{"id":24827,"date":"2021-12-14T14:27:03","date_gmt":"2021-12-14T14:27:03","guid":{"rendered":"https:\/\/todaysveterinarypractice.com\/?p=24827"},"modified":"2022-03-01T15:58:50","modified_gmt":"2022-03-01T15:58:50","slug":"nutrition-and-feline-idiopathic-constipation","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/nutrition\/nutrition-and-feline-idiopathic-constipation\/","title":{"rendered":"Nutrition and Feline Idiopathic Constipation"},"content":{"rendered":"

Constipation is characterized by prolonged gastrointestinal (GI) transit, associated with dry stool and difficult or absent defecation.1<\/sup> Although cats of all ages and both sexes can be affected, middle-aged to older male cats are over-represented.2-5<\/sup> Constipation can occur secondary to local GI or systemic diseases (<\/span>TABLE 1<\/span><\/strong>). After predisposing causes are excluded, the diagnosis for an estimated 60% to 70% of cats is idiopathic constipation.16<\/sup> Cats with recurrent constipation require lifelong therapy; some with refractory disease need periodic hospitalization or surgical intervention. This article describes the diagnosis and medical management of feline idiopathic constipation, with a focus on nutritional strategies.<\/span><\/p>\n

\"Causes<\/a><\/p>\n

Etiology of Feline Constipation<\/h2>\n

The pathophysiology of feline idiopathic constipation is incompletely understood but is most likely multifactorial; contributing factors include dehydration, GI neuronal signaling, and GI-microbiome interactions. An in vitro study showed that the colonic contractile response to neurotransmitters (e.g., acetylcholine, cholecystokinin, substance P) is less in cats with end-stage disease (i.e., megacolon) than in healthy cats.17<\/sup> Studying cats with megacolon limits the ability to interpret whether dysmotility is the underlying cause of disease or secondary to chronic distention. The same study found that decreased contractility was not related to decreased colonic muscle mass and that smooth muscle histopathology was normal.17<\/sup><\/span><\/p>\n

A recent study found that, in cats with constipation of varying severity, GI pacemaker cells (i.e., interstitial cells of Cajal) were decreased, numbers of myenteric neurons were decreased, and myenteric neurons were degenerate.4<\/sup> Together, those findings suggest disordered enteric nervous system stimulation rather than a primary muscular disorder, which enables selection of therapies that could improve response to enteric nervous system signaling.\u00a0<\/span><\/span><\/p>\n

Additional evidence supports a self-perpetuating process, wherein retained feces become progressively dehydrated as a result of normal colonic water absorption.18<\/sup> Recurrent constipation contributes to permanent distention and dysmotility.2,10,19<\/sup><\/span><\/p>\n

Diagnosis of Feline Constipation<\/h2>\n

History<\/h3>\n

For cats presented with constipation, a thorough history is critical. History enables assessment of disease severity and identification of environmental and diet factors that can be targeted therapeutically. Key questions include duration of signs, frequency of constipation episodes, time of last defecation, and stool volume during defecation. Fecal scoring20<\/sup> can be used to define stool consistency at presentation and to gauge therapeutic response. <\/span>BOX 1<\/span><\/strong> lists clinical signs reported in cats with constipation as well as less common signs related to GI mucosal irritation or marked tenesmus (e.g., vomiting). Key environmental questions include litter box accessibility and hygiene, difficulty getting into the litter box, and water sources (e.g., types and accessibility). Diet history should include diet form (i.e., dry versus canned), amount fed, feeding frequency, specific diet (including protein and carbohydrate sources), recent diet changes, and any treats or supplements.\u00a0<\/span><\/span><\/p>\n

 <\/p>\n

BOX 1 Clinical Signs of Idiopathic Constipation in Cats2,5,7,15,18,21<\/sup><\/div>
<\/p>\n

Commonly Observed<\/strong><\/p>\n