ISSN 2398-2969      

Constipation

icanis

Introduction

  • Cause: multifunctional including: obstruction, neurological, orthopedic, prostatic, metabolic and functional causes.
  • Signs: tenesmus, anorexia, reduced fecal output, dry hard feces, vomiting.
  • Diagnosis: signs, radiography.
  • Treatment: find and correct underlying cause, fecal softening, enemas, occasionally manual removal.
  • Prognosis: good for resolution of signs but may recur.
  • If untreated megacolon Megacolon: acquired may develop.

Pathogenesis

Predisposing factors

General

  • Foreign material in diet, eg bones, rawhide, hair accumulation.
  • Intestinal lumen narrowing:
    • Prostatic enlargement.
    • Pelvic fracture malunion.
    • Neoplasia (intraluminal, mural or extraintestinal).
    • Foreign body impaction.
    • Rectal tumor/stricture Rectum: stricture.
    • Rectal polyp.
  • Behavioral - related to infrequent voiding:
    • Paraplegia/spinal.
    • Animal unwilling to posture, eg hip dysplasia Hip: dysplasia.
    • Painful defecation, eg pelvic fracture, anal sacculitis Anal sacculitis.
    • Laziness or lack of opportunity to exercise (hospitalized).
  • Inadequate water intake:
    • Lack of access to water due to social or mobility issues.
    • Oral disease or difficulty swallowing.
    • Diet high in insoluble fiber such as commercial therapeutic weight loss diet.
  • Obesity Obesity.
  • Dysautonomia Dysautonomia (very rare) (except in Kansas and Missouri).
  • Lead toxicity Lead toxicity  - can cause constipation or diarrhea.

Pathophysiology

  • Failure to pass feces due to functional/mechanical causes.
  • Prolonged retention of feces in colon → increased water resorption → harder drier feces.
  • Resorption of toxins may also occur → vomiting.
  • Vomiting can also result from vagal stimulation of vomiting center as a result of bowel wall stretching and/or irritation.
  • Prolonged constipation may lead to megacolon.

Timecourse

  • Days to weeks for constipation to develop.
  • Predisposing factors may be present for years.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Chandler M (2013) Focus on nutrition: dietary management of gastrointestinal disease. Compend Contin Educ Vet 35 (6), E1-3 PubMed.
  • Nemeth T (2008) Long-term results of subtotal colectomy for acquired hypertrophic megacolonin eight dogs. JSAP 49 (12), 618-624 PubMed.
  • Washabau R J (2003) Gastrointestinal motility disorders and gastrointestinal prokinetic therapy. Vet Clin North Am Small Anim Pract 33 (5), 1007-1028 PubMed.
  • Sherding R G (1990) Management of constipation and dyschezia. Comp Cont Educ 12 (5), 677-685 VetMedResource.

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