Bowel incontinence in cats is involuntary passage of feces, and appears to happen without awareness.
• This symptom is not to be confused with straining to defecate or inappropriate defecating/house soiling
• Bowel incontinence can be divided into two categories, reservoir: the inability to hold and store stool; and sphincter: the inability to keep the anal sphincter closed
• The causes vary but are categorized as neurologic and non-neurologic
• Diagnostics include physical examination, urine, blood, and fecal analysis, and diagnostic imaging
• Treatment varies depending on the cause and can include dietary modifications, surgery, medications, and palliative care.
Bowel incontinence can be divided into two types.
• Caused by diseases involving the rectum
• Involves an inability to store a normal amount of stool
• Caused by disorders affecting the anal sphincter
• Involves an inability of the sphincter to completely close properly
Both types have similar symptoms. The frequency of bowel incontinence events is usually unrelated to the severity of the underlying disease.
It can also be categorized as chronic or acute. Acute and temporary are typically associated with diarrhea. Both acute and chronic cases can be associated with a number of other symptoms depending on diagnosis.
The causes of bowel incontinence in cats can be divided into two categories:
Neurologic disorders which interfere with the nervous system control over bowel movements, such as:
• Cognitive dysfunction syndrome
• Organophosphate toxicosis
Non-neurologic disorders which are anything that causes diarrhea, structural anomalies, etc, such as:
• Exocrine pancreatic insufficiency
• Feline infectious peritonitis
• Bacterial and viral infections that cause diarrhea
• Injuries: esp. Tail, spinal cord, pelvic, brain
• Intervertebral disc disease
• Dietary intolerance
• Tumors and cancer
• Perineal hernia
Some cases of fecal incontinence have no identifiable cause.
Bowel incontinence in cats is rare. Incontinence does not necessarily indicate an emergency as a solitary symptom, but it is a problem as it is messy, hard to live with, and hard to treat. Prompt veterinary care is advised for any cats showing symptoms of incontinence.
Diagnostics begin with a medical history and physical examination of the cat. After this, a number of diagnostic tests are used:
• Fecal testing
• Imaging (x ray, ultrasound, CT, MRI)
• Blood work
• Biopsies of the colon or intestine
• Colonoscopy (visualization of the colon using a camera)
• Nerve conduction studies
Treatment varies widely depending on the cause of the incontinence. The severity of treatment also varies from minor, supportive treatments to palliative, symptom-focused care in the case of severe incurable conditions.
Some treatments include:
• Diet changes to diets that promote reduced fecal volume
• Medications to treat underlying disease
• Medication that reduces intestinal motility to reduce fecal passage
• Waiting for symptoms to pass in mild cases associated with disorders that resolve on their own
Supportive care for patients with fecal incontinence include:
• Veterinary-administered enemas to reduce feces in the colon
• Changing soiled bedding immediately
• Frequent bathing to remove feces from the hair and skin
• Manual stimulation of defecation
• Physical therapy
Bowel incontinence is not to be confused with
• Inappropriate elimination/house soiling due to a behavioral issue
• Straining to defecate
• Manx cat syndrome
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