ACUTE COLITIS
Colitis is inflammation of the large bowel or colon. It is quite common, most often brought about by some other offending
substance that irritates the bowel. These include the ingestion of table foods or garbage, whipworms, giardia, foreign objects
that do not block but that irritate the bowel allowing a bacterial infection to begin, food allergies, the eating of certain plants and
systemic fungi. As the bowel becomes inflamed, mucus and blood may be produced and become present in the stool.
The clinical signs of colitis include diarrhea that will often consist of frequent but smaller stools that may be watery, mucoid
and/or bloody. The cat may strain to defecate, which is often confused with constipation, and many cats show obvious
discomfort. Fever, dehydration, abdominal pain, foreign objects in the stool and an increased need to defecate are also
common symptoms. (Colitis Diarrhea)
It should be understood that cats do on occasion pass blood in their stool for no apparent reason. This is called Idiopathic
Hematochezia and is considered normal when sporadic and no other symptoms exist. Diagnosis is based on history, physical
examination, fecal analysis, colonic cytology, fecal culture, X-rays and colonoscopy. Many cases of colitis may occur
concurrently with cases of enteritis.
TREATMENT OF COLITIS
Most cases of acute colitis will respond quickly when properly treated. Treatment of intestinal parasites should be done if
needed. Giving only liquids for 24-48 hour so the bowel can rest is very important. Then, gradual introductions of a bland, low
fat and easily digestible food for a week or two works well. Antibiotics, anti-inflammatory medications, motility modifiers to
slow diarrhea and fluids for dehydration also help these patients.
CHRONIC COLITIS (ULCERATIVE COLITIS)
If a cat has recurrent or continuous bouts of colitis, changes in bowel function, alteration of the health of the bowel lining and
ulceration are likely to occur. While many possible causes for this condition have been proposed, the exact cause of this
inflammatory syndrome has not been determined. Dietary intolerance including food allergy, whipworms, histoplasmosis,
inflammatory bowel disease and other more specific causes of colonic disease have all been implicated. Tumors and polyps
may also mimic chronic colitis. In some cases no cause may ever be determined.
The symptoms of chronic colitis include chronic diarrhea which includes frequent defecation but passing only small stools,
mucus and liquid consistency to the stools, blood in the stool, urgency to defecate, straining to defecate and pain upon
defecation. Many cats will otherwise appear normal; a few may loose weigh, have a fever and be sensitive to touch. Diagnosis
is based on physical examination, stool analysis, blood counts and serum chemistries, X-rays including dye studies,
colonoscopy and colonic biopsy.
TREATMENT OF CHRONIC COLITIS
Many cases of chronic colitis respond well to the feeding of either a high fiber food or a highly digestible food low in fat. Cats
should be on an extremely strict diet, as often any other food will stimulate the colitis. In some cases, special, non-allergenic
foods work well. The use of antibiotics can be effective, as has metronidazole in some cases. While it is generally not advised,
cortisone like drugs seems to help in a small percentage of cats. Some cats will benefit from the use of stool binders of various
types.
LYMPHOCYTIC/PLASMACYTIC COLITIS
Lymphocytic/plasmacytic colitis occurs when millions of lymphocytes and plasmacytes (these are types of white blood cells)
infiltrate and line the colon. This will most likely occur in conjunction with lymphocytic/plasmacytic enteritis. This is also
considered a type of Inflammatory Bowel Disease. The exact cause is not known, but it is thought to be an abnormal
immune response.
Symptoms of LPC include chronic diarrhea, which may contain blood, having frequent, small bowel movements, mucoid
stools, and a poor response to any general treatment. Loss of appetite, vomiting, weight loss and enlarged lymph nodes may
also be noted. Diagnosis is based on history, physical examination, fecal analysis, blood counts, serum chemistries, X-rays
including dye studies, and endoscopy including biopsy. The only actual way, however, to actually get an exact diagnosis is by
performing a colonic biopsy.
TREATMENT OF LYMPHOCYTIC/PLASMACYTIC COLITIS
While it is difficult to cure this condition, control is very possible if the proper treatment is provided. Feeding of high-quality
diets that are either highly digestible or high fiber or non-allergenic can be tried until the best results are obtained. Special types
of antibiotics and cortisone type drugs in various doses are often employed and some degree of lifetime therapy will be
required. Vitamin therapy is also indicated in most cases.
EOSINOPHILIC COLITIS
Eosinophilic colitis is an Inflammatory Bowel Disease similar to eosinophilic enteritis. Eosinophils, a type of white blood cell,
migrate and infiltrate the lining of the colon and interfere with normal colonic function. While the cause is not understood, this
may be a form of allergic reaction, including a response to food allergens or internal parasites. It is generally considered and
abnormal immune reaction.
Clinical signs include diarrhea which may be regular or come and go, blood in the stools, straining to defecate, frequent
defecation, mucoid stools and small stool volume. Other symptoms will be present if this is an extension of eosinophilic enteritis.
Diagnosis is based on history, physical findings, blood counts, fecal analysis, X-rays, colonoscopy and colonic biopsy.
TREATMENT OF EOSINOPHILIC COLITIS
First, all cats will need to be on some type of hypoallergenic diet, probably for life. Parasites should be eradicated. Cortisone
and cyclophosphamide are often effective in controlling the inflammatory process. Long term success is usually good with this
basic treatment. Treatment will need to continue for life.
HISTIOCYTIC COLITIS
Histiocytic colitis is another type of Inflammatory Colon Disorder, this time characterized by a special type of macrophage,
a type of white blood cell, infiltrating and lining to colon. The cause is unknown but may have initiating factors similar to that of
chronic colitis. Symptoms include a chronic, bloody, mucoid diarrhea similar to other types of chronic colitis. Other physical
and diagnostic findings are also similar. Definitive diagnosis is by colonic biopsy. (see.. treatment of chronic colitis for
treatment of this condition.)
MISCELLANEOUS TYPES OF COLITIS
HISTOPLASMA COLITIS: Colitis cause by histoplasmosis.
PSEUDOMEMBRANOUS COLITIS: Colitis caused by antibiotic damage to the colon.
TYPHILITIS: Colitis and irritation caused to the cecum, often caused by whipworms.
IRRITABLE BOWEL SYNDROME (STRESS COLITIS)
This is a non-inflammatory dysfunction of the colon that is usually associated with stress or stressful events. The symptoms
include a sudden onset of diarrhea that may be mucoid, and in some cases, only mucus may be passed. Straining to defecate,
frequent defecation and blood in the stool are also possible. Usually there are no other physical findings. Diagnosis is based
on history, physical examination, fecal analysis, fecal cytology, colonoscopy and biopsy, and X-rays (Mucoid Diarrhea)
TREATMENT OF IRRITABLE BOWEL SYNDROME
Most cats will do well with a combination of drugs. Mild tranquilizers or sedatives will help to reduce stress levels. Medications
that alter bowel motility are also employed. Adding coarse wheat fiber to the diet has also proven highly beneficial in healing to
colon although long term use of such may be required.
PSEDOCOPROSTASIS
Pseudocoprostasis literally means "false constipation". In some cats, especially breeds with fine and/or thick coats, hair and
fecal material may become matted and impacted onto the area around the anus; actually blocking the flow of feces from the
body. Clinical signs will include straining to defecate and some decree of pain. Diagnosis is simple upon physical
examination.
TREATMENT OF PSEUDOCOPROSTASIS
Cats may or may not need to be sedated because of the pain involved, and then clipping and cleansing the anal area, giving an
enema if needed and using antibiotics and cortisone orally and/or topically to heal the associated irritation. Keeping the area
clipped a little extra short should also help to prevent the problem.
MEGACOLON
In some cats, the colon can become grossly dilated and stop functioning normally, with large quantities of feces being retained
in the colon. This is called megacolon. While megacolon can occur at birth in rare cases, most of the time, intestinal foreign
objects, tumors or some other blockage of the colon will lead to chronic constipation and megacolon.
Clinical signs include repeated bouts constipation, failure to defecate for several days, straining and repeated attempts to
defecate, loss of appetite, vomiting, depression, weakness, abdominal pain, and even possibly passing soft, mucoid and bloody
stools on occasion. Diagnosis is based on history, physical examination, X-rays, fecal analysis and colonoscopy.
(Megacolon)
TREATMENT OF MEGACOLON
Upon initial presentation, most cats will need enemas and lubrication of the colon so that they can pass impacted feces. Some
cats may require manual removal of the feces while under sedation. If the cat is weak and depressed, fluids and electrolytes will
also be required. If an underlying problem can be identified and corrected, the megacolon may resolve itself. In most cases,
long term use of bran or Metamucil in the diet, oral laxatives or lactulose can keep the pet defecating smoothly. Many cats,
however, will need lifetime therapy. In extreme instances, all or part of the colon will need to be removed.
FECAL INCONTINENCE
Fecal incontinence is a rare problem whereby a cat is unable to partially or completely control the passage of bowel
movements. This often results in feces being passed while the cat is resting, or even while it is walking from place to place.
Most cats suffering from this condition will have had anal/rectal surgery, or have advancing, degenerative neuological or
muskuloskeletal conditions including cauda equina syndrome, degenerative myelopathy, and degenerative joint disease. The
clinical signs are obvious, and diagnosis is based on this history, physical and neurological examination, X-rays and
colonoscopy.
TREATMENT OF FECAL INCONTINENCE
Most cases will not be well treated. Loperamide may work to enhance anal tone in some cases. Diets that produce fewer
stools, a firm feeding schedule and frequent trips to the litter pan. Some cats have responded to spinal manipulation,
acupuncture and surgery.
