A subtotal colectomy is a surgical procedure used to treat advanced cases of feline megacolon. The subtotal colectomy removes a portion of a cat's large intestine, and is used as a last resort if other megacolon treatments aren't effective. A 1990 study, conducted by the Department of Surgery at UC Davis' School of Veterinary Medicine, confirmed that relatively normal bowel function returned in four cats that underwent a subtotal colectomy, making this procedure a viable option for megacolon management.
Megacolon occurs when a cat's large intestine expands and becomes impacted with hard fecal material that it cannot pass. Pet Education.com reports that the cause of megacolon is never determined in approximately two-thirds of its cases; there is speculation that these cases are caused by an inherent abnormality in the colon's smooth muscle tissue. In the other one-third of cases, megacolon might be caused by a narrowing fracture in the cat's pelvic area, a nerve injury, spinal cord deformity, cancer or inflammation.
Mar Vista Animal Medical Center reports that a subtotal colectomy offers a "permanent resolution" to megacolon. Initial treatment of megacolon involves hospitalisation, intravenous therapy and veterinary-administered enemas to remove the impacted faeces. Cats are also fed all-meat diets and prescribed stool-softening medication to keep the bowel movements regular. Should these methods prove ineffective, the subtotal colectomy removes the compromised portion of the large intestine and restores regular elimination.
The subtotal colectomy restores a "low maintenance lifestyle" for the cat and its owner, states Mar Vista. Once the diseased portion of the colon is removed, there should no longer be any need for the medication or frequent trips to the vet for hydration therapy and enemas. Mar Vista also reports that the cats adjust nicely after the surgery and, as discussed by UC Davis vet school, in most cases normal bowel function is restored by the subtotal colectomy.
The most common side effects of a subtotal colectomy are loose stools and (sometimes) diarrhoea that might last for several weeks or months. In 80 per cent of cats that undergo a subtotal colectomy, the fecal matter generally returns to a normal consistency. The remaining 20 per cent of cats that continue to suffer from loose stools will need to consume a specialised diet the rest of their lives to reduce production of fecal matter, explains Mar Vista.
Although the subtotal colectomy is a highly successful procedure that comes with a low risk of side effects, Mar Vista does warn it is major surgery and not without serious complications in rare cases. A plethora of bacteria live in the colon and might leak from the incision left in the remaining portion of the colon and cause infection, peritonitis or even death.
The cat may also become anorexic after surgery; it's just endured major surgery and might not want to eat. This is understandable for a few days, but the feline must be force fed if it has refused to eat for five days. In some cases, Mar Vista advises a feeding tube is necessary to administer the recovering cat proper nutrition.
Lastly, the surgery site on the colon will have a scar. Should this scar cause a constriction, or narrowing, of the remaining intestine, the cat might need to undergo a second surgery to remove the constricted piece of colon and restore normal fecal pass-through yet again.
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