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Medical Conditions, Disorders and Illnesses
 

SHABARI  - CONDITION  MEGACOLON
Shabari is a cat who has been suffering from Chronic Constipation, which led to Obstipation and finally MEGACOLON.   Shabari has been suffering from Megacolon since October 2008.

Till July 2010 she has undergone 7 surgeries.  She needs a surgery every 3 months.  She is on medications since the past 6 years with the type and nature of medications changing with time.  She is on a liquid diet since the past 2 years and also is given regular supportive fluid therapy subQ by me almost daily.  Shabari is 17 years old as of the  year 2010.

We are very thankful to God and our vets through whom  we had the guidance and surgery to be done by a competent vet that we got almost 2 more years with her.

If it is was not for her surgery in November 2008, which was more of an emergency as her intestine had partially torn in 2 places , Shabari would have not been with us .Shabari did not undergo Mesenteric Anastomosis earlier as sadly we were not informed of this option earlier.  Shabari, now has her complete  colon(large intestine) lost its muscle tone and elasticity and the intestine also seems to have developed much wear and tear. Yet, it’s a blessing God pulled her through all these surgeries and it is her will to live that she is with us.  Shabari probably may not be able to undertake any more surgeries now, but we cherish every single moment we have been blessed with her !!

 

 WHAT IS MEGACOLON ?

Megacolon is a condition more commonly seen in cats than dogs

Megacolon occurs when an animal is unable to defecate and the fecal contents remain obstructed within the large intestine (colon) and have to be removed surgically . There is progressive retention of fecal matter and loss of ability of the colon(Large Intestine) to propel the feces to the exterior. This results in a complete fecal impaction of the Large Intestine . This normally occurs as a result of loss of elasticity and smooth muscle tone of the Colon.

There are 2 procedures which can be performed

  1.  Incision on the wall of the colon and surgical removal of faecal matter and stitching up of the colon and subsequently the abdomen
  1.  Another surgical process is called Mesenteric Anastomosis

Megacolon could be a result of a deformity occurring in the anatomy of the colon – large intestine as a result of a severe pelvic fracture which could have changed the anatomy of the large intestine or could be a genetic malfunction or could also be of idiopathic origin.

However, most commonly it is a result of Constipation which follows the particular pattern

Constipation
Chronic Constipation
Obstipation
Megacolon

Constipation is a condition where the animal is unable to pass faeces, however this may happen occasionally and can be cured by consulting your vet and giving your animal the necessary medication like laxatives and faeces softeners.

Lactulose(softener), Cremaffin(Milk of Magnesia-Laxative)  Liquid Paraffin(laxative) and Psyllium Husk(laxative) are used – dosage and duration depending on the severity of Constipation.  Most animals would recover from Constipation after treatment with laxatives, stool softeners and dietary management for over a period time.  In some cases, however, the condition might become chronic. Enemas become the choice when all other medications fail or their action is reduced.

Chronic Constipation is also accompanied by vomiting in an animal.

Vomiting is as a result of excessive straining on the part of animal to defecate resulting in putting a strain on the pyloric valve separating the oesophagus from the stomach and causing a vomitus of food that may have been consumed by the animal shortly or even a while back.

Post Vomiting – the animal may or may not be able to pass stools and might still be in discomfort.

Sometimes with severe constipation, enemas are used, although this should be done under medical advice and supervision only.  Your vet would be best able to determine the kind of enema that needs to be given to your animal, either  an Isotonic  solution or a Phosphate based enema solution commercially available in the market.

The usage, frequency of administering an enema, should best and ideally be under a veterinary consult as excessive administration of enema to an animal could result in the animal going into shock and further requiring Emergency help.

Obstipation  - Obstipation is a stage where the nature of constipation is too chronic and the stools get hardened and the animal has to use much pressure to defecate. This is rather painful and discomforting resulting in the animal often vomiting rather than passing any stools.

Here enemas can be used under medical supervision and this must also be accompanied by fluid therapy for your animal, as appetite is distinctly reduced due to obstruction of the colon.  The animal also starts accumulating gas which he would be unable to pass due to colon being impacted by feces.

Obstipation in most cases leads to Megacolon which is the last stage in this cycle.

Megacolon would cause the abnormal distention of the colon and loss of smooth muscle tone of the large intestine. This loss of smooth muscle tone, prevents the animal from propelling the feces any further and ultimately to the exterior . The stool is extremely hardened and on palpating the intestine of the animal , there is visible discomfort and pain accompanied with a disgruntling sound. The animal has a markedly reduced appetite, starts looking heavy at the region of the stomach.  There is too much gas retention and the animal normally remains seated most of the time and becomes rather inactive.

The general health of the animal begins to decline, there is a change in the electrolyte balance when a blood picture report is done by the vet. This would occur because due to much fecal retention, there is lot of toxin accumulation which alters the normal blood picture of the animal.

The kidney, liver are all likely to be affected.  Thus, when you know your animal does have chronic constipation, also vomits whilst straining to pass stool,   keeps straining for a long time with no success, or is in much physical discomfort,  is unable to sit in the normal squatting position to pass stool and lies down in a sleeping position and yet tries to pass stool, please take this as an emergency and consult your vet without  any delay.

For Megacolon, there is no option other than “surgical removal of the feces under general anaesthesia”.

Failure to do this timely could result in the hardened feces rupturing the intestinal wall and release of fecal contents into the circulatory system of the animal. This will result in Death as a result of Toxaemia.

The Surgical procedure for Megacolon called Anastomosis is the surgical removal of the distended part of the colon and removal of all the fecal content inside. This is a major surgery done under General Anaesthesia – the type of Anesthesia used depending on the Age of the Animal and overall Blood picture.

It is preferable if a few days before scheduling surgery, an owner would perform a Complete Blood Count, Liver Function and Kidney Function tests to assess the overall health of the animal and thus be prepared for surgery.

As this surgery is a very major surgery, involves much delicate and intricate work, should be done under a competent vet  and the owners must be prepared to undertake very good post operative care to avoid any complications. Complications and post operative infections are very likely as result of Infectious Peritonitis since the faecal contamination of the surrounding parts within the body could occur.

The surgery which involves incision on the intestinal wall and removal of the faeces and then stitching it back, is a common surgery and the stitches would heal. The animal needs to be maintained on a wet food diet, or, if your cat likes only dry food, please ensure you hydrate her with chicken broth or any soup she likes atleast 2 to 4 times a day.

This surgery does not cure Megacolon, but helps the animal to continue living her /his life and with supportive medication, she could be well for long and would have a better quality of life.

Post surgery the animal needs to be maintained on a 80% liquid diet with semi solids being administered from time to time orally. Intermittent Fluid Therapy and regular vet checks also become important.

Use of stool softeners, medications to maintain smooth muscle tone of the colon so as to delay another surgery as much as possible and other laxatives becomes a daily affair and this would have to administered life-long to your animal.

Mesenteric Anastomosis

This is the second type of surgery for a condition of Megacolon.

Here the portion of the Colon which has lost its muscle tone and gets distended is ligated and removed completely and the good part of the intestine on either side of the portion removed is brought together joined  and stitched.

This is a more effective surgery if undertaken soon, before the entire colon loses its tone and then subsequently removing the entire intestine is a task too tough and involves much risk. As the distended past of the colon is removed, the cat can pass her faeces normally after healing, and she may not develop the problem again for a long time if maintained well on liquid diets, medications and vet checks.

There is no option for Megacolon.  To save the life of your animal there is only surgery or then Humane Euthanasia again done by a vet after having evaluated all the possibilities and personal limitations of the owner.

Please also note in a stage of Obstipation and Megacolon, it is not advisable to feed high fibre diets to the animal as that puts excessive strain on the colon and accumulation of more fecal matter, as the animal has lost its ability to pass a normal stool easily, thus any fibres would put an excessive pressure on the colon. In such cases, it is best to maintain the animal on clear soups like Chicken soup and clear vegetable soup alongwith some semi solid low fibre foods.

The content is an experience of the owner with her cat and is a representation of the same.

Some things may vary depending on the health and diet of your cat. This information is to be taken only as a guideline to understand the condition of Megacolon better.

Please ensure you consult your vet for your animal and administer medication only under a Professional Veterinarian’s advice.

- By Priya Shindurnikar