Folding of the Intestines in Cats

The most common sign of intussusception is vomiting or diarrhea that lasts for more than two days. It is often accompanied by blood in the stools or vomit, a noticeable loss of appetite, and signs of depression. Cats displaying these symptoms should receive prompt medical attention. Depending on the severity of the condition, hospitalization and emergency surgery may be necessary. If left untreated, a fold in the intestine can damage the protective mucus membrane of the G.I. tract, allowing bacteria and toxins to enter the system. In extreme cases, swelling in the affected area may result in necrosis (tissue death).

Intussusception is the medical term for a fold in the intestine that causes inflammation and blockage. The condition often affects the middle of the small intestine or the area where the small intestine connects with the large intestine or colon. 

Symptoms resulting from a fold in the intestine may be intermittent or long-lasting. It is possible for the condition to resolve on its own. However, a medical consultation is always recommended to determine the severity of the blockage and whether surgery will be needed. Symptoms will vary depending on the area of the intestine that is affected and whether the blockage is total or partial. Common symptoms include one or more of the following:

• Diarrhea (sometimes bloody)
• Straining to defecate
• Vomiting (sometimes with blood)
• Abdominal pain
• Abdominal mass
• Loss of appetite
• Difficulty swallowing
• Weight loss
• Difficulty breathing
• Collapse or sudden death (in cases of a total obstruction)

Intussusception may occur in cats of any age, but is more commonly found in kittens and younger cats. Those with weakened immune systems are more likely to be affected, and the condition is more common in Siamese cats than in other breeds. Common causes of the disorder include:

• Intestinal parasites (roundworms, hookworms, whipworms)
• Viral or bacterial gastroenteritis 
• Ingestion of foreign bodies
• Abrupt dietary changes
• Inflammation of the small intestines
• Tumors
• Complications following intestinal surgery

The examining veterinarian will likely begin by reviewing the cat’s full medical history including information regarding recent symptoms and other possible causes. The frequency of vomiting and diarrhea should be discussed.

It may be difficult to recognize intussusception as the symptoms are common to many other gastrointestinal disorders. The vet is likely to order a series of tests in order to rule out other possible conditions and reach a differential diagnosis. Common tests include a complete blood count (CBC), biochemical profile, electrolyte panel, and urinalysis. A fecal test may be ordered to check for parasites.

A complete physical exam will be performed, with special attention paid to the abdominal area. The vet may notice a firm sausage-shaped mass in the intestines. X-rays may be needed to look for physical obstructions and the presence of gas and fluids. A barium contrast study, abdominal ultrasound, or endoscopy may be recommended. In some cases, exploratory surgery will be needed.

Treatment recommendations will depend on the severity of the condition, whether tissue death has occurred, how long the condition has been present, and the effects of any underlying conditions. 

Stabilization 

When a cat has been suffering from vomiting and/or diarrhea for an extended period of time, it is likely to be dehydrated and may suffer from electrolyte imbalances. Aggressive treatment with I.V. fluids and a sodium solution may be needed to stabilize the animal before surgery can be considered.

Surgical Treatment

Surgical treatment can be difficult and complicated. It is recommended that it only be performed by a board-certified surgical specialist. In certain circumstances, it may be possible for the surgeon to manually unfold the affected area. This method of treatment is less invasive, but creates a high likelihood that the condition will recur. More commonly, the affected area will be removed and the healthy ends reattached using sutures or staples. This procedure is known as intestinal anastomosis. 

Prognosis for affected animals will vary widely depending on the degree of the intussusception and the severity of accompanying symptoms. Following surgery, the cat should be kept calm and quiet and activities should be limited until it has fully recovered. Follow-up visits will be needed to ensure proper healing. Since recurrence is most likely to occur in the first few weeks, close observation during this time is required. Any signs of recurrence will require immediate medical attention. 

The vet will likely prescribe antibiotics to prevent post-surgical infection and will recommend a diet consisting of small and easily digestible meals. Owners should be aware of the dangers of dehydration and take preventative measures. Once the cat has fully recovered it should be able to begin eating a balanced diet and resume normal activities.