4Īlmost invariably, medical management will eventually fail as the colon loses more and more contractibility. High doses can result in diarrhea – like any laxative. It was shown to mildly increase potassium levels and may result in some dehydration if a patient does not drink adequately. Polyethylene glycol (PEG) 3350 is not absorbed from the intestinal tract and binds to as many as 100 water molecules resulting in a softer stool. The starting dose is 1/ 8 to ¼ teaspoon BID, and this dose is titrated upwards depending on desired stool consistency. It has virtually no flavor and can be easily sprinkled on or mixed with wet food. MiraLax™ (polyethylene glycol 3350) may be replacing lactulose as the stool softener of choice for cats with megacolon and obstipation. It can sometimes be difficult to give to cats due to the flavor and mouth feel, limiting client compliance. It is an indigestible sugar that osmotically pulls water in to the bowel. The dose of this medication may be adjusted by the owner to achieve a desired stool consistency. Lactulose (0.5 ml/kg BID-TID) 3, has historically been the laxative of choice. Stool softeners are also a common first line choice for any cat that is having difficulty defecating. Other prokinetics that may be considered include ranitidine, misoprostol, and metoclopramide, but they are likely not as effective as cisapride. Cisapride is no longer available for human use due to its arrhythmogenicity, but it can be gotten from compounding pharmacies for veterinary use. The starting dose is 2.5 mg BID, but can be titrated upwards as needed to 5-7.5 mg TID. Nonetheless, it remains a rational and anecdotally supported medication to use. It has been shown to improve smooth muscle cell contraction in vitro, but the in vivo benefits of this medication for feline idiopathic megacolon are unproven. Cisapride is often the prokinetic of choice. Prokinetic medications may be successful in early management. 2 As colon function declines and obstipation develops, low residue diets can help to decrease stool volume. The soluble vs insoluble fiber fraction usually does not appear on pet food labels, rather crude fiber is listed which is a measure of both soluble and insoluble fiber. Soluble fiber is highly fermentable, attracts water into the stool, and aids in gel formation within the colon. Soluble fiber is preferable to insoluble fiber foods, since insoluble fiber tends to be bulk forming and further distend the colon. Higher fiber diets can be useful at this stage of management. If management efforts lapse, obstipation may result.ĭietary management is often a first line choice to manage developing feline megacolon. The colon still maintains some ability to contract and expel stool, but defecation may be infrequent or incomplete (constipation). In the development of feline megacolon, medical and dietary management can be successful in delaying the need for deobstipation. This is unfortunately a slowly progressive disease, and the ability to defecate usually worsens over months and years. If obstipation is severe, it can result in vomiting, and even diarrhea due the irritation that the hard stool causes against the colonic wall. Most obstipated cats strain to defecate and produce little or no stool. It is the result of dysfunction of the colonic smooth muscle. Feline megacolon is most commonly seen in middle aged male cats, and any breed can be affected. Some other causes of obstipation include pelvic deformity from trauma, neoplasia, strictures, foreign bodies, and cauda equina syndrome. Feline idiopathic megacolon is the most common cause of obstipation in the cat. Stool then accumulates in the colon becoming more and more voluminous as the patient eats, and getting harder and harder as the large bowel absorbs more and more water from the mass of stool. Veterinary Clinic for Low Income Pet OwnersĪngell Animal Medical is the term applied when constipation (incomplete defecating) is so severe that the stool can no longer be passed.Vet Services Report Cruelty Animal Advocacy Adopt
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