In this VETgirl online veterinary CE blog, we demonstrate how to treat the constipated cat. These patients often present slightly dehydrated, very obese, and with underlying disease - in other words, a disease process that predisposes them to a dehydrated state (e.g., renal failure, diabetes mellitus, etc.) or due to primary gastrointestinal (e.g., colonic) disease. Treatment typically includes fluid therapy (e.g., intravenous, subcutaneous), pro kinetics, and enemas. With severe constipation, manual de-obstipation may be required under sedation.
Personally, VETgirl isn't a huge fan of manual de-obstipation - instead, we aggressive hydrate and enema-ize. In this VETgirl video, we show our secret enema concoction: warm water, lots of lubrication, and lactulose. We typically administer 120-180 mls of this solution rectally every 4-6 hours while simultaneously hydrating the patient. Keep in mind that the gastro-colonic reflex can be stimulated from the enema - in other words, the patient may vomit from the enema. More importantly, educate your pet owners on why they shouldn't be using Fleet enemas!
That said, with aggressive supportive care, these patients can do well! What's your enema concoction that you use with success? Comment below!