Difficult Defecation in Cats

Cats of any age can suffer from constipation, although it is more common in middle-aged animals. The frequency of normal defecation varies, but one to three times a day is common in a healthy cat. If a cat has not defecated in two days or longer or is straining to defecate, a veterinary consultation is recommended. If left untreated, constipation can worsen and a fecal impact known as obstipation may occur. This requires hospitalization, intense therapy, and potential manual removal of the fecal obstruction. Straining in the litter box may also be associated with a lower urinary tract infection or obstruction, a condition that requires emergency care.

Constipation is a common problem in cats. It is usually a result of a colon or rectum disorder. Difficult or painful defecation (dyschezia) and the presence of bright red blood in the stools (hematochezia) are common symptoms. The condition may be a temporary problem that resolves itself or it may be indicative of the presence of a more serious condition.

Cats that are suffering from a difficulty with defection will often display one or more of the following symptoms:

• Hard, dry feces
• Blood or mucus on feces
• Frequent attempts at defecation
• Reluctance to defecate
• Whimpering or crying during defecation
• Lumps around the anus
• Draining pus tracts around the anus
• Weight loss
• Poor appetite
• Lethargy
• Vomiting

Difficulty defecating is associated with a variety of possible causes and underlying conditions. Some of the most common are:

• Dehydration
• Inappropriate diet
• Litterbox avoidance 
• Fractured pelvis
• Mass of hair blocking the anus
• Colon inflammation
• Intestinal blockages
• Trauma or injury to anal area Cancer
• Rectal polyps
• Immune disease
• Inflammatory bowel disease (IBD)
• Parasites
• Adverse reaction to medication
• Allergic colitis 
• Prostate disease
• Perineal hernia
• Anal sac infection
• Megacolon (gradual loss of muscle tone in colon)

Diagnosis of constipation or dyschezia is confirmed by the presence of retained faces in the cat’s body. The veterinarian will need a complete medical history and details about the cat’s symptoms, current diet, and any other possible contributing factors. It is likely that common tests will be ordered including a complete blood count (CBC), blood chemical profile, electrolyte panel, and urinalysis. A physical exam will be performed, including abdominal palpation and rectal examination. The vet may order x-rays, an abdominal ultrasound, and may use a colonoscope or proctoscope for visual diagnosis and to obtain tissue samples for biopsy. In some cases, a neurological exam may be needed to rule out spinal cord injury or trauma to the pelvic nerve.

Treatment recommendations will depend on the severity of the constipation and the underlying cause. 

Home Care

It a cat is straining to defecate but is still producing feces daily, home care may be sufficient. As long as the cat remains hydrated, changes in diet may correct the problem. Feeding the cat canned food and adding a small amount of laxative to meals is often helpful. Feeding plain canned pumpkin (not pumpkin pie mix) may help to regulate the affected cat.

For willing owners with compliant cats, short-term use of suppository laxatives may aid in relief. It is best to consult with your veterinarian prior to administering any over-the-counter medication. Owners should be aware that human enema solution should never be used as it contains a high amount of potassium that can be fatal to cats. If the cat fails to defecate after 48 hours, a trip to the veterinarian’s office is highly recommended.

Veterinary Care

If the affected cat is dehydrated or bleeding internally, the veterinarian will treat this immediately. Fluids are likely to be administered either under the skin, intravenously, or both. The vet may perform one or more warm-water enemas and is likely to prescribe laxatives, antibiotics, and/or anti-inflammatory drugs. Balloon dilation, a treatment that slowly widens the intestinal canal to allow feces to be expelled, may be performed.

In severe cases, a manual extraction of the fecal matter may be required. Sedation will be required and multiple attempts may be needed over the course of several days. When rectoanal polyps are present, surgical removal will often be recommended. If constipation is chronic and does not respond to medical treatments, as is often the case with megacolon, a partial or total colectomy may be necessary.

Routine follow-up veterinary appointments are recommended to monitor progress and confirm that underlying conditions have been resolved. The vet will want to observe the cat on a regular basis as it is possible that medications or treatment recommendations may need to be adjusted over time. 

Owners should carefully follow the vet’s instructions and monitor the cat’s activity level and appetite. If the cat presents with bloody stools or symptoms appear to be worsening, it should be brought back to the vet for additional medical attention.