This is a radiograph of a 14 year old cat. She was brought in because the owner said that she had not defecated for 2 months. Hard stool in the colon was palpated and a radiograph was taken. The large white tube in her abdomen is her colon packed with hard stool. The pelvic inlet is where the stool is lodged and cannot exit that small opening. The colon is widely distended. The wide distention is called megacolon-a more common problem in middle age to older cats. The colon loses is contractility and stretches. The normal intestinal peristaltic movement to defecate is lost. The diagnosis for this cat is Constipation/Megacolon.
Multiple enemas, subcutaneous fluids to rehydrate her, stool softeners, and manual break down of the stool by external palpation is her treatment. A manual evacuation of the stool may be the next step under anesthesia.
If she can be evacuated, she will be placed on a prescription diet with soluble fiber, stool softeners, laxative if needed, and possibly medication to increase contractility of her colon. In cases where medical management no longer solves the problem, there is a surgical procedure called a subtotal colectomy (remove the colon) that can be done that will usually will resolve the situation, but not without risks.