Megacolon in cats

Re: Megacolon in cats

Martin Atkinson — Fri, 21 Oct 2011 12:50:42 GMT

[quote user="Richard Carter"]

Was a really good talk by Margery Scherk BSAVA/ FAB last year where she recommended sx over medical as medical always breaks down and the owner has to rx every day. Anyway bit the bullet and did total colectomy on megacolon cat the other day and not only no further problems but has put on 300g in 10 days. The surgery is in fact easy - - colon easily accessible and all blood vessels easy to identify. The longest part was finding that the sub-total colectomy couldn't reach the rectum without tension on the mesentry but easy to attach once caecum also removed. Standard antibiotics, omental covering sx site, A/d first few days. Cat now outside running up trees.

[/quote]

You're right Richard the surgery is easy but it is not always the choice of the client, in fact most of them would rather dose daily with lactulose than go for surgery. Surgery is clearly not without risk from complications and I would argue with Margery's view: all the medically managed cases I have where the client has followed follow-up instructions are doing OK, as previously suggested it is monitoring and titrating dose of laxative that is the key. If they go away and don't come back most will re-impact within a few months.

Re: Megacolon in cats

Richard Carter — Fri, 21 Oct 2011 10:45:55 GMT

Re: Megacolon in cats

Martin Atkinson — Fri, 21 Oct 2011 09:35:07 GMT

[quote user="KathW"]

Can you still obtain cisapride?

[/quote]

Cisapride is available in the UK from Summit Veterinary www.svprx.co.uk, in cat doses what's more. I have managed all bar one of my megacolon cases non-surgically with just lactulose but I insist on them coming back for an examination at least every month even when apparently stable, once a week if they're not, it is ensuring that there is no build up of faeces before impaction occurs and judicious use of a Microlax that does the job, so to speak, IMO.

Re: Megacolon in cats

Gerry Henry — Fri, 21 Oct 2011 09:30:56 GMT

Any other symptoms, not Key Gaskell is it? Saw loads in the '80s then nothing until a few years ago when we had a classic one.

Re: Megacolon in cats

SteveOwen — Thu, 20 Oct 2011 23:37:49 GMT

Low residue!! Eg RC gastrointestinal.

Re: Megacolon in cats

David Mills — Thu, 20 Oct 2011 23:18:38 GMT

Which dietary management? Low or high residue?

And what's the thinking behind ranitidine?

Re: Megacolon in cats

David Mills — Thu, 20 Oct 2011 23:17:44 GMT

[quote user="KathW"]

Can you still obtain cisapride?

[/quote]

Not easily - think it's on import licence? Try erythromycin instead at 1-2mg/kg. Can get this as paedriatric suspension which works out about 0.5-1ml TID. Incredibly cheap cf cisparide.

If getting nowhere then subtotal colonectomy is very effective, but shoud be done quite early - progressive constipation seems to lead an ascending gut paralysis.

Re: Megacolon in cats

KathW — Thu, 20 Oct 2011 22:31:55 GMT

Can you still obtain cisapride?

Re: Megacolon in cats

Andrew Kent — Thu, 20 Oct 2011 22:28:52 GMT

Usually try medical management first with ranitidine, lactulose +/- cisapride plus dietary management. If not controlling then can consider surgery but I think it is rare to have to resort to this. Andy