By Jean Hofve, DVM
article kindly provided by Jean Hofve, DVM of www.littlebigcat.com.
surprising number of cats have problems with constipation (abnormal
accumulation of feces and difficulty defecating), and similar but more
serious conditions such as obstipation (complete obstruction of the
colon by feces) and megacolon (damaged nerves and muscles in the colon
causing an inability to defecate). Constipation is uncomfortable, even
painful. Constipated cats may defecate (or try to) outside the
litterbox, because they associate pain or discomfort with the box
itself. Other signs of constipation include irritability, painful
abdomen, lethargy, and poor appetite or even loss of appetite.
The colon, the last part of the intestinal tract, is a large muscular
structure ending at the rectum. It contains most of the intestinal
bacteria that reside in the gastrointestinal (GI) tract. These bacteria
finish up the digestion of protein. By-products of this process include
short-chain fatty acids that nourish the cells lining the colon. Some
of these lining cells absorb water, while others secrete mucus to
lubricate the stool and keep it moving along.
Most cats defecate about once a day. A constipated cat may only
defecate every 2 to 4 days, or even less. Usually the stools are hard
and dry, because their long stay in the colon allows for absorption of
most of their water content. However, occasionally a constipated cat
can appear to have diarrhea, because liquid stool is the only thing
that can get around the stuck mass of feces.
Causes for pooping problems include neurologic problems, pelvic injury,
obstruction (by hair, bones, etc.), and Inflammatory Bowel Disease
(IBD). (See this article
for more info on IBD.) A dirty litter box may cause a cat to avoid the
box and become constipated by holding the stool too long. Hooded
litterboxes are a particular problem because they hold odor in,
potentially making the box environment extremely unpleasant for the
In my 10+ years of experience as a
feline veterinarian, I have not seen constipation problems in cats who
do not eat dry food. It's logical, therefore, to think that diet plays
a significant role in development of the problem. (Since writing this
article, I have heard from 2 readers whose cats developed constipation
problems even on all-wet-food diets; so, it's not impossible, but
happily it is fairly rare. Some cats may need more fiber than is
present in those typically very low fiber diets).
Indeed, the initial treatment for constipation is usually a change in
diet. Historically, these cats have usually been put on high-fiber dry
foods. Fiber modulates intestinal mobility. Depending on the type of
fiber and the circumstances, fiber can either speed up or slow down
digestion. It's therefore used for both constipation and diarrhea.
Light, senior, and hairball foods all contain increased fiber, and
there are also several medical high-fiber diets.
Usually the diet change helps, at least initially. However, eventually
these foods often seem to lose their effectiveness over time. More
fiber, such as canned pumpkin, may be added. Again, sometimes this
produces a temporary improvement. Yet most of these cats continue to
Since fiber encourages water
absorption and increases the amount of stool produced (because it is
indigestible), many experts have swung the other way and are
recommending "low-residue" diets to minimize stool volume.
"Low-residue" means that the food is highly digestible and produces
minimal waste. Cats digest protein and fat best, but there is
controversy about carbohydrates; it is clear that many cats are
carb-intolerant. By this theory, the best food would be high fat, high
protein, and low fiber, as well as high moisture. One would think that
such a food would also be low fiber, but that is not necessarily true.
Eukanuba Low Residue dry food contains 4% fiber, which is fairly high.
Most canned foods fit this description, as do most homemade diets.
However, Eukanuba Low Residue manages to incorporate a large amount of
carbohydrate, even in its canned food. Reading the label is an
important skill to develop (learn more about it in this article).
Water balance is crucial in constipated kitties. Most vets will give
constipated cats subcutaneous (or even intravenous) fluids to boost
Treatment for constipation
depends on the severity of the problem. For mild cases, occasional
enemas may be all they need. For severe blockages, the cat must be
anesthetized for manual extraction of the feces (a process my tech
graphically but accurately refers to as a "dig-out").
Once the cat is "cleaned out" by whatever means, it's wise to take
steps to prevent the problem from recurring. Several options are
available; an individual cat may need only one of these, while others
need several or all of them.
- Canned or homemade diet.
High-moisture diets keep the cat hydrated, and these diets are far more
digestible – and produce far less waste – than dry food. Because canned
and homemade diets tend to be extremely low in fiber, addition of a
small amount of rice bran or powdered psyllium (available in bulk at
most health food stores) is helpful.
This is a sugary syrup that holds water in the stool and keeps the
stool soft; therefore it's easier for the cat to pass. Cats are usually
not fond of the taste. Fortunately, lactulose now comes in a
mild-tasting powder (Kristalose) that can be encapsulated by a
compounding pharmacy, or simply added to canned food.
- Other stool softeners, such as DSS (docusate sodium). Your veterinarian can prescribe these.
- Petroleum Jelly.
The primary ingredient in most over-the-counter hairball remedies
(Laxatone, Kat-a-lax, Petromalt), petroleum jelly can be given to the
cat by mouth. Most cats tolerate it, many cats come to like it, and a
few even enjoy it. The Vaseline brand is, according to my cats, the
tastiest; but other cats prefer one of the flavored hairball types.
Give 1/3 to 1/2 teaspoon per day. It can also be mixed with a small
amount of canned food. However, it can interfere with nutrient
absorption so giving it on an empty tummy is best.
- Cisapride (Propulsid).
This drug was withdrawn from the market for humans because of dangerous
side effects, but it is considered safe for cats. Your vet can order it
from a compounding pharmacy. It seems to work best in combination with
- Pediatric glycerin suppositories.
Although they may not appreciate having a suppository pushed into their
rectums, most cats tolerate it. Your vet can advise you on technique
Many cat guardians have gotten good at giving enemas at home. Mineral
oil, K-Y jelly, soapy water, and plain warm water are all fine; you may
have to experiment to see which one works best for your particular cat.
- Slippery Elm. This
powdered herb can be added to canned food (add extra cool water) or
made into a syrup. Its mild taste is well tolerated by most cats. See this article for more information. There are many herbal formulas available for people, but many herbs, such as Cascara sagrada, may be too harsh for a cat.
- Exercise. Staying active helps stimulate the intestines and keep things moving. If your constipated cat is also a couch potato, try Play Therapy.
- Stress Management. There
is always an energetic or emotional component of any chronic disease,
and stress plays a significant role in many gastrointestinal
conditions. The essence remedy "Happy Tummy" was designed by SpiritEssence to help address the energetic underpinnings of constipation and other GI diseases.
If there is damage to the nerves and muscles of the colon, a "sub-total
colectomy" is the last resort. This surgery removes the colon, and
joins the small intestine to the rectum. Unless and until the small
intestine develops more colon-like functioning, the result is chronic
diarrhea. However, the cat will be much more comfortable.
If your cat is chronically constipated, the most important thing for
you to do is be observant. Look for early signs of constipation;
straining, abdominal discomfort, decreasing appetite, etc. Be aware of
how often the cat is defecating. If he does not produce adequate stool
for more than 2-3 days, call your vet, or begin home treatments if you
have established this routine. Kitty constipation is far easier to
treat when it's caught early. If you wait, treatment will be far more
expensive, and there is a greater chance of irreversible colon damage.
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