Sunday, March 4, 2012

Megacolon, A Story of Two Cats.


Wren helping me write my blog.
Last Wednesday one of the foster care providers for Animal Rescue came in with his foster cat Missy.

Missy is a rather rotund calico cat. She is a calm, shy, reclusive cuddler and purrs readily with even the slightest bit of attention. It is apparent to me that she is a resident of a large cat household and that she has also been a part of the rescue program for years.

There is something about a rescue cat that I am drawn to. They are usually oddly sedate, adaptable, and more at ease around strangers than the typical family house cat. (In stark contradiction to my kitten Wren, who on the other hand has become a holy-terror if she is put into the position of being a patient again. She is officially spoiled to the point of being rotten about it. But I still love her to pieces and I am sure I am responsible for creating the monster inside her. In fact she is sitting on the computer blocking my monitor now, so any mis-spellings are her fault. She is of course to adorable to move. But back to my point.)


Wren, not exactly helping me write my blog.
Mr. Biser who is Missy's foster-dad is a quiet, straight-forward little man who is always a bit more impeccably dressed than I expect, and always greets me with a firm handshake and formal introduction, even though we have met many times before.  He always provides a rapid fire but extremely thorough history on all of his cats when he visits.

I believe most of Mr. Biser's cats are Animal Rescue fosters, (although I also think we are talking like 20 cats, so I could be off a little on their true status with respect to specific "ownership").

I am fairly certain that society labels most people with more than 5 cats "crazies" for lack of a better term. (And yes, present company is included because currently I stand at 5, and that's the lowest I have been in about 2 decades). But I don't know many "cat-crazy" men. Mr. Biser is one of only three male "cat-crazy" clients that I have. Most of us "crazies," are women in our late 30's or plus, single, introverted, home-bodies, (God, I might have a really difficult time should I find myself ever needing the services of match.com). But there aren't to many men I know taking care of cat colonies at their home.

Missy, always tongue hanging out just a little bit, relaxing on her bed.



Today Missy was here to see me because as Mr. Biser explained it, "her colon was back-up and the poop was side-ways and she couldn't get it out."

I know Mr. Biser well enough to know that he watches his cats very closely, and he cares about them very deeply. He is an active participant in their treatment plans and he never hesitates to seek medical care for them if they appear to need it. I also know my cat anatomy well enough to have some difficulty in understanding how "your poop gets sideways?" Fecal matter is the waster your body can't use and it is formed in the direction it is produced by your muscular tube-like colon.

Our intestines job is to digest our food and then dump whats left over into our colon. The colon then removes any excess water (so you don't have the runs) and holds your waste cargo until you safely arrive at a drop-off location. The colon then squeezes out your waste and this waste takes its cigar shaped form from this muscular tube like action.

But if your colon, (aka "muscular tube") isn't muscular enough anymore, and/or it gets dilated to the point that it can't recover its tube like shape, then your poop can be produced with a circular, or even square like shape. (I think this is what Mr. Biser was referring to as "sideways").

We don't always know what triggers a cats first bout of megacolon. Sometimes it is a poor quality food, or a low fiber diet, or  poor muscle tone to the colon, or an abnormal neuromuscular input to the muscle of the colon. But if you have difficulty eliminating your colon starts to get weaker and weaker therefore causing your fecal material to become more and more compacted in the colon. As the colon becomes packed with fecal material it begins to dilate wider and wider. With the feces being retained longer than is normal more and more water gets pulled out hence the feces get drier and drier, making it even harder to defecate out. We call this the "snow ball" effect in medicine. (See how important physiology is?) This condition is typical with megacolon.

Because Mr. Biser has had previous issues with Missy's megacolon before he has her on a special diet, and tries to monitor her pooping schedule closely. But with lots of other kitties sharing the same food and litter boxes monitoring poops can be difficult.

This was actually the second time in two weeks that she had gotten a bout of constipation and obstipation. Constipation is difficulty defecating and obstipation is intractable constipation, or inability to defecate due to constipation.

On Missy's examination I could feel an abnormally large colon that was full of feces. She was indeed having trouble defecating but her x-ray revealed that although her colon was more dilated than it should have been the fecal balls were scattered throughout the colon, and not the dreaded, and more difficult to treat, compacted.

Her treatment plan was to resume her lactulose (adds water to the feces), stay on her strict high fiber diet, start i.v. fluids, (to help add water to the feces and get the gut moving), add a motility drug, and start some soapy enemas. We monitored her daily and she remained in her good spirits and also started producing those large feces we had seen on the x-ray in her litter box.

After a few days on i.v. fluids and a few not-so-fun enemas Missy is doing great! She needs to stay on an appropriate diet long term, be monitored closely and will likely need a repeat of the lactulose and/or fluids again sometime in the future. This disease is rarely corrected on its own, and these cats tend to have flair ups sporadically over time.

Appropriate diet, lots of exercise and a good body condition score do wonders for effectively managing this disease. Some cats need surgical resection (fancy for removal) of their diseased flaccid colon because at some point nothing moves through it anymore.


Buddy is one of our clinic cats. He was brought to us years ago for his issues with constipation and megacolon for euthanasia. They were frustrated with his having to be on a strict diet, and were not willing to address the care he needed to keep his colon working. He has lived with us since his owners signed him over to us those many years ago. We do our best to keep him on a high fiber diet, (which he cheats on at every given chance in the clinic) and we monitor his litter box closely. Through the years he has had some bouts of constipation. He has actually gotten so constipated before that he actually starts vomiting. (Now that's backed up, yuck!).

Pictures of Buddy;






Buddy playing with Kiki.


Buddy's terribly backed up, waaay over full colon, OUCH!


We have had some constipated cats that are so backed up and their colon is soo full that we have to anesthetize them and manually remove the feces. (Not a fun job for either party, but who ever claimed veterinary medicine was a glamorous job?)


This is an x-ray from a cat that was found unable to walk. His inability to walk was most likely because he had damaged his spinal cord. This colon is severely backed up with feces that are hard and compact. This cat would have needed anesthesia and manual removal of the feces. But because he was also paralyzed he was euthanized.


I expect that Missy will go back home today.

Mr. Biser and his daughter wrote a book called, "Cats Believe in Santa, Tales of Finding a Forever Home." It is written with his daughter Jennifer B. Foulk and available on Amazon. It is an adorable book telling the tales of the cats he has fostered, and helped. There are some beautiful photos of "his" cats. It is a testament to all of the amazing cats out there looking for a forever home and all of those dedicated volunteers trying to help get them there.

The dedication of his book says it best;
"To all of the volunteers throughout the country who give of themselves to care for animals in need. For all of the organizations dedicated to providing shelter and help for lost, abandoned, injured and newborn animals. May this book be a small token to them. we also hope to inspire others to donate whatever they can to help meet the continuing needs of cats and other animals throughout the year. Most importantly, what they give back to you is priceless."


Here are some excerpts and pictures from Mr. Biser's book.









Buddy resides at  our clinic Jarrettsville Vet in Jarrettsville MD. He is looking for a home that will love him in spite of his condition. He is a sweet affectionate boy that has an enormous amount of love to give.

Update;
Buddy was adopted by a wonderful long time client. She, just like Mr. Biser monitors Buddy's megacolon closely. Buddy is a lucky, well loved, companion. 

June 6, 2014. Buddy passed away from complications of cancer. He was loved every single day of his life with us and his second time mom. He will be missed and we send our deepest sympathies to his family, and thank them from the bottom of our hearts for loving him as much as we did, and for giving him a home in spite of his megacolon obstacles.

If you have a question about this blog, or any pet care condition, you can find a whole bunch of helpful people at Pawbly.com. Pawbly is free to use and we welcome all animal lovers to help us build a safe, welcoming place for people who love pets. 

You can also find me at the clinic, Jarrettsville Vet, or on Twitter @FreePetAdvice.

5 comments:

  1. Krista, My daughter came across your site and ask me if I saw this. What I'm about to say has nothing to do with the fact you wrote much of this article about, me or our book "Cats Believe in Santa". It was really well done and all our cats (including Missy who we adopted) thank you very much.

    Your site or blog has so much information and real examples of many of the health issue which face our feline friends and dogs. I don't do a lot of blogging or even know where to find all the ones of real importance. Yours is truly one of the best and I hope this if found by the masses. I have meet many Veterinarians over the years but I don't know if anyone has all the respectful, and admirable personalities which you have..honestly, dedication, humor, just to mention a few. Thank you for all your efforts.
    To all the readers of this blog, please help make a difference for all theses homeless animals who have so much to give back to you.

    Robert Biser

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  2. I do hope you call people with multiple dogs crazies too

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  3. This comment has been removed by a blog administrator.

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    1. Thank you for your input and recommendation. I will try it in future cases.

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  4. Hello Krista,
    The comment made by Anon on January 1, 2016, is from someone hired by Royal Canin to promote their product, and it's an infomercial. The exact same comment has been left on scores of other websites, and cat forums over many many months. It's a shame people fall for the claims of the big pet food companies, and especially the so-called "prescription" products. If you want the best for your pets, you need to feed them raw food, and stay away from any kibble, and not over-vaccinate. There are many vets who have seen the light regarding the significant harm dry-food causes for cats in particular, and one of these is the former technical director for Hill's, Dr Elizabeth Hodgkins. Dr Lisa Pierson DVM also has valuable insight on feline nutrition at her labor-of-love blog. Our own cat family, all hard-to-place rescues, have had their lives turned round by staying away from the garbage made by pet food companies, and are fed both vet-recipe raw food, and commercial raw. The over-touted "prescription" products are poor nutritionally, and based on junk-science, and many feline health issues can be reversed with switching to raw -- also advocated by Dr Jean Hofve, Jackson Galaxy's vet advisor, and by integrative vet Dr Karen Becker. Latter did a first-class interview on pet vaccination protocol with USA's foremost expert, Prof Ron Schulz at the Univ of Wisconsin School of Vet Medicine, that is available on youtube.

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