Pathogenesis, diagnosis, and therapy of feline idiopathic megacolon

Scientific advances in the past decade have brought new understandings to t he pathogenesis and therapy of feline colonic motility disorders. Epizootio logic studies have shown, for example, that 96% of the documented cases of obstipation are accounted for by idiopathic megacolon (62%), pelvic canal s tenosis (23%), nerve injury (6%), or Manx sacral spinal cord deformity (5%) . Recent physiologic studies suggest that most of the idiopathic cases resu lt from colonic smooth muscle dysfunction. The latter studies have also pro vided evidence that colonic prokinetic agents are useful adjunctive therapy in the treatment of constipation. Many cats are now successfully treated w ith multicomponent therapy (i.e., dietary fiber supplementation, emollient or hyperosmotic laxatives, and colonic prokinetic agents). Those cats who f ail to respond to conservative medical management will generally manifest m arked clinical improvement with subtotal colectomy.