Our Summary

The study looked into the effects of a specific surgery on cats suffering from idiopathic megacolon, a condition where the large intestine becomes abnormally enlarged. The surgery, known as a subtotal colectomy, involves removing a large part of the colon. The researchers wanted to see how successful this surgery was and if removing an extra part (the ileocecocolic junction or ICJ) affected the results. They examined the records of 166 cats that had this surgery between 2000 and 2018.

They found that about 10% of the cats experienced serious complications during or after the surgery, and 14% of the cats died as a direct result of the treatment or complications from the condition. The cats that had a lower body condition score (a measure of their overall health), preexisting heart disease, major complications during surgery, or long-term diarrhea after surgery were more likely to die sooner.

About a third of the cats had a recurrence of constipation at an average of about a year after surgery. Whether the ICJ was left in place or removed didn’t affect the likelihood of constipation returning. However, cats that had the ICJ removed were more likely to have long-term diarrhea and their owners tended to rate their overall outcome as fair or poor.

In conclusion, the subtotal colectomy can lead to long survival times and high owner satisfaction. But, taking out the ICJ was linked with less favorable outcomes.

FAQs

  1. What is a subtotal colectomy and why is it performed on cats with idiopathic megacolon?
  2. What were the findings of the study regarding the success of the surgery and the effects of removing the ileocecocolic junction (ICJ)?
  3. What factors were found to increase the likelihood of a cat dying sooner after undergoing a subtotal colectomy?

Doctor’s Tip

A doctor might tell a patient considering a colectomy that while the surgery can lead to successful outcomes and improved quality of life, there is a risk of serious complications and a possibility of long-term diarrhea. It is important to discuss all potential risks and benefits with your healthcare provider before making a decision.

Suitable For

Patients who are typically recommended for colectomy include those with severe inflammatory bowel disease, ulcerative colitis, Crohn’s disease, colorectal cancer, familial adenomatous polyposis, or severe diverticulitis. These conditions often require surgical removal of part or all of the colon to alleviate symptoms and prevent complications.

Timeline

Before colectomy:

  • Patient experiences symptoms of idiopathic megacolon such as chronic constipation, difficulty passing stool, and abdominal discomfort
  • Patient undergoes diagnostic tests such as imaging studies and colonoscopy to confirm the diagnosis
  • Patient may be treated with medications or dietary changes to manage symptoms, but these may not be effective in severe cases
  • Patient and medical team discuss the option of colectomy as a surgical treatment for the condition

After colectomy:

  • Patient undergoes subtotal colectomy surgery to remove a large portion of the colon
  • Some patients may also have the ileocecocolic junction (ICJ) removed during the surgery
  • Patients may experience complications during or after the surgery, with about 10% experiencing serious complications and 14% dying as a direct result of the treatment or complications
  • Patients with lower body condition score, preexisting heart disease, major complications during surgery, or long-term diarrhea after surgery are more likely to have poorer outcomes
  • About one-third of patients may experience a recurrence of constipation about a year after surgery, regardless of whether the ICJ was removed or not
  • Patients who had the ICJ removed are more likely to have long-term diarrhea and their owners may rate their overall outcome as fair or poor
  • Overall, subtotal colectomy can lead to long survival times and high owner satisfaction, but the decision to remove the ICJ may affect outcomes

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a colectomy surgery?
  2. How successful is a subtotal colectomy in treating idiopathic megacolon in cats?
  3. What factors could increase the likelihood of complications or mortality during or after the surgery?
  4. How long can I expect my cat to live after undergoing a colectomy?
  5. Is it necessary to remove the ICJ during the surgery, and how does this affect the outcome?
  6. What are the signs of recurrence of constipation after a colectomy, and how can it be managed?
  7. How can I help my cat recover and maintain their health after a colectomy surgery?
  8. Are there any alternative treatments or therapies that could be considered instead of a colectomy?
  9. Will my cat require any special dietary or lifestyle changes post-surgery?
  10. What follow-up care or monitoring will be needed for my cat after a colectomy surgery?

Reference

Authors: Grossman RM, Sumner JP, Lopez DJ, Dornbusch JA, Singh A, Lux CN, Sample SJ, Liptak JM, Grimes JA, Upchurch DA, Blumenthal MS, Traverson M, Buote NJ, Marvel SJ, Steffey MA, Arai S, Little JP, Atilla A, Huck JL, Pitt KA. Journal: J Am Vet Med Assoc. 2021 Nov 1;259(11):1292-1299. doi: 10.2460/javma.20.07.0418. PMID: 34727062