Do you have experience with colectomy surgery in cats?
July 31, 2022 9:55 PM Subscribe
My beloved 15-year-old cat, Charlie (cat tax), has suffered from chronic constipation for the past 2+ years (and periodic bouts of constipation his whole life). We've been managing it medically with laxatives and fluids with varying degrees of success, but it does seem to be getting worse. I'm quite confident he has been suffering from megacolon, and I'm considering asking his vet about surgical options. If you have experience with colectomy surgery in cats, I'd be grateful to hear about it.
It has only been a few days since another of my beloved cats, Bella, died from kidney failure, and my wife and I are grieving hard. However, we've also been too busy to grieve properly as we're trying to manage the health issues of our other aging cat, Charlie. In addition to constipation he also has recurrent respiratory tract problems, and the two are frequently linked (problems with one cause stress, which exacerbate the other). These flare-ups often leave him feeling pretty lousy for a week or two, but so far every time he's bounced back. However, for the last year or two, it's also becoming clear that each time he's bouncing back a little less well, and never quite manages to put back on all the weight he lost during his illness.
Last week he had a particularly nasty flare-up of his respiratory problems followed by constipation, culminating in him eating almost nothing for about 48 hours. We were really worried we were going to lose him, too, but fortunately on Friday his appetite came back, and he ate well on Saturday as well. Today, Sunday, his constipation is worse again, even though I can feel in his abdomen that his feces is pretty soft. He did manage to produce a single large-ish turd after several visits to the litter box and a lot of straining, but I can feel there's a fair bit left in his abdomen.
I'm worried he's hit the point where his colon just isn't functioning properly any more, and even soft feces just can't get shifted through. I found some information published by the American College of Veterinary Medicine about surgical treatment for megacolon, in which the affected bowel is removed. In theory, this sounds like a good option for him, and I plan to ask his vet about it, probably tomorrow. However, while I think Charlie's vet is excellent overall, his practice is a bit over-extended and it's sometimes hard to get a chance to talk to him about treatment options in as much detail as I'd like (which is probably an excessive amount of detail).
If you've ever had a cat surgically treated for megacolon, I'd be grateful to hear your experience. I'm worried Charlie won't survive too much more of this, but I also don't want to subject him to a major surgery if the odds are that he's just approaching the end of his life anyway. I can't say that money's not an object, but if it's something that could buy him another year or two of good quality of life, I'll try to find a way to pay for it. Bella's the second cat we lost within the last year, and my wife and I are going to really struggle if we lose Charlie as well.
It has only been a few days since another of my beloved cats, Bella, died from kidney failure, and my wife and I are grieving hard. However, we've also been too busy to grieve properly as we're trying to manage the health issues of our other aging cat, Charlie. In addition to constipation he also has recurrent respiratory tract problems, and the two are frequently linked (problems with one cause stress, which exacerbate the other). These flare-ups often leave him feeling pretty lousy for a week or two, but so far every time he's bounced back. However, for the last year or two, it's also becoming clear that each time he's bouncing back a little less well, and never quite manages to put back on all the weight he lost during his illness.
Last week he had a particularly nasty flare-up of his respiratory problems followed by constipation, culminating in him eating almost nothing for about 48 hours. We were really worried we were going to lose him, too, but fortunately on Friday his appetite came back, and he ate well on Saturday as well. Today, Sunday, his constipation is worse again, even though I can feel in his abdomen that his feces is pretty soft. He did manage to produce a single large-ish turd after several visits to the litter box and a lot of straining, but I can feel there's a fair bit left in his abdomen.
I'm worried he's hit the point where his colon just isn't functioning properly any more, and even soft feces just can't get shifted through. I found some information published by the American College of Veterinary Medicine about surgical treatment for megacolon, in which the affected bowel is removed. In theory, this sounds like a good option for him, and I plan to ask his vet about it, probably tomorrow. However, while I think Charlie's vet is excellent overall, his practice is a bit over-extended and it's sometimes hard to get a chance to talk to him about treatment options in as much detail as I'd like (which is probably an excessive amount of detail).
If you've ever had a cat surgically treated for megacolon, I'd be grateful to hear your experience. I'm worried Charlie won't survive too much more of this, but I also don't want to subject him to a major surgery if the odds are that he's just approaching the end of his life anyway. I can't say that money's not an object, but if it's something that could buy him another year or two of good quality of life, I'll try to find a way to pay for it. Bella's the second cat we lost within the last year, and my wife and I are going to really struggle if we lose Charlie as well.
Have you tried a special diet yet? My Fat Tony had chronic constipation for years and we were about to do the colon surgery and someone instead suggested trying this dry food and wet food only, and adding a teaspoon of Miralax to his morning wet food.
Within days the constipation ended and has not recurred in years.
posted by yes I said yes I will Yes at 8:23 AM on August 1, 2022 [2 favorites]
Within days the constipation ended and has not recurred in years.
posted by yes I said yes I will Yes at 8:23 AM on August 1, 2022 [2 favorites]
Response by poster: Just to follow up, yes, we've tried a variety of special diets. The efficacy of special diets is somewhat limited by us being a multi-cat household, but Charlie's been getting special foods for a while now. We've tried adding Miralax, which actually seems pretty effective, but he seems to notice that it's in his food and will refuse to eat it. Pumpkin powder for added dietary fiber works pretty well and he actually seems to like it, but that's no longer working as well either. We are sometimes able to give him subcutaneous fluids, which definitely helps, but he really hates it and makes it pretty hard to keep him restrained long enough to do it (even our vet has failed to successfully give him subcutaneous fluids once or twice, he's a real pistol when he wants to be). He's on a lot of meds already; we've never tried suppositories though.
All that just to say, I wouldn't even be thinking surgery if I didn't think we were already trying just about everything else. However, I do appreciate the suggestions, and any other thoughts are still welcome in case we've missed something. As a little update, it looks like he won't be able to see the vet until tomorrow, and unfortunately I'm going to be out of town on a work trip so my wife will be on her own taking him in. Fingers crossed everything stays stable!
posted by biogeo at 9:07 AM on August 1, 2022
All that just to say, I wouldn't even be thinking surgery if I didn't think we were already trying just about everything else. However, I do appreciate the suggestions, and any other thoughts are still welcome in case we've missed something. As a little update, it looks like he won't be able to see the vet until tomorrow, and unfortunately I'm going to be out of town on a work trip so my wife will be on her own taking him in. Fingers crossed everything stays stable!
posted by biogeo at 9:07 AM on August 1, 2022
Head's up, phosphate-containing enemas (Fleet is one brand) must be avoided in cats. A medication to ask the vet about, if it hasn't been tried yet: Cisapride (brand names: Prepulsid®, Propulsid®), "used to enhance the movement of the gastrointestinal (GI) system to treat conditions such as stasis, reflux, and constipation/megacolon (in cats)."
posted by Iris Gambol at 9:21 AM on August 1, 2022 [2 favorites]
posted by Iris Gambol at 9:21 AM on August 1, 2022 [2 favorites]
I have a success story if it helps! I adopted Feliner 2 at age 7 in 2016 and already knew she had megacolon; even though she was on Royal Canin and would eat food with Miralax sprinkled on top, she still had at least quarterly episodes of serious constipation. We're talking to the tune of $800-$1200 at a time to dig everything out. When I switched her to a vet that lived closer by, he practically begged me to let him operate on her. He'd done it a few times before with great results. Near the end of 2020, she was getting stopped up like every six weeks, so once I got a solid Christmas bonus, I relented. At that time Feliner 2 was 12 and had no other chronic conditions. She made it through surgery in January 2021, no problems, and she's only had one episode of constipation since that I was able to treat with lactulose and cisapride. Right now, at 13 1/2, she's happily stretched out on the floor by me.
posted by Recliner of Rage at 5:58 PM on August 1, 2022 [2 favorites]
posted by Recliner of Rage at 5:58 PM on August 1, 2022 [2 favorites]
Response by poster: An update on Charlie's condition for the curious:
He's had a rough week but things are looking a little bit better right now. He got two enemas at the vet but still wasn't able to poop, so we ended up hospitalizing him so he could get sustained fluids and more intensive care. Even that ended up not being enough, so this afternoon the vets ended up sedating him and manually removing the feces from his colon. Poor guy's not feeling too great, but he's home again, his appetite is back, and his immediate prognosis, at least, is good.
His primary vet doesn't think he's a good candidate for surgery due to a heart murmur. However, I definitely appreciate the recommendation of cisapride, as I asked about it and she agreed it's a good idea to try. We're hoping that between that, regular miralax, and more frequent subcutaneous fluids, we'll be able to keep him a little more regular. We're definitely not out of the woods with him yet, but I'm less worried than I was at the beginning of the week.
posted by biogeo at 9:43 PM on August 4, 2022 [2 favorites]
He's had a rough week but things are looking a little bit better right now. He got two enemas at the vet but still wasn't able to poop, so we ended up hospitalizing him so he could get sustained fluids and more intensive care. Even that ended up not being enough, so this afternoon the vets ended up sedating him and manually removing the feces from his colon. Poor guy's not feeling too great, but he's home again, his appetite is back, and his immediate prognosis, at least, is good.
His primary vet doesn't think he's a good candidate for surgery due to a heart murmur. However, I definitely appreciate the recommendation of cisapride, as I asked about it and she agreed it's a good idea to try. We're hoping that between that, regular miralax, and more frequent subcutaneous fluids, we'll be able to keep him a little more regular. We're definitely not out of the woods with him yet, but I'm less worried than I was at the beginning of the week.
posted by biogeo at 9:43 PM on August 4, 2022 [2 favorites]
This thread is closed to new comments.
I'm so sorry about Bella, you sound like such loving cat owners; I'm sure she was as lucky to have you as you were to have her.
posted by theora55 at 8:04 AM on August 1, 2022 [1 favorite]