Page 787 - Problem-Based Feline Medicine

34 – THE CAT WITH SIGNS OF LARGE BOWEL DIARRHEA 779

Treatment Clinical signs

Surgical removal is curative. Large bowel diarrhea and flatulence.
Recurrence is unusual. Constipation.
Abdominal pain (due to typhilitis or gas distention).
Prognosis
Diagnosis
Excellent.
These are rare congenital diseases.
CONGENITAL MALFORMATIONS (SHORT Kittens are usually presented at just weeks of age.
COLON SYNDROME, VASCULAR ECTASIA,
DIVERTICULUM) Blood work (CBC, profile) will usually be completely
normal.

Classical signs Survey radiographs will generally not be helpful,
except in cases of short colon syndrome, where the
● Signs depend on the location of the
colon may be visibly abnormal.
anomaly.
● Large bowel diarrhea, constipation or Contrast radiographs may be very helpful in identi-
abdominal pain (typhilitis). fying short colon syndrome.
● Young cats or kittens, and do not worsen
Ultrasonography is very useful in identifying an
with age, except with short colon
abnormal enterocyst, but colonoscopy or surgical
syndrome.
exploration may be required to make the definitive
diagnosis.
Pathogenesis Differential diagnosis
The etiopathogenesis of the congenital malformations The differentials are usually limited to those things
affecting the large bowel is unknown. causing colonic disease in kittens, e.g. parasites,
infectious, mechanical (foreign objects) and dietary
The most frequently reported malformations affect-
indiscretion or food intolerance.
ing the large bowel are vascular ectasia, short colon
syndrome and enterocyst formation.
Treatment
Vascular ectasia is a syndrome of abnormal blood
Treatment of vascular ectasia and enterocysts is via
vessel formations that results in abnormal bowel func-
surgical resection of the affected area(s).
tion (especially motility) due to the lack of a normal
blood supply. Short colon syndrome must be managed medically
by providing a low-residue diet (e.g. Hill’s i/d diet,
Short colon syndrome can be congenital or iatro-
Iam’s low residue diet or IVD neutral formula), use of
genic (secondary to surgical removal of the colon due
motility-modifying drugs as needed (e.g. lomotil,
to neoplasia or other disease). Cats with short colon
loperamide), and antibiotics when they are indicated.
syndrome are unable to reabsorb water and elec-
trolytes and thus, are not able to form normal feces Prognosis
without providing very highly digestible diets that
reduce the amount of ingesta that reaches the colon. The prognosis is guarded to good, depending on the
anomaly that is present.
Diverticular formations are also found, however, they
can be congenital or secondary to chronic disease. Cats with vascular ectasia or enterocysts that can be
corrected surgically have a very good prognosis.
Many diverticular formations are incidental findings
and are not associated with abnormal colon function Cats with short bowel syndrome have a very guarded
unless they are large or become diseased. prognosis and will require life-long therapy.