The cat had diarrhea for 7 d after surgery and subsequently passed slightly soft but formed stools over the next 6 mo. The colon was mobilized and a rectal pull-through maneuver was completed just beyond the ileocolic junction and a subtotal colectomy was performed with ileocolic anastamosis.
Following enemas and medical management with a high fiber diet, colonic stimulants, and fecal softeners (liquid paraffin Vetway lactulose Sandoz), there was an immediate recurrence of the obstipation.Įxploratory celiotomy revealed a dilated, atonic colon and cecum with a gross thickening of the wall of the distal descending colon. Radiographs demonstrated megacolon with solid fecal impaction, without pelvic narrowing.
On physical examination the cat was dehydrated and a caudal abdominal mass (7 cm × 4 cm × 3 cm) was palpated. The cat passed loose, formed stools by 4 d after surgery and then normal stools before the time of suture removal, with no subsequent constipation over the subsequent 6 mo.Ī 7-year-old, neutered male, British short-haired cat was presented, having vomited daily for the previous 3 wk, with ravenous appetite, weight loss, and obstipation. At exploratory celiotomy, a generally dilated and atonic colon was mobilized, a rectal pull-through maneuver was performed to the level of the ileocolic junction and subtotal colectomy was performed with colocolic anastamosis. Rectal examination revealed no obstruction or narrowing of the pelvic canal.
On physical examination the cat was bright, although dehydrated, with impacted feces palpable along the length of the distended colon. Previous chronic pancreatitis (diagnosed by elevated feline pancreatic lipase immunoreactivity) was managed with a low-fat diet. Advantages of this technique include its speed, simplicity, ease of access for suturing an appositional anastamosis, and reduced risk of abdominal contamination.Ī 12-year-old, neutered male, Siamese cat was presented with a 9-month history of severe recurrent constipation, treated by increased dietary fiber intake, colonic stimulants, and fecal softeners (liquid paraffin Vetway, York, UK: lactulose Sandoz, Bordon, Hants, UK.) Despite medical management, bouts of obstipation continued requiring anesthesia for soapy water enemas. The aim of this report is to detail use of the rectal pull-through technique for access to the entire colon for subtotal colectomy. Hence surgically treated cats are reported to have an excellent prognosis, although patients in which the ileocolic junction is removed may produce softer stools in the long-term ( 6).Ī rectal pull-through technique has been described for excision of distal rectal lesions in dogs and cats, allowing surgical access without need for pubic osteotomy or extensive dissection of the perineum ( 7). Bowel adaptation occurs following subtotal colectomy, with surgically treated cats producing feces at slightly increased frequency but with no significant difference in fecal volume or water content compared with normal cats ( 4, 5). Subtotal colectomy is indicated with chronic constipation refractory to medical therapy or with obstructive disease ( 2– 4). Medical management is aimed at increasing dietary fiber, fecal softening, lubrication, and promoting colonic motility ( 2). Megacolon is defined as dilation of the colon which may occur as a congenital disease, an acquired condition due to neurological damage or mechanical obstruction of the colon, or frequently as an idiopathic condition in middle-aged to older cats ( 1).
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