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Kitty Constipation – A Holistic Vet’s Secrets to Prevention and Treatment
A surprisingly large number of cats have problems with constipation (abnormal accumulation of feces and difficulty defecating) and similar but more serious conditions such as constipation (complete blockage of the colon with feces) and megacolon (nerves and muscles in the colon that cause the inability to defecate). Constipation is uncomfortable, even painful. Constipated cats may defecate (or try to) outside the litter box because they associate the pain or discomfort with the box itself. Other signs of constipation include irritability, a painful stomach, lethargy and poor appetite or even loss of appetite.
The colon, the last part of the intestinal tract, is a large muscular structure that ends in the rectum. It contains most of the intestinal bacteria found in the gastrointestinal (GI) tract. These bacteria stop digesting proteins. Byproducts of this process include short-chain fatty acids that feed the cells lining the colon. Some of these lining cells absorb water, while others secrete mucus to lubricate the stool and keep it moving.
Most cats defecate about once a day. A constipated cat may only have a bowel movement every 2-4 days or even less often. Usually, stools are hard and dry, as their long stay in the colon allows most of the water content to be absorbed. But sometimes a constipated cat can have diarrhea because liquid stool is the only thing that can get past the mass of trapped stool.
Causes of pooping problems include neurological problems, pelvic injuries, obstruction (due to hair, bones, etc.) and inflammatory bowel disease (IBD). A dirty litter box can cause your cat to avoid the litter box and become constipated if you keep the stool for too long. Hooded litter boxes are a particular problem because they trap odors, making the cat’s environment extremely unpleasant for the cat.
In 15+ years of experience as a feline veterinarian, I only know 2 constipated cats that do not eat dry food. Therefore, it is logical to believe that diet plays an important role in the development of the problem. Some cats may need more fiber than a very low-fiber diet, such as most canned, raw, and home-made diets. You can always add a pinch of fiber (ground flaxseeds and ground chia seeds or Salba are quite tasty and work very well).
Indeed, the first treatment for constipation is usually a change in diet. Historically, these cats have typically been put on high-fiber dry food. Fiber modulates intestinal motility. Depending on the type of fiber and the circumstances, fiber can speed up or slow down digestion. Therefore, it is used for both constipation and diarrhea. Light, aged, and hairball foods all contain more fiber, and there are also a number of high-fiber medical diets.
A change in diet usually helps, at least initially. But eventually, these foods seem to lose their effectiveness over time. More fiber can be added, such as canned pumpkin. Again, this sometimes results in a temporary improvement. But most of these cats continue to have problems.
Because fiber promotes water absorption and increases the amount of stool produced (since it is indigestible), many experts have gone the other way and recommend a “low-residue” diet to minimize the amount of stool. “Low residue” means that the food is easily digestible and produces minimal waste. Cats digest proteins and fats best, but carbohydrates are controversial; it is clear that many cats are carb intolerant. According to this theory, the best foods would be high in fat, high in protein, low in fiber, and high in moisture. You might think that such food is also low in fiber, but this may not be true. Eukanuba Low Residue dry food contains 4% fiber, which is quite high. Most canned foods fit this description, as do most homemade foods. However, Eukanuba Low Residue can add large amounts of carbohydrates even to its canned foods. Label reading is an important skill to develop.
Water balance is crucial for constipated kittens. Most vets give constipated cats subcutaneous (or even intravenous) fluids to increase hydration.
Treatment for constipation depends on the severity of the problem. In mild cases, an occasional enema may be sufficient. For severe blockages, the cat must be anesthetized to manually pull out the feces (a process that my favorite technique graphically but accurately refers to as “digging out”).
Once the cat has been “cleaned out” by any means, it is wise to take steps to prevent the problem from recurring. There are several options available; an individual cat may only need one of these, while others may need several or all of them.
- Canned or homemade diet. High moisture diets keep the cat hydrated and these diets are much more digestible – and produce much less waste – than dry food. Since canned and homemade diets tend to be extremely low in fiber, adding a small amount of rice bran or psyllium powder (available in bulk at most health food stores) is helpful.
- A fountain. Many cats drink far more running water than they ever take from a bowl. There are many types of pet fountains, from “cascades” to “waterfalls” to models that could be from Rome! They are easily available online. Be sure to keep the fountain clean so your cat continues to drink.
- Lactulose. It is a sugary syrup that holds water in the stool and keeps the stool soft; therefore, it is easier for the cat to pass. Cats usually don’t like the taste. Fortunately, lactulose is now available as a mild-tasting powder (Kristalose) that can be encapsulated at a compounding pharmacy or simply added to canned foods.
- Other stool softeners such as DSS (Docusate Sodium). Your vet can prescribe them.
- Vaseline. The main ingredient in most over-the-counter medications (Laxatone, Kat-a-lax, Petromalt) is petroleum jelly, which can be given orally to cats. Most cats tolerate it, many cats grow to like it, and some even enjoy it. The Vaseline brand is the tastiest for cats in my opinion; 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 the absorption of nutrients, so it is better to give it on an empty stomach.
- Cisapride (Propulsid). This drug was withdrawn from the market due to dangerous side effects in humans, but is considered safe for cats. Your vet can order it from a compounding pharmacy. It seems to work best with stool softeners.
- Children’s glycerin suppositories. Although they may not appreciate pushing the suppository into their rectums, most cats can tolerate it. Your vet can advise you on technique and frequency.
- Enema. Many cat guardians have done well with home enemas. Mineral oil, KY jelly, soapy water, and plain warm water are all fine; you may need to experiment to see which one works best for your particular cat.
- Slippery elm bark or marshmallow. These herbs can be added to preserves (add extra cool water) or made into syrup. Most cats tolerate their mild taste well. They form mucus, a slippery substance that helps move intestinal contents. Many herbal mixtures are available for humans, but many herbs, e.g Cascara sagradaare too harsh for the cat.
- Exercise. Staying active helps stimulate the gut and keep things moving. If your constipated cat is also a couch potato, try cat play therapy.
- Stress management. Any chronic illness always has an energetic or emotional component, and stress plays an important role in many gastrointestinal diseases. Flower essences are helpful in changing the energetic foundations of constipation and other gastrointestinal diseases.
- Fluid therapy. Some cats do very well with occasional (daily to weekly) infusions of subcutaneous fluids. Your vet or veterinarian can show you how to do this at home. Give fluids whenever you notice that your cat’s behavior indicates impending constipation.
- Surgery. If the nerves and muscles of the colon are damaged, the last resort is a “sub-total colectomy.” This surgery removes the colon and connects the small intestine to the rectum. If and until the small intestine no longer develops colon-like function, the result is chronic diarrhea. However, the cat is much more comfortable.
If your cat is chronically constipated, the most important thing for you to do is to pay attention. Look for early signs of constipation; straining, abdominal discomfort, loss of appetite, etc. Be aware of how often the cat defecates. If he doesn’t produce enough stool for more than 2-3 days, call your vet or start home remedies once you’ve established a routine. It is much easier to treat kitty constipation if it is caught early. If you wait, treatment is much more expensive and the chance of irreversible colon damage is higher.
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