Introduction | Causes & Prevention | Symptoms & Signs | Diagnosis & Test | Treatment Options

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Introduction

Constipation is the infrequent, incomplete or difficult passage of feces from the colon. The colon – also called the large bowel or large intestine - is the lower part of the gastrointestinal tract that spans from the cecum to the rectum and anal canal. The cecum is the beginning of the large intestine.

How Constipation Affects Cats

Constipation, which is fairly common in domestic cats, does not necessarily indicate loss of bowel function. Most cats defecate once or twice a day. When a cat only passes stool every two or three days, the waste matter remains in the colon and becomes hard and dry, because the lower large intestine is the primary site of concentration and storage of digestive waste products. Affected animals will strain to defecate, with little if any fecal output. (Note that cats with colitis, urethral obstruction or feline lower urinary tract disease can also show signs of straining; these conditions must be differentiated from constipation before treatment begins.)

Constipated cats may vocalize due to pain, "scoot" their hind end across the floor and lick or bite at their anal area. Any stool that is successfully passed typically is small in volume, very dry and rock-hard. Sometimes, a small amount of greasy and/or bloody diarrhea will be passed around the dry fecal balls. Prolonged constipation can cause weakness, depression, lethargy, loss of appetite (inappetence; anorexia), weight loss and vomiting. Affected cats may become bloated and uncomfortable, be reluctant to play and even reject favorite treats. The constant straining can cause the entire anal area to become irritated and inflamed. While mild constipation can resolve itself, severe cases require immediate veterinary attention. If left unattended, the lower bowels can become completely impacted with fecal matter, making defecation impossible. This dangerous and potentially life-threatening condition is called obstipation. Obstipation is a true medical emergency.

Causes & Prevention

Causes of Constipation in Cats

The causes of feline constipation are many and varied. They include behavioral and environmental conditions, such as sudden changes in household routines, people or activities, lack of exercise or dirty litter boxes. Dietary indiscretion is a major cause of constipation in dogs, but less so in cats. Some cats do become constipated by ingesting indigestible things like paper, bones, cloth, fabric, pieces of rugs, plastic, pebbles or grass. Cats are especially prone to becoming constipated from dehydration and from ingesting fur associated with self-grooming.
Constipation can also be caused by hormonal abnormalities, pain in the pelvic area from trauma, arthritis or otherwise, spinal disk disease, and injuries or masses that impact the lower gastrointestinal tract such as polyps, anatomical deformities or cancer. Anal gland infections, rectal foreign bodies and bite wounds around the "rear end" can interfere with normal defecation and contribute to constipation. Certain drugs can impair the contractility of the muscles lining the small and large intestines, and certain foods can increase the chance of constipation as well. Cats that are obese, dehydrated, elderly, inactive or particularly stressed may defecate less frequently than normal, predisposing them to constipation and colonic impaction. Cats suffering from chronic renal failure are also predisposed to becoming constipated.
A chronic medical condition called megacolon can also contribute to constipation. Cats with this disorder have an abnormally large colon that does not contract and move stool down its path as it is supposed to. These cats require lifelong medication with stool softeners, motility modulators and special dietary management, always under the supervision of a veterinarian. Cats that are genetically or congenitally tailless, such as the Manx, are prone to constipation from the developmental and neurological abnormalities associated with their condition.

Prevention of Constipation in Cats

No one feels good when they are constipated, dogs and cats included. Cats are especially prone to constipation because of their constant grooming, which causes hairballs to accumulate in their digestive tract and "clog up the pipes," so to speak. The best way to prevent constipation is to brush cats regularly and use an oral hairball preventative. This is especially important in long-haired breeds. Some cats also become constipated when the fur around their anus becomes matted, forming a physical barrier to defecation. Keeping this fur trimmed and the surrounding area clean can help prevent this cause of constipation.
All cats should have free access to fresh water at all times, unless otherwise recommended by a veterinarian. Good hydration can greatly reduce the risk of constipation. A healthy diet and moderate activity also promote regularity in cats, as in people. In cases of chronic constipation, a veterinarian can teach the owner how to palpate the cat's abdomen to assess whether and to what extent it is has retained fecal matter. This will give the owner a head start on treating the problem, before it becomes serious.

Special Notes

Chronic constipation causes significant discomfort and can permanently damage the sensitive lining of the colon and rectum. Owners of constipated cats should consult with their veterinarian to determine the best diagnostic and treatment protocols.

Symptoms & Signs

Cats, like people, can periodically suffer from constipation. The condition is often caused by diet or medications, but sometimes constipation can be a result of an underlying condition that your cat may be suffering from. The symptoms of constipation in cats is much like the symptoms that people experience when they are constipated, and your cat will be thankful for a quick and effective treatment.

Symptoms of Constipation

If your cat is constipated, one of the most common symptoms you will notice is frequent attempts at defecation with little to no results. You may see your cat repeatedly straining to go to the bathroom, and you may notice that nothing is resulting from the constant strain or that your cat is only able to produce small amounts of hard dry fecal material. The constant straining often causes the anal area to become red and swollen as well. Sometimes after repeated straining, a small amount of liquid may be discharged.
Severely constipated cats may not want to eat, they may vomit sporadically, and they will probably display lethargy and depression. You may notice that your cat is bloated and uncomfortable, that your cat does not want to play, and that your cat is turning away from favorite treats. While mild constipation usually resolves itself, severe constipation needs to be treated immediately.
Your veterinarian will be able to check your cat for constipation and talk with you about the possible causes. Medication or dietary treatments may be prescribed. Constipation can be dangerous, so it is important for your cat to receive treatment as quickly as possible.

Treatment Options

Cats with mild constipation can usually be treated symptomatically through dietary modification and increased fluid intake. Moderate to severe cases of constipation may require prescription medications and/or enema treatments, in addition to dietary and fluid therapies. Sometimes, surgery may be appropriate. The goals of treating constipation are to evacuate the colon, reestablish normal hydration, correct any identifiable cause of the constipation and, hopefully, prevent its recurrence.

Treatment Options for Constipated Cats

Owners of constipated cats should consult with their veterinarian to identify and treat the underlying cause of the cat's condition. The veterinarian will perform a thorough physical examination, take a good history and probably will take blood, urine and stool samples for analysis. Sometimes, radiographs (X-rays) of the abdomen and pelvic region, and perhaps an ultrasound, will be recommended. Medication or dietary changes also may be suggested, to see how the cat responds to treatment. Constipation can be dangerous, so it is important for affected cats to receive treatment as quickly as possible.
The severity of a cat's constipation is determined based upon its history (appetite, behavior, diet, last known stool movement), physical examination results, symptoms and abdominal and pelvic radiographs (X-rays). The treatment for constipation depends upon the underlying cause of the condition. If an animal is only occasionally or mildly constipated, dietary supplementation with high fiber, bulk-forming ingredients such as bran or canned unsweetened pumpkin, along with laxatives and/or an enema, may be all that is suggested by the attending veterinarian. Good supportive care - with appropriate intravenous or subcutaneous fluid therapy, electrolyte supplementation, pain management, anti-inflammatory medication and possibly antibiotics – can be quite important for constipated cats, again depending upon the underlying cause of their condition.
Owners can increase their cats' water intake by feeding canned/soft food instead of dry kibble. Other ways to increase hydration are to add meat broth or water to dry food. Supplements such as flax seed, wheat or rice bran and unsweetened canned pumpkin may be added to a cat's regular diet to increase fiber intake and soften the stool.
Moderate cases of constipation may require prescription medication, in addition to fluid management and dietary changes. Stool softeners, laxatives, suppositories and prescription medications that promote intestinal motility and stool movement are available from a veterinarian. Some of these treatments should not be used in cats with intestinal obstructions. Activity should be encouraged in most constipated cats.
When constipation is caused by colonic impaction, the situation can rapidly become a life-threatening medical emergency. Abdominal surgery may be necessary to save the cat's life. In these cases, the veterinarian typically will hospitalize the cat for a few days post-operatively, so that it can be monitored and managed after the obstruction has been surgically removed.

Prognosis

Cats suffering from constipation have a variable prognosis, depending upon the cause of their condition. In most cases, medical attention and follow-up management can address the problem and relieve the cat of its discomfort, with a fair to excellent prognosis. Of course, if constipation is due to cancer or an anatomical abnormality, the prognosis becomes more guarded.

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