Page 473 - Problem-Based Feline Medicine

22 – THE CAT WITH ABDOMINAL DISTENTION OR ABDOMINAL FLUID 465

Large-volume abdominocentesis to reduce uremia. Diagnosis
Peritoneal dialysis will further reduce uremia but is not
Abdominal radiography will demonstrate marked
usually required.
accumulation of feces in the colon.
Ruptured urinary bladders are usually surgically
repaired.
Differential diagnosis
Non-surgical management (catheterization to keep the
The main differential diagnosis for a cat with chronic
bladder empty) has been described in other species. It
dyschezia, tenesmus and abdominal distention is
may be considered if the cat is too unstable for surgery,
colonic neoplasia with metastases resulting in obstruc-
but will not usually reduce costs because of the longer
tive ascites.
hospitalization period.
Ruptured urethras may be treated by surgical repair
Treatment
or by placement of an ante-pubic urinary catheter,
or less optimally by chronic urethral catheterization. For the cat with megacolon sufficiently severe to cause
abdominal distention, subtotal colectomy is recom-
Prognosis mended.
If medical therapy is desired, correct dehydration,
Uroperitoneum in-itself carries a good prognosis.
administer parenteral antibiotics (e.g. ampicillin) to
Uremia will rapidly resolve once the urinary tract is
protect against bacterial translocation, and administer
repaired. Chemical peritonitis from urine also usually
multiple small volume enemas with lactulose prior to
rapidly resolves. Prognosis is largely determined by
anesthetizing the cat for manual disimpaction. Use of
associated injuries.
enema soap will facilitate the latter (do not use
chlorhexidine soaps). If disimpaction is successful,
MEGACOLON** chronic therapy consists of a low-residue diet, lactulose
and prokinetic agents (e.g. cisapride).
Classical signs
● Chronic straining to defecate. JUVENILE ABDOMINAL FLUID**

See main reference on page 783 for details (The Classical signs
Constipated or Straining Cat).
● Mild excess in abdominal fluid encountered
during pediatric ovariohysterectomy.
Clinical signs

Variable anorexia, lethargy, weight loss, unkempt hair- Clinical signs
coat and vomiting.
More peritoneal fluid may be encountered when spay-
Straining to defecate, with the resultant minimal pas- ing a cat at an early age (e.g. 3 months) than at a tradi-
sage of feces that may be dry or mucoid. tional age (e.g. 6 months).
Large volume of firm feces in the colon on abdominal
palpation. Digital rectal examination may reveal nar- Diagnosis
rowing of pelvic canal secondary to fractures or tumor.
The fluid is a transudate.
Neurologic examination may reveal sacral nerve
injury.
Differential diagnosis
Marked colonic dilation may occur causing abdominal
distention. FIP, where the fluid is a non-septic exudate.