Subtotal colectomy for treatment of chronic constipation associated with idiopathic megacolon in cats: 38 cases (1979-1985)

Chronic constipation, nonresponsive to medical management and associated with idiopathic megacolon, was diagnosed in 38 cats from 1979 to 1985. All cats were treated by subtotal colectomy and enterocolostomy, in which the ileum or distal portion of the jejunum was joined to a 2- to 4-cm segment of distal portion of the colon preserved to accommodate an end-to-end anastomosis. After surgery, cats usually were depressed and anorectic, had tenesmus, and passed liquid tarry feces. In 37 cats 1 week to 3 months after surgery, character of the feces changed from diarrhea to soft semiformed or formed feces. One cat had severe diarrhea that was nonresponsive to diet change and pharmacologic treatment; the diarrhea resolved after 4.5 months. One cat developed a stricture of the enterocolostomy, which was relieved by 3 balloon catheter dilatations. All cats regained normal appetite, did not lose weight, and were not incontinent. Three cats had sporadic episodes of constipation and were easily treated. Results of histologic examination of the resected portion of colon in 23 cats were inconclusive.     

Subtotal colectomy for treatment of acquired megacolon in the dog and cat

The case records of 4 cats and 1 dog with megacolon and constipation were reviewed to study the history, clinical signs, pathologic changes, and longterm results of surgical treatment. The 4 cats had idiopathic megacolon. The dog had megacolon secondary to dietary indiscretion. All animals had radiographic evidence of a large colon, which was confirmed by exploratory coeliotomy. Two of the cats and the dog had an intraoperative finding of megacecum as well. Subtotal colectomy was performed in all cases, with the ileocolic valve being removed in 3 of these cases. End-to-side anastomosis was used to restore the integrity of the bowel. All animals were treated successfully with this surgical technique, as judged by clinical response and owner satisfaction. Histologically, there were no consistent lesions to explain the cause of this disease in the cats.     

Subtotal colectomy and ileocolonic anastomosis in a Vietnamese pot-bellied pig with idiopathic megacolon

A 7-month-old sexually intact female Vietnamese pot-bellied pig was evaluated because of constipation. On abdominal palpation, a hard tubular structure was palpated in the middle of the abdomen. Abdominal radiography revealed loops of intestine that were markedly distended with ingesta, consistent with obstructive intestinal disease. On exploratory celiotomy, a massively distended cecum and spiral colon were found. A subtotal colectomy, with a side-to-side ileocolonic anastomosis, was performed. The cause of the megacolon was not discovered. The pig did well following surgery and eventually defecated normally following an initial period of diarrhea. To our knowledge, this is the first report of therapeutic removal of a substantial portion of the large intestine in swine. Our decisions concerning the pig of this report were based largely on our knowledge of megacolon in cats. The outcome for this pig indicates that subtotal colectomy along with removal of the cecum and ileocecal valve can be used to successfully treat idiopathic megacolon in Vietnamese pot-bellied pigs.     

Comparison of biofragmentable anastomosis ring and sutured anastomoses for subtotal colectomy in cats with idiopathic megacolon

OBJECTIVE: To report use of a biofragmentable anastomosis ring (BAR) device in cats with idiopathic megacolon (FIM) and compare outcome after subtotal colectomy with sutured colocolic anastomosis. STUDY DESIGN: Retrospective study. ANIMALS: Nineteen cats with megacolon. METHODS: Medical records (January 1990-January 2004) of cats treated surgically for idiopathic megacolon with sutured (SUT) or BAR anastomosis were retrieved and reviewed. Operative, short- and long-term complications, and survival times were recorded and Kaplan-Meier survival analysis used to assess outcome. RESULTS: There were 11 SUT and 8 BAR cats. One BAR cat had anastomotic dehiscence 36 hours after surgery. Mild serosal tearing during BAR insertion in 6 cats was corrected by suture reinforcement. One SUT cat developed anastomotic stricture at 32 days. Short-term complication rates at 3 and 7 days were 18% and 45% in the SUT group and 25% and 87.5% in the BAR group, respectively (P=.058). Two SUT cats had persistent loose stool consistency and were euthanatized 254 and 1661 days after surgery. One BAR cat had recurrence of constipation which was managed medically. Long-term complication rates were not significantly different between SUT and BAR (P=.61). The 1 and 4-year survival rates were 90% for SUT and 100% for BAR (P=.29). CONCLUSIONS: No difference was detected for short and long-term complication rates and survival times between SUT and BAR groups. CLINICAL RELEVANCE: The BAR device can be used for colocolic anastomosis in cats with idiopathic megacolon. Serosal tearing during BAR insertion was a common intraoperative complication. Regardless of anastomotic technique, survival outcome after colonic resection is excellent for cats with FIM.     

Preservation versus excision of the ileocolic junction during colectomy for megacolon: A study of 22 cats

From 1984 to 1991, 22 cats with megacolon underwent colectomy by end-to-end anastomosis of the distal colon to either the proximal colon (preserving the ileocolic junction in 14 cats) or to the distal small intestine (excising the ileocolic junction in eight cats). During the postoperative adaptive period, the two groups showed similar stool consistency, and the presence of either anorexia, lethargy, weight loss or diarrhoea with faecal incontinence. During the long term post-operative adaptive period, no significant difference in recurrent constipation was found between the two groups. The overall constipation rate after colectomy was 45 per cent (10 cats), and because of constipation recurrence 18 per cent (four cats) were euthanased, and 18 per cent (four cats) required further surgery. Long term following colectomy, those cats which under-went excision of the ileocolic junction had significantly looser stools than those cats in which the ileocolic junction was preserved. The preservation of the ileocolic junction during colectomy is therefore recommended.     

Transanal pull-through rectal amputation for treatment of colorectal carcinoma in 11 dogs

Objective— To evaluate outcome after transanal rectal pull-through amputation of single colorectal adenocarcinoma and in situ carcinoma (T is ) in dogs.
Study Design— Retrospective case series.
Animals— Dogs (n=11) with colorectal cancer.
Methods— Full-thickness colorectal amputation by either simple transanal (7 dogs) or combined abdominal–transanal (4) pull-through technique.
Results— Adenocarcinoma (8) and T is (2) were removed with 3–6 cm of grossly normal tissue, cranial and caudal to the tumor, or in 1 T is with 2 cm grossly normal tissue, cranial and caudal. Two dogs that had a combined abdominal–transanal approach died within 4 days. In the other dogs, postoperative complications included short-term tenesmus (6 dogs), rectal bleeding (11), rectal stricture (3), and long-term fecal incontinence (1). Postoperative recurrence and metastatic rates for adenocarcinoma were 18.2% and 0%, respectively. Median disease-free interval and survival time were not reached. Mean disease-free and overall survival times were 44.3 and 44.6 months (range, 0–75 months), respectively.
Conclusion— En bloc excision of colorectal T is and adenocarcinoma may be followed by a long survival. Complications of the transanal approach are usually moderate and self-limiting, but complications are more common and severe when more extensive resections are performed through a combined abdominal–transanal approach.
Clinical Relevance— Transanal rectal pull-through amputation is suitable for en bloc resection of colorectal neoplasia. A combined abdominal–transanal approach should be reserved for tumors extending from the mid-cranial region of the rectum to the descending colon.     

Long-term results of subtotal colectomy for acquired hypertrophic megacolon in eight dogs

Objectives : To evaluate the long‐term results of subtotal colectomy for acquired hypertrophic megacolon in the dog. Methods : Eight dogs with acquired hypertrophic megacolon underwent subtotal colectomy with preservation of the ileocolic junction. Long‐term follow‐up was obtained by clinical records and telephone interviews with the owners. Results : Eight large‐breed dogs (age range: 6 to 12 years; mean age: 10·75 years) were enrolled. The use of bone meal, low levels of exercise, chronic constipation with dyschesia and tenesmus refractory to medical management were factors predisposing dogs to acquired hypertrophic megacolon. The diagnosis was confirmed in all animals by abdominal palpation, plain radiography and postoperative histopathological findings. There were no intraoperative complications. One dog died as a result of septic peritonitis. The clinical conditions (that is, resolution of obstipation and stool consistency) of the remaining seven dogs were improved at discharge; all animals returned to normal defecation in five to 10 weeks (mean: 7·3 weeks) and were alive 11 to 48 months (mean: 40·5 months) after surgery. Clinical Significance : Predominantly bony diet and/or low levels of physical activity may predispose dogs to acquired hypertrophic megacolon. Our results emphasise the long‐term effectiveness of subtotal colectomy with preservation of the ileocolic junction in this condition.     

Long-term evaluation of the pull-through technique for vertical canal ablation for the treatment of otitis externa in dogs and cats

Between January 1985 and May 1987 53 ears of 35 dogs and five cats with chronic otitis externa were operated on using the pull-through technique for vertical canal ablation. Their postoperative follow-up is analysed, evaluated and described in detail.     

Levetiracetam as an adjunct to phenobarbital treatment in cats with suspected idiopathic epilepsy

OBJECTIVE: To assess pharmacokinetics, efficacy, and tolerability of oral levetiracetam administered as an adjunct to phenobarbital treatment in cats with poorly controlled suspected idiopathic epilepsy. DESIGN-Open-label, noncomparative clinical trial. ANIMALS: 12 cats suspected to have idiopathic epilepsy that was poorly controlled with phenobarbital or that had unacceptable adverse effects when treated with phenobarbital. PROCEDURES: Cats were treated with levetiracetam (20 mg/kg [9.1 mg/lb], PO, q 8 h). After a minimum of 1 week of treatment, serum levetiracetam concentrations were measured before and 2, 4, and 6 hours after drug administration, and maximum and minimum serum concentrations and elimination half-life were calculated. Seizure frequencies before and after initiation of levetiracetam treatment were compared, and adverse effects were recorded. RESULTS: Median maximum serum levetiracetam concentration was 25.5 microg/mL, median minimum serum levetiracetam concentration was 8.3 microg/mL, and median elimination half-life was 2.9 hours. Median seizure frequency prior to treatment with levetiracetam (2.1 seizures/mo) was significantly higher than median seizure frequency after initiation of levetiracetam treatment (0.42 seizures/mo), and 7 of 10 cats were classified as having responded to levetiracetam treatment (ie, reduction in seizure frequency of >or=50%). Two cats had transient lethargy and inappetence. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that levetiracetam is well tolerated in cats and may be useful as an adjunct to phenobarbital treatment in cats with idiopathic epilepsy.     

Pathogenesis, diagnosis, and therapy of feline idiopathic megacolon.

Many cats have one or two episodes of constipation without further recurrence, although others progress to complete colonic failure. Middle-aged male cats are particularly at risk for the clinical continuum of constipation, obstipation, and dilated megacolon. Pelvic canal stenosis and nerve injury are minor causes in the development of this syndrome. In most affected cats, the underlying pathogenesis appears to involve colonic smooth muscle dysfunction. In this group of cats, it is not yet clear whether this disorder represents a primary or secondary (resulting from long-standing constipation and colonic distension) abnormality. Many cats with mild to moderate constipation respond to conservative medical management (e.g., dietary fiber supplementation, emollient or hyperosmotic laxatives, colonic prokinetic agents). Indeed, early use of colonic prokinetic agents is likely to prevent the progression of constipation of obstipation and dilated megacolon in many cats. Some cats may become refractory to these therapies, however, as they progress through moderate or recurrent constipation to obstipation and dilated megacolon. These cats eventually require colectomy. Cats have a generally favorable prognosis for recovery following colectomy, although mild to moderate diarrhea may persist for 4 to 6 weeks postoperatively in some cases.     

An idiopathic facial dermatitis of Persian cats

The clinical and histopathological features of 13 Persian cats which presented with chronic skin disease primarily affecting the face are described. Lesions were characterized by black material adherent to the skin and hair, accompanied by erythema and variable degrees of excoriation. Concurrent ceruminous otitis externa was observed in 7 cases. Histopathological examination of skin biopsy specimens showed marked acanthosis with crusting, hydropic degeneration and dyskeratotic basal epithelial cells, a mixed diffuse superficial inflammatory infiltrate and sebaceous hyperplasia. Malassezia pachydermatis yeasts and various bacteria were isolated from the lesions in some of the cats but in no case was antimicrobial therapy curative. The response to glucocorticoids was variable and often poor. No satisfactory therapeutic regimen could be identified and the cause of the disorder is unknown although a genetic basis is possible.     

Review of idiopathic feline vestibular syndrome in 75 cats

Idiopathic feline vestibular syndrome, a peripheral vestibular deficit of unknown cause, was diagnosed in 75 cats at the New York State College of Veterinary Medicine Teaching Hospital from July 1975 to October 1984. Review of the medical records of these cats indicated that the syndrome was seen in more cats in July and August (P less than 0.001) than in other months. Clinical signs included head tilt, ataxia, rolling, rotatory or horizontal nystagmus, and occasional vomiting.     

Food sensitivity in cats with chronic idiopathic gastrointestinal problems

The objectives of this study were to investigate the prevalence of food sensitivity in cats with chronic idiopathic gastrointestinal problems, to identify the food ingredients responsible, and to characterize the clinical features. Seventy cats that presented for chronic gastrointestinal signs underwent diagnostic investigation. Fifty-five cats had idiopathic problems and were entered into the study. Diagnosis of food sensitivity was made by dietary elimination-challenge studies by using commercial selected-protein diets as the elimination diet. Sixteen (29%) of the 55 cats with chronic idiopathic gastrointestinal problems were diagnosed as food sensitive. The clinical signs of another 11 cats (20%) resolved on the elimination diet but did not recur after challenge with their previous diet. The foods or food ingredients responsible for the clinical signs were dietary staples. Fifty percent of affected cats were sensitive to more than 1 food ingredient. The clinical feature most suggestive of food sensitivity was concurrent occurrence of gastrointestinal and dermatological signs. Weight loss occurred in 11 of the affected cats, and large-bowel diarrhea was more common than small-bowel diarrhea. Assay of serum antigen-specific immunoglobulin E (IgE) had limited value as a screening test, and gastroscopic food sensitivity testing was not helpful. In conclusion, adverse reactions to dietary staples were common in this population of cats, and they responded well to selected-protein diets. Diagnosis requires dietary elimination-challenge trials and cannot be made on the basis of clinical signs, routine clinicopathological data, serum antigen-specific IgE assay, gastroscopic food sensitivity testing, or gastrointestinal biopsy.     

The urinary lipid profile in cats with idiopathic cystitis

Although feline idiopathic cystitis (FIC) distresses of many cats, its pathogenesis is unknown and the diagnosis is challenging. Polyunsaturated fatty acids (PUFAs) are metabolized into various lipid mediators. Lipid mediators such as prostaglandins (PGs) modulate inflammation and many of them are excreted into the urine. Thus, the investigation of the urinary lipid profile may reveal pathogenesis and help diagnosis of FIC. We collected urine samples from five FIC cats by spontaneous urination and analyzed 158 types of lipid mediators in urines using liquid chromatography-mass spectrometry. The urinary levels of PUFAs were higher in FIC compared to those of the healthy group. The excretions of a major inflammatory mediator, PGD₂, were less in FIC. Other well-known inflammatory mediators such as PGE₂, PGI₂, and their metabolites did not show a difference. In contrast, the levels of PGF_2α and its 2 metabolites and PGF_3α were higher in FIC. These results may provide new insights into the future management of cat FIC.     

Ketoconazole for treatment of dermatophytosis in cats.

Twelve cats with generalized dermatophytosis were treated with ketoconazole (10 mg/kg of body weight, PO, with food, q 24 h). This treatment was successful in 8 cats, with resolution of lesions and negative findings on mycologic evaluation after 2 to 10 weeks (median duration, 6 weeks). One additional cat failed to improve initially, but complete resolution was achieved after the dosage of ketoconazole was doubled. Adverse effects in 3 cats included anorexia, weight loss, vomiting, and diarrhea.