Feline Defecation Dr. Serena Mills

Terms

• Diarrhea • The passing of loose or liquid stool, more often than normal.

• Constipation• The infrequent or difficult evacuation of feces, which are typically dry and hard.

• Obstipation• Inability to evacuate the mass of dry, hard feces• Impaction extending from the rectum to the ileocolic valve can result.

• Megacolon• A pathologic condition of hypomotility and dilation of the large intestine that

results in constipation and obstipation• Generalized dysfunction of colonic smooth muscle

The four C’s of Poop• COLOR

• Happy healthy color = chocolate brown• Comes from bilirubin, a pigment in bile, from the gallbladder that is used to help digest food

• Red = bleeding large intestine or rectum• Tarry black/maroon = bleeding in stomach or small intestine• Clay/pale yellow = problem with liver, gallbladder, or pancreas

• CONSISTENCY• Fecal scoring system (next page)

• COATING• Happy healthy coating = none• Mucus coating = large intestine problem

• CONTENTS• Worms• Excessive grass• Hair• Etc.

What’s in a fecal?

Causes for diarrhea…

• Diet • Allergy (S)• Rapid change (S)• Poor quality food (S)

• Parasites• Roundworms (S)• Hookworms (S)• Tapeworms (S)• Whipworms (L)• Coccidia/giardia (S)

• Infections• Viral (S)

• Panleukopenia• Coronavirus• FeLV/FIV

• Bacterial (S)• Salmonella• Clostridium• E-coli• Campylobactor

• Other• IBD (S/L)• SIBO (S)• Lymphoma (S/L)• Liver disease• Hyperthyroidism• Renal disease• Pancreatic disease• Stress (L)

Small Intestinal diarrhea Large intestinal diarrhea

-Large amount of stool -Small amounts of stool

-Increased frequency (3-5 x per day) -Increased frequency (>5 x per day)

-No straining/difficulty passing stool -Yes straining/difficulty

-May vomit and lose weight -Does not usually vomit or lose weight

-Excess gas production sometimes seen -May be slimy w/mucus

-If blood in stool = digested and black in color

-If blood in stool = red in color

Cause Most at risk Diagnosis Treatment

Diet change Any History and r/o other causes

Bland diet and then slowly back to normal diet

Food allergy Any Food trial/elimination diet Feed appropriate diet

Worms Kittens Fecal flotation Pyrantel or droncit

Coccidia Kittens + immunosuppressed

Fecal flotation Marquis paste

Giardia Kittens + immunosuppressed

Fecal float + microscopic exam of feces +/- ELISA

Metronidazole (25mg/kg)

Bacterial infection Kittens + immunosuppressed

Microscopic slide exam of feces

Antibiotics

Panleukopenia Kittens CBC and parvo snap test Supportive care and antibiotics

FeLV/FIV Outdoor cats/kittens Snap test and r/o other causes

Supportive care (poor prognosis)

IBD Middle-age catsCan occur in kittens

Biopsy and r/o other causes

Modify diet, probiotics, canned pumpkin,Metronidazole (15mg/kg), prednisolone

SIBO Middle-age cats Biopsy +/- GI panel (folate/cobalamin)

Antibiotics, modify diet, give vitamin B12 injection

A few notes on diet…• Beef, wheat, and corn are the top 3 allergens for cats• Cats with IBD

• Highly digestible (Hill's i/d, Iams Low Residue, Royal Canin GAstrointestinal, Purina EN, canned and dry)

• Cats with food allergy or IBD• Highly digestible + novel ingredients (Hills d/d, Royal Canin select protein) • Highly digestible + hydrolyzed protein sources (Hill's z/d, Royal Canin HP, Purina HA)

• Cats with large intestinal diarrhea• High fiber (Hills w/d, Royal Canin GI fiber response).

• High fiber diets are usually low on energy density, so cat might lose weight because the effect on the diarrhea is only cosmetic or because it cannot eat enough

Causes for constipation…

• Diet• Excessive fiber• Ingestion of hair

• Obstruction• Perineal hernia• Foreign body• Tumor• Abscess• Stricture

• Behavioral• Change in routine• “Bad box”• Inactivity• Pain• Stress

• Drugs• Opiates

(buprenorphine)• Sucralfate

• Other• Hypercalcemia• Hypokalemia• Nerve damage• Obesity• Dehydration (renal dz)• Megacolon• Pelvic fracture

*Note: typical feline patient is middle-age and male

A note on radiographs…

• Colon >1.5x length of L7 = megacolon

Why is constipation a problem?

• Job of large intestine/colon and rectum = reabsorb excess water, collect and retain feces in preparation for defecation• If fecal material is not passed it becomes extremely desiccated (dried

out) making it even more difficult to pass• Can lead to megacolon• Decrease in peristaltic contractions and smooth muscle degeneration from

over distention• Often permanent

• Can result in systemic toxicity• Over absorption of toxic intestinal products

Treatment options…

• Removal of impacted feces• Enema or rectal suppository

• Laxitaves• Only in well hydrated cats• Lactulose, Miralax, DSS

• Prokinetics• Usually only work if acute not chronic• Cisapride, ranitidine

• High fiber diets (Royal Canin GI fiber response, canned pumpkin)• Canned diet (increased water intake)• Acupuncture• Megacolon – subtotal colectomy if refractory to medical or dietary therapy

Questions??