7 Red Flag Symptoms That Foretell This Painful Colon Condition

cat colon xray

Story at-a-glance -

  • Megacolon means large colon, and is the result of too much waste accumulation in the bowel, which causes it to enlarge; the condition is much more common in cats than dogs
  • Megacolon can be congenital or acquired; the acquired form is more common and has a number of causes
  • Symptoms of megacolon include constipation, obstipation, infrequent elimination, straining to eliminate, vomiting and loss of appetite
  • To treat megacolon, I use a combination of chiropractic care, acupuncture, dietary change and bowel supplements to try to manage these conditions in a nonsurgical fashion
  • In very severe cases, surgery may be the only option to return quality of life to the kitty

By Dr. Karen Shaw Becker

Literally speaking, "megacolon" means large colon, and it occurs when too much waste accumulates in the bowel, causing it to enlarge well beyond its normal diameter. The condition is more common in cats than dogs, and can occur in any age, breed or sex of cat. However, most cases are seen in middle-aged male kitties.

The colon is a portion of the digestive tract that starts at the cecum and ends at the rectum. The cecum is the junction at which the small and large intestines meet. The main job of the colon is to temporarily store waste while extracting water and salt from it, and to move feces down to the rectum in preparation for elimination.

In cats with megacolon, the waste doesn't pass through the large intestine normally. Studies show kitties with the condition have a defect in the ability of the muscles of the colon to contract. This causes chronic constipation and also obstipation, which is severe, unrelenting constipation that blocks the passage of both gas and waste through the colon.

As you've probably guessed from this description, megacolon is a terrible condition in which the large intestine is extremely dilated, has very poor motility and there is an accumulation of fecal material that the poor cat can't eliminate from his body.

Causes of Megacolon

Megacolon can be present at birth, or it can be an acquired condition, which is more common. Kitties with congenital megacolon have abnormal smooth muscle function through the large intestine from birth.

Acquired megacolon develops when the large intestine chronically retains feces, the water has been completely resorbed out of the colon, and the feces become large and rock hard. If these masses of waste material remain for a prolonged period of time, the colon distends and enlarges.

This can result in irreversible colon inertia, which means the colon's smooth muscle gets so stretched out and fatigued that it no longer effectively contracts to move waste down to the rectum. Acquired megacolon in cats can be the result of, or made worse by, many factors including:

Diet and microbiome balance

Lack of exercise

Litterbox or behavioral issues

A foreign body in the colon

A problem with the anal glands

Certain types of drugs

A narrowed pelvic canal caused by a fracture or tumor

A neurologic or neuromuscular disease that prevents the cat from assuming the posture necessary for defecation

A neurologic condition affecting the nerves the control defecation

A metabolic disorder that results in low potassium levels or severe dehydration

There are also cases of idiopathic megacolon, which means we simply don't know why it occurs.

Signs to Watch for, and How Megacolon Is Diagnosed

Symptoms of megacolon include:

Constipation

Vomiting

Obstipation

Loss of appetite

Infrequent elimination

Dehydration

Straining to poop and small amounts of loose stool

Megacolon is diagnosed based on the kitty's history and a physical exam. The veterinarian will find a very hard colon upon palpation of the rectum and will find fecal impacts during a rectal exam. In order to determine how severe the condition is and possible underlying causes, other tests will be needed. These can include blood work, urinalysis, an ultrasound, X-rays with barium contrast studies and also neurologic testing.

Treating Megacolon

The treatment goal for megacolon is to clean out the large intestine and identify any underlying issues that have created or contributed to the condition. The type of treatment used will depend on the severity of the problem, how long it has existed and the underlying cause.

Many animals need to be hospitalized for IV fluid therapy and to have the colon evacuated. This can involve anesthesia so that enemas and manual extraction of feces can be accomplished. Most kitties are in too much pain to undergo these procedures without sedation, and it's also extremely stressful for them.

In severe cases of megacolon, surgery may be recommended, and in fact, may be the only way to return quality of life to the cat. The surgery is extensive, and involves removing most of the colon (called a subtotal colectomy), leaving just enough to sew or staple the two ends together. It's important to remove as much colon as possible to prevent recurrence of the condition.

Obviously, this is a very serious procedure that carries significant risk, and should only be performed by a veterinary surgeon with experience with this particular procedure.

I typically consider surgery to be an option of last resort after all alternatives have been tried without success, and the condition is compromising the kitty's quality of life. I use a combination of chiropractic care, acupuncture, dietary change and bowel supplements to try to manage these conditions in a nonsurgical fashion.

I also recommend addressing constipation immediately when it happens, and continuing to actively work to finding viable solutions to chronic constipation to avoid the need for surgery.

Recommendations for Helping Your Cat Avoid Megacolon

As a proactive wellness veterinarian, I encourage cat parents to try to prevent megacolon by making healthy lifestyle choices for their pet.

A moisture-rich, nutritionally balanced, species-appropriate diet and a constant supply of fresh filtered drinking water are very important in helping to prevent dehydration and constipation. I also recommend a high-quality pet probiotic and digestive enzymes with each meal.

Many functional medicine doctors believe a diseased microbiome from poor-quality food and environmental toxins contributes to this syndrome, so partnering with an educated practitioner that focuses on creating vibrant gut health is important.

I can't stress enough the important of keeping kitties well-hydrated. Especially if you're still feeding a dry diet (which I absolutely don't recommend), in order to make sure your cat is getting enough moisture each day, try adding a little water or bone broth to her food. Also consider buying a pet drinking fountain, since many cats who won't drink still water will happily drink moving water from a fountain. Regular exercise is very important, as is helping your pet maintain her ideal body weight.

In multi-cat households, kitties should be provided with enough litterboxes of the right size in low traffic areas with the cat's preferred litter to encourage normal and healthy defecation. If your cat is eliminating outside the box, it's important to not only have her checked by your veterinarian, but also to experiment with different types of litter and litterboxes.

Monitor your pet's "output" and keep the boxes clean by scooping them at least once a day, and thoroughly sanitizing them weekly. Regularly brushing or combing your cat's coat to remove loose fur and debris can help keep things moving smoothly through the gastrointestinal (GI) tract and also prevent hairballs. There are a number of natural remedies for constipation that I always recommend trying before resorting to harsher laxatives. These include:

Psyllium husk powder: 1/2 teaspoon per 10 pounds of body weight one to two times daily on food

Ground dark green leafy veggies: 1 teaspoon per 10 pounds of body weight one to two times daily with food

Coconut oil: 1/2 teaspoon per 10 pounds of body weight one to two times daily

Canned 100 percent pumpkin: 1 teaspoon per 10 pounds of body weight one to two times daily on food

Organic apple cider vinegar (ACV), raw and unfiltered: 1/4 teaspoon per 10 pounds of body weight added to food one to two times daily

Aloe juice (not the topical gel): 1/4 teaspoon per 10 pounds of body weight one to two times daily on food

Acacia fiber: 1/8 teaspoon per 10 pounds of body weight one to two times daily as prebiotic fiber

It's important to never use a human laxative product on kitties, and if you're using a daily hairball remedy, choose a petroleum-free product to avoid adding unnecessary toxins to your pet's body.