasler AH, Washabau RJ.
    Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia 19104-6010, USA.

    We have previously shown that cisapride, a substituted piperidinyl benzamide, stimulates contraction of healthy feline colonic smooth muscle. The purpose of the present investigation was to determine the effect of cisapride on feline idiopathic megacolonic smooth muscle function. Longitudinal smooth muscle strips from ascending and descending colon were obtained from cats with idiopathic megacolon, suspended in a 1.5 mM Ca(2+)-HEPES buffer solution (37 degrees C, 100% O2, pH 7.4), attached to isometric force transducers, and stretched to optimal muscle length (Lo). Control responses were obtained at each muscle site with acetylcholine (10(-8) to 10(-4) M), substance P (10(-11) to 10(-7) M), or potassium chloride (10 to 80 mM). Muscles were then stimulated with cumulative (10(-9) to 10(-6) M) doses of cisapride in the absence or presence of tetrodotoxin (10(-6) M) and atropine (10(-6) M), or in a 0 calcium HEPES buffer solution. In cats with idiopathic megacolon, cisapride stimulated contractions of longitudinal smooth muscle from both the ascending and the descending colon. Cisapride-induced contractions were similar in magnitude to those induced by substance P and acetylcholine in the ascending colon, but were less than those observed in the descending colon. Cisapride-induced contractions in megacolonic smooth muscle were only partially inhibited by tetrodotoxin and atropine, but were virtually abolished by removal of extracellular calcium. We concluded that cisapride-induced contractions of feline megacolonic smooth muscle are largely smooth muscle mediated and dependent on influx of extracellular calcium. Cisapride-induced contractions in megacolonic smooth muscle are only partially dependent on enteric cholinergic nerves. Thus, cisapride may be useful in the treatment of cats with idiopathic megacolon.