Constipation in Kittens: A Comprehensive Veterinarian’s Secrets to Prevention and Treatment

A surprising number of cats have problems with constipation (abnormal accumulation of stool and difficulty in defecating), and similar but more serious conditions such as constipation (complete obstruction of the colon by stool) and megacolon (damaged nerves and muscles in the colon that cause a inability to defecate). Constipation is uncomfortable, even painful. Constipated cats may defecate (or attempt to) outside of the litter box, because they associate pain or discomfort with the box itself. Other signs of constipation include irritability, a painful abdomen, lethargy, and a lack of appetite or even loss of appetite.

The colon, the last part of the intestinal tract, is a large muscular structure that ends in the rectum. It contains most of the intestinal bacteria that reside in the gastrointestinal (GI) tract. These bacteria finish the digestion of proteins. The by-products of this process include short-chain fatty acids that nourish the cells that line the colon. Some of these lining cells absorb water, while others secrete mucus to lubricate the stool and keep it moving.

Most cats defecate about once a day. A constipated cat can only defecate every 2 to 4 days, or even less. In general, stool is hard and dry, because its long stay in the colon allows the absorption of most of its water content. However, occasionally a constipated cat may appear to have diarrhea, because liquid stool is the only thing that can prevent the stuck mass of stool.

Causes of defecation problems include neurological problems, pelvic injury, obstruction (from hair, bones, etc.), and inflammatory bowel disease (IBD). A dirty litter box can cause a cat to avoid the box and become constipated from holding the stool for too long. Hooded litter boxes are a particular problem because they retain odor, which can make the box environment extremely unpleasant for the cat.

In over 15 years of experience as a feline veterinarian, I know of only 2 cats that had constipation problems and did not eat dry food. Therefore, it is logical to think that diet plays an important role in the development of the problem. Some cats may need more fiber than is present in very low fiber diets, such as most canned, raw and homemade diets. You can always add a pinch of fiber (ground flaxseeds and ground chia seeds, also known as Salba, are reasonably appetizing and work great).

In fact, the initial treatment for constipation is usually a change in diet. Historically, these cats have generally been fed high fiber dry foods. Fiber modulates intestinal mobility. Depending on the type of fiber and the circumstances, fiber can speed up or slow down digestion. Therefore, it is used for both constipation and diarrhea. Light, senior, and hairball foods contain increased fiber, and there are several high-fiber medical diets as well.

Changing your diet usually helps, at least initially. However, over time, these foods often seem to lose their effectiveness over time. More fiber can be added, such as canned pumpkin. Again, this sometimes produces a temporary improvement. However, most of these cats still have problems.

Since fiber encourages water absorption and increases the amount of stool produced (because it is indigestible), many experts have switched to recommending “low residue” diets to minimize stool bulk. “Low residue” means that the food is highly digestible and produces minimal waste. Cats digest protein and fat better, but there is controversy over carbohydrates; it is clear that many cats are intolerant to carbohydrates. According to this theory, the best food would be high in fat, high in protein, and low in fiber, as well as high in moisture. You’d think such a food would also be low in fiber, but that’s not necessarily true. Eukanuba Low Residue dry food contains 4% fiber, which is quite high. Most canned foods fit this description, as do most homemade ones. However, Eukanuba Low Residue manages to incorporate a lot of carbohydrates, even in its canned foods. Reading the label is an important skill to develop.

Fluid balance is essential in constipated cats. Most vets will give constipated cats subcutaneous (or even intravenous) fluids to stimulate hydration.

Treatment for constipation depends on the severity of the problem. For mild cases, occasional enemas may be all they need. For severe blockages, the cat must be anesthetized for manual stool removal (a process that my favorite technology refers to graphically but accurately as “digging”).

Once the cat is “cleaned” by any means, it is advisable to take steps to prevent the problem from reoccurring. There are several options available; An individual cat may need only one of these, while others need several or all of them.

• Canned or homemade diet. High moisture diets keep the cat hydrated, and these diets are much more digestible and produce much less waste than dry foods. Because canned and homemade diets tend to be extremely low in fiber, adding a small amount of powdered psyllium or rice bran (available in bulk at most health food stores) helps.
• Water source. Many cats will drink much more plain water than they will ever drink from a container. There are various types of pet fountains, from “waterfalls” to “waterfalls” and models that could be from Rome. They are available online. Make sure to keep the fountain clean so your cat continues to drink.
• Lactulose This is a sugary syrup that retains water in the stool and keeps the stool soft; therefore, it is easier for the cat to pass. Cats generally don’t like the taste. Fortunately, lactulose now comes in a mild-flavored powder (Kristalose) that can be encapsulated in a compounding pharmacy or simply added to canned foods.
• Other stool softeners, such as DSS (docusate sodium). Your vet can prescribe them.
• Petroleum jelly. The main ingredient in most over-the-counter hairball remedies (Laxatone, Kat-a-lax, Petromalt), Vaseline can be given to the cat by mouth. Most cats tolerate it, many like it, and some even enjoy it. The Vaseline brand is, according to my cats, the tastiest; But other cats prefer one of the flavored hairball types. Give 1/3 to 1/2 teaspoon per day. It can also be mixed with a small amount of canned food. However, it can interfere with nutrient absorption, so it is best given on an empty stomach.
• Cisapride (propulsid). This drug was withdrawn from the market for humans due to dangerous side effects, but it is considered safe for cats. Your vet can order it from a compounding pharmacy. It seems to work best in combination with stool softeners.
• Pediatric glycerin suppositories. Although they may not appreciate having a suppository inserted into the rectum, most cats will tolerate it. Your vet can advise you on technique and frequency.
• Enemas Many cat keepers have gotten good at giving enemas at home. Mineral oil, KY gelatin, soapy water, and warm water are fine; you may have to experiment to see which one works best for your particular cat.
• Slippery elm bark or marshmallow. These herbs can be added to canned foods (add more cold water) or in syrup. Most cats tolerate its mild taste well. They form mucilage, a slippery substance that helps move intestinal contents. There are many herbal formulas available to people, but many herbs, such as Cascara sagrada, they are too harsh for a cat.
• Exercise. Staying active helps stimulate your intestines and keep things moving. If your constipated cat is also addicted to television, try Play Therapy for Cats.
• Stress management. There is always an energetic or emotional component to any chronic illness, and stress plays a role in many gastrointestinal conditions. Flower essences are useful for changing the energy bases of constipation and other gastrointestinal diseases.
• Fluid therapy. Some cats do very well with occasional infusions (daily or weekly) of subcutaneous fluids. Your vet or vet tech can show you how to do this at home. Give fluids whenever you notice that your cat’s behavior indicates impending constipation.
• Surgery. If there is damage to the nerves and muscles of the colon, a “subtotal colectomy” is the last resort. This surgery removes the colon and attaches the small intestine to the rectum. Unless and until the small intestine develops more like the colon, the result is chronic diarrhea. However, the cat will be much more comfortable.

If your cat has chronic constipation, the most important thing to do is be vigilant. Look for the first signs of constipation; exertion, abdominal discomfort, decreased appetite, etc. Take into account how often the cat defecates. If he is not producing adequate stool for more than 2-3 days, call your vet or start home treatments if he has established this routine. Constipation in kittens is much easier to treat when caught early. If you wait, the treatment will be much more expensive and there is a greater chance of irreversible damage to the colon.