Constipation is defined as infrequent or difficult evacuation of the feces. Typically dry hard fecal material is seen. Obstipation is one step further than constipation and is characterized by the inability to pass the accumulation of dry hard feces. This can cause impaction of the entire length of the colon and lead to permanent damage if present for a substantial amount of time.
Clinical signs of constipation can range from straining to defecate to lethargy, depression, decrease appetite to loss of appetite, vomiting and abdominal discomfort. It is also possible that liquid feces are passed around a hard fecal impaction so passing of diarrhea or liquid stools cannot rule out constipation or obstipation. It is important to monitor your pets bowel movements on a regular basis.
Cause of constipation can results from primary intestinal or GI tract disease or secondary to other metabolic disease processes. Primary intestinal disease can range from loss of innervations and lack of motility, stricture formations or congenital malformations to something as simple as dietary indiscretion. Ingestion of rocks, sticks, plant material at times can lead to pain on defecation and lead to straining. Secondary non GI disease causes can range from endocrine disorders that can lead to a persistent state of dehydration such as hyperthyroidism, diabetes mellitus, hypothyroidism, high levels of calcium, low levels of potassium, and kidney disease, to a mechanical obstruction from an enlarged prostate can also cause constipation. Other extra-intestinal causes such as previous trauma to the pelvis from a car accident can narrow the pelvic canal and predispose an animal to constipation and obstipation. Some animals can be too painful to posture to defecate from primary orthopedic disease. Also if your pet is on any oral prescription medications it is possible that side effects include constipation. Lastly excessive grooming from allergies or dermatologic problems can also lead to excessive ingestion of hair and constipation as well.
Some breeds have a higher predisposition to certain diseases. Megacolon is a more common disease in cats than in dogs. Spinal cord deformities are more commonly seen in the Manx cat. German shepherds are over represented in perianal fistulas as well. Any breed predisposed to orthopedic or spinal pain (cruciate ligament ruptures, hip dysplasia etc) such a Golden Retrievers, Labradors, etc. can also be predisposed to constipation/obstipation.
For a simple constipation or first time constipation drastic measures do not need to be taken. If there are no concerns of pelvic malformations or motility disorders bulking up the diet by adding fiber can help increase stimulation and contraction of the GI tract this can be achieved by adding canned pumpkin (not pumpkin pie filling), Metamucil or other human fiber supplements. There are prescription high fiber diets available through your primary veterinarian’s office as well. Another option is adding an oral stools softener. The most commonly used oral stool softener is lactulose. Over the counter laxatone can also be used. Historically, an at home remedy was giving mineral oil to your pet. This is NOT RECOMMENDED by veterinarians. The mineral oil is tasteless and can be accidentally aspirated into the lungs. Due to the oily consistency of it, it can cause significant damage and chronic lung disease.
If an enema is needed there are various enema options. We recommend that you consult a veterinarian before attempting to give an enema on your own. Giving the wrong type of enema can lead to complications and most animals require light to heavy sedation for enema administration. Again, please contact your veterinarian for enema options.
If your pet has a metabolic, mechanical, or functional problem leading to constipation it would be better to manage their disease process by making the stools less bulky and smaller. This can be achieved by feeding a low residue high digestibility diet. These diets are readily available through your primary veterinarian’s practice.
Recurring constipation may be treated similarly however the diet changes and oral stool softeners may need to be given long term. Some additional medications in addition to an oral stool softener may include motility drugs. Do not change any doses of medications without consulting your veterinarian first. It may also be necessary to address the primary problem, i.e., get better control of the diabetes, give additional fluids under the skin for chronic kidney disease, neutering for enlarged prostates. If medical management is not successful a subtotal colectomy may be needed. A subtotal colectomy can have many complications and risks associated with it and should not be taken lightly. Consulting a surgeon and going over potential complications such as constant diarrhea, incontinence, bacterial overgrowth should be discussed prior to under taking a radical surgery.
In obstipated animals they will commonly require IV fluid therapy, repeat enemas, and manual deobstipation under heavy sedation by veterinarians. Repeat stretching and filling of the colon with hard stools can lead to megacolon or severe distention of the colon and loss of motility and function.
To avoid repeat constipation and or constipation fixing the underlying cause is recommended. Make sure animals with primary endocrine diseases have access to water at all times. Place ice cubes in the water, multiple water bowls in different areas of the home, or having a water fountain are ways to increase drinking. Again please consult your veterinarian with any questions or concerns.