Lavender, a sweet middle-aged cat, has lived an idyllic life. Pampered by her people. Far from the road. Acres of woods to explore. But something went awry recently. Lavender didn’t come home one night. This was unusual for her, though not unheard-of for any cat that risks the great outdoors. When she returned home the following day, Lavender was having a bit of a delicate problem. She was, um, well, constipated. Her people could actually see poop trying to come out. They even tried to help, but to no avail. I will pause now to say that if you’re perusing this article while enjoying your morning coffee and a delicious chocolate croissant, you might want to save it to read later. Maybe in the bathroom. Let’s talk about, um, well, you know.
Constipation refers to “infrequent or difficult evacuation of hard, dry stool,” while obstipation is when it crosses into a severe situation of “prolonged, intractable constipation with marked impaction of feces in the rectum and/or colon.” The longer fecal matter sits in the bowel, the drier and harder it becomes, and the more difficult to pass. There are many reasons these conditions may occur, but the most common in cats include ingestion of indigestible things (such as hair and bones), dehydration, obesity, lack of exercise, anatomic abnormalities of the pelvic canal, and/or a neurological disorder called idiopathic megacolon.
When Lavender’s people called my office, we started with a classic miscommunication. “Lavender’s owners are on the phone,” my assistant reported. “Their cat has some feces stuck to her anal area that they can’t get off. Should I just have them drop by and we can just shave it for them?” The fun part here is vocabulary. Euphemisms versus medical terminology. What lay people say versus what medical people say. We see lots of pets who get dingleberries. That’s the technical term, I swear. If you don’t know what a dingleberry is, ask any 10-year-old kid. Anyway, owners sometimes ask if we can clean up their pet’s hind end. We call this “perianal clipping” on the medical record, but in the back room, we just call it a “poop chute.” It took a few minutes of conversation to clarify Lavender’s situation — the obstinate fecal matter was on the inside, not the outside. Lavender needed more than a quick visit for a shave and a haircut.
When cats present with difficulty defecating, the first thing we do is palpate the abdomen to determine the extent of the problem. Radiographs may be needed if the cat is very obese, but oftentimes we can assess just by feeling through the belly. Some cases have fecal matter backed up throughout the rectum and descending colon. Others may just have a single large ball causing the obstruction. That was Lavender’s situation — one very large, very dry, very firm wad of material right at the end of her rectum — like a huge cork blocking the exit. Treatment varies depending on age, body condition, extent of the obstipation, and other underlying factors, but it is sometimes worth trying a medical approach first.
We admitted Lavender for the day, gave subcutaneous fluids to hydrate her, and administered repeated cat-safe enemas to soften and lubricate the stool. An important note: Please NEVER try to give your cat an enema at home. Certain types of over-the-counter enemas are toxic to cats. You can kill your cat. No joke. Even the ones that are safe for cats can do a lot of damage if you do not know how to administer them correctly. (Conversely, your cat can do a lot of damage to you while you’re trying to do it.) We also gave Lavender pain medication in hopes it would relax her enough that she could go. But no. No go.
Later that day, it was clear I would have to go fishing. We anesthetized Lavender and I proceeded to try to get that bigger-than-a-golf-ball, harder-than-a-rock lump to pass. But it was simply too big and too dense. (Right about now is when veterinarians start making cracks about how much we love our jobs, and what a romantic profession it is, being an animal doctor. Insert humorous scatalogical joke here.) Aided by repeated flushing of the rectum using a long, thin feeding tube and doses of warm water, laxative, and lubricant enemas, I was able to reach inside with a finger and slowly, slowly, gently, gently, break down the mass and manipulate it out, bit by bit. At first it felt so smooth and solid I wondered if Lavender had swallowed some type of whole animal skull, but, no, it was just an incredibly dense ball of fur and grit (probably macerated bone) encased in solidified, clay-like feces.
Once she was awake, we sent Lavender home with additional pain medication, as I am sure she was sore, along with instructions to feed soft, wet foods, encourage fluid consumption, and observe her bowel movements. Cats with recurrent issues need to be evaluated for underlying issues, and even maintained with regular use of a variety of laxatives, stool softeners, and/or fiber supplements. Severe cases may need daily medications to promote bowel contraction and evacuation of feces.
Today I was examining another senior cat named Zinnia when her person volunteered that the kitty’s previous issues with constipation had totally resolved. “That was good advice,” she said. “You told me to give her a spoonful of canned pumpkin every day. It works great. You should write about it.” Oh, right. I should. Canned pumpkin. For mild cases, this is an easy, natural preventive. Many cats will eat it right off a plate as a treat. You want plain canned pumpkin, not sweetened “pumpkin pie filling.” After Zinnia left, I called to check on Lavender. She’s feeling better, and ate today. Hers was likely a one-time situation precipitated by eating some very furry critter, but her people will keep an eye on her and make sure that, um, well, you know … poop happens.