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Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats

Grossman RM, Sumner JP, Lopez DJ, et al. Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats. J Am Vet Med Assoc. December 2021:1-8. doi:10.2460/JAVMA.20.07.0418

Megacolon is the end-stage of chronic constipation and refers to an irreversible loss of muscle tone within the colon. This leads to chronic, often intractable constipation. While medical management is generally the first-line option, some cats with chronic or recurrent obstipation will require surgical management, often in the form of subtotal colectomy. This is a major surgery with severe possible complications. Several older papers described follow-up, quality of life, and prognosis information, however, they are dated and often conflicting. Likewise, the importance of the preservation of the ileocolic junction has been debated.
The purposes of this study were to evaluate outcomes in a large group of cats undergoing subtotal colectomy for the treatment of idiopathic megacolon and to determine whether removal of the ICJ was associated with differences in outcome. The study was designed as a retrospective observational study with a cohort component.
Medical records from 18 referral and academic teaching hospitals were searched for cats that underwent subtotal colectomy for the treatment of idiopathic megacolon between January 1, 2000, and December 31, 2018.
Some limitations were present in this study. The Median follow-up duration was only 64 days, which is likely adequate for most acute outcomes but may not be representative of long-term prognosis and late complications.
The authors of this study concluded that subtotal colectomy was associated with long survival times and a high rate of owner satisfaction. Overall, removal of the ICJ was associated with a worse outcome. These results suggest that subtotal colectomy may be recommended for the management of idiopathic megacolon with minimal concern for the long-term outcome; however, the ICJ should be preserved if at all possible.

See Also:
Bertoy RW. Megacolon in the cat. Vet Clin North Am Small Anim Pract. 2002;32 (4):901–915White RN. Surgical management of constipation. J Feline Med Surg. 2002;4(3):129–138.
Sweet DC, Hardie EM, Stone EA. Preservation versus excision of the ileocolic junction during colectomy for megacolon: a study of 22 cats. J Small Anim Pract. 1994;25(7):358–363.

Related Blog Posts:
https://everycat.org/cat-health/oral-laxatives-for-feline-constipation/
https://everycat.org/cat-health/dietary-therapy-for-feline-constipation/

Related Terms:
Constipation
Obstipation
Surgery