Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats

Grossman, Rachel; Sumner, Julia P.; López, D.; Dornbusch, Josephine A.; Singh, Ameet; Lux, Cassie N.; Sample, Susannah J.; Liptak, Julius M.; Grimes, Janet A.; Upchurch, David A.; Blumenthal, Michael S.; Traverson, Marine; Buote, Nicole J.; Marvel, Sarah J.; Steffey, Michelle A.; Arai, Shiori; Little, Jeffrey P.; Atilla, Aylin; Huck, Jennifer; Pitt, Kathryn A.

doi:10.2460/javma.20.07.0418

Cited by 3 publications

(11 citation statements)

References 12 publications

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“…In this study, the most presenting cats with megacolon were domestic shorthair breeds, which is comparable to another study where 61.4% of cats were domestic shorthairs (17). We also found male cats were presented with 6.1 years (SD: 3.05) median age and 4.3 kg (SD: 0.87) weight, relative to another study where they reported the median age and weight of the affected cats were 8.6 years and 5.3 kg, respectively (17).…”

Section: Discussionsupporting

confidence: 90%

“…In the present study, cats with idiopathic megacolon had obstipation (tenesmus without defecation), which is similarly presented by another study, as the principal clinical sign (17). Obstipation means there is no bowel motility, whereas constipation means there are about ≤3 bowel motility per week (5).…”

Section: Discussionsupporting

confidence: 83%

“…In this study, the median duration of clinical signs before admittance was 11.25 months (SD: 5.66). Another study demonstrated that the median preoperative duration of clinical signs of megacolon in cats was 24 months (IQR, 12-42 months) (17). More importantly, herein, in feline cases having ≥6 months duration of clinical signs showed unsatisfactory medical treatment due to irreversible colonic changes, hence sub-total colectomy was the only intervention of choice with satisfactory results.…”

Section: Discussionmentioning

confidence: 71%

“…Megacolon is irreversible dilation and dysmotility of the colon and eventually resulted from chronic constipation/obstipation. In felines, idiopathic megacolon has been recently reported to affect an estimated 182 cats during 18 years within 18 veterinary hospitals worldwide (17). Improving the prognosis of megacolon is challenging which is in part due to the difficulty in treating cats with megacolon medically.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, secondary megacolon in 9 dogs was effectively treated with subtotal colectomy (8). Moreover, in cats, a retrospective study has shown that sub-total colectomy was highly successful in treating idiopathic megacolon with an improvement in survival rate, however, excision of ICJ was accompanied by less satisfying outcomes (17).…”

Section: Discussionmentioning

confidence: 99%

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Use of radiographic and histologic scores to evaluate cats with idiopathic megacolon grouped based on the duration of their clinical signs

et al. 2022

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Since the duration of clinical signs could be used to identify cases of chronic constipation, in addition, prolonged duration is often associated with irreversible changes. Thus, the main objective of this study was to determine whether the duration of clinical signs of idiopathic megacolon in cats affected their diagnosis and prognosis after treatment. Medical records of cats that either had confirmed megacolon for an unknown cause (cat patients) or with normal bowels (control cats) were reviewed. Cat patients were grouped based on the duration of their clinical signs (constipation/obstipation) to cats <6 months and ≥6 months. For all feline patients, abdominal radiographs (for colonic indexes) and resected colon specimens (for histology) were assessed vs. control cats. Treatment applied to cat patients was also evaluated. Cat patients were older (p = 0.0138) and had a higher maximum colon diameter (MCD; mean 41.25 vs. 21.67 mm, p < 0.0001) and MCD/L5L ratio (1.77 vs. 0.98, p < 0.0001) than controls. Compared to cats with <6 months, cats ≥6 months showed a higher MCD (43.78 vs. 37.12 mm, p < 0.0001) and MCD/L5L ratio (1.98 vs. 1.67, p < 0.0001). Histologically, increased thickness of the smooth muscularis mucosa (54.1 vs. 22.33 μm, p < 0.05), and inner circular (743.65 vs. 482.67 μm, p < 0.05) and outer longitudinal (570.68 vs. 330.33 μm, p < 0.05) smooth muscular layers of the muscularis externa was noted only in cat patients with ≥6 months compared to controls. Similarly, fewer ganglion cells (0.93 vs. 2.87, p < 0.005) and more necrotized myocytes (2.25 vs. 0.07, p < 0.005) were observed in cats with ≥6 months. In contrast to <6 months, the majority of cats (94.4%) with ≥6 months duration did not show any response to medical treatment and therefore underwent surgery with favorable results. In conclusion, this study suggests that the duration of clinical signs should be considered in conjunction with maximal colon scores to evaluate cats for idiopathic megacolon and determine the level of treatment. Functional abnormalities of the colonic smooth muscles may be a possible cause of idiopathic megacolon in cats.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Use of radiographic and histologic scores to evaluate cats with idiopathic megacolon grouped based on the duration of their clinical signs

et al. 2022

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Surgical intervention for the correction of fecal impaction in an obstipated cat with an old compression injury in the lumbosacral region of the spine

Munif,

Safawat,

Hannan

2023

Bull Natl Res Cent

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Background Feline obstipation is a clinical condition often manifested by defecation inability that results in fecal impaction. This is frequently associated with a blunt traumatic injury that affects mostly the spine and surrounding structures in the caudal part of the back leading to vertebral compression. Case presentation A 6-month-old, female, mixed-breed cat of 1.49-kg BW was presented with a history of prolonged constipation (i.e., obstipation) along with discomfort and weakness. Prior to the presentation, the cat was medically treated with dietary fibers, fecal softeners, and enemas, but obstipation persisted. Clinical examinations revealed that there was straining but not effective for defecation. In addition, the cat had poor appetite and dehydration, electrolyte abnormalities, and defects in posture and gait. The lumbosacral region showed a depression that was supposed to be the consequence of an old, untreated regional injury. Radiographic imaging indicated a marked ventral curvature in the lumbosacral spine including major deviations in the positions of the L6 and L7 vertebrae and the sacrum as well. A firm tubular structure was felt on ventral abdominal palpation, and further ultrasonography revealed the tubular impaction. Laparotomy exposed a definite large bowel impaction, and enterotomy was performed to evacuate the firm feces. Postoperatively, supportive medications and care were provided for better recovery. However, the impaction recurred within 3 months after surgery, and euthanasia was a further choice. Conclusions Traumatic injuries involving the lumbosacral spine in cats might be serious enough to lead to severe constipation and thereby bowel impaction. Therefore, treatment should be prompt and accurate in any case of spinal injury to avoid further complications.

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Surgical Anatomy of the Gastrointestinal Tract in Cats

Angelou,

Fiska,

Tsingotjidou

et al. 2023

Animals

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In cats, the gastrointestinal tract is one of the regions in which surgical procedures are most frequently performed by veterinary surgeons; therefore, knowledge of the surgical anatomy of the feline gastrointestinal tract is of high importance. The main surgical procedures performed include gastrotomy, gastrectomy, enterotomy, and enterectomy, as well as procedures in the liver and pancreas. There are also anatomical differences between dogs and cats, increasing the need for deep knowledge of the anatomy treated in the different surgical approaches. The aim of the present review is to describe in detail the anatomy of the gastrointestinal tract in cats highlighting the anatomical regions of significant importance in different surgical procedures.

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Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats

Cited by 3 publications

References 12 publications

Use of radiographic and histologic scores to evaluate cats with idiopathic megacolon grouped based on the duration of their clinical signs

Use of radiographic and histologic scores to evaluate cats with idiopathic megacolon grouped based on the duration of their clinical signs

Surgical intervention for the correction of fecal impaction in an obstipated cat with an old compression injury in the lumbosacral region of the spine

Surgical Anatomy of the Gastrointestinal Tract in Cats

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