Changes

Megacolon may be managed medically, or surgically if the condition is severe or recurrent. Medical therapy aims to restore the patient's hydration and then clear the faecal impaction. Under anaethesia, the colon is manulally evacuated using warm water enemas, lubrication and gentle extraction of faeces with forceps or a finger. Care must be taken not to damage the colonic mucsoa during this procedure, and prophylactic antibiotics are recommended before commencement. Once the patient's colon is clear, the focus is shifted to preventing recurrence. Dogs and cats must have adequate access to litter or the outdoors to encourage regular defaecation, and regular exercise may be beneficial. Diets containing bulk-forming fibre may contribute to the recurrence of impaction, but a high-fibre diet may occasionally be useful in prevention. Stool softeners such as lactulose, and prokinetic drugs such as cisapride can promote motility and defaecation. Medical management is usually an ongoing, life-long committment which may be frustrating for the owner, and relapse is common.

Megacolon may be managed medically, or surgically if the condition is severe or recurrent. Medical therapy aims to restore the patient's hydration and then clear the faecal impaction. Under anaethesia, the colon is manulally evacuated using warm water enemas, lubrication and gentle extraction of faeces with forceps or a finger. Care must be taken not to damage the colonic mucsoa during this procedure, and prophylactic antibiotics are recommended before commencement. Once the patient's colon is clear, the focus is shifted to preventing recurrence. Dogs and cats must have adequate access to litter or the outdoors to encourage regular defaecation, and regular exercise may be beneficial. Diets containing bulk-forming fibre may contribute to the recurrence of impaction, but a high-fibre diet may occasionally be useful in prevention. Stool softeners such as lactulose, and prokinetic drugs such as cisapride can promote motility and defaecation. Medical management is usually an ongoing, life-long committment which may be frustrating for the owner, and relapse is common.

The term subtotal colectomy describes the removal of the majority

Sub-total colectomy can be used to correct megacolon in the cat. However, this technique is very poorly tolerated in the dog. The term refers to the removal of the majority of the colon, and the ileocaecocolic valve may be preserved or removed. The ileocaecocolic valve prevents reflux of colonic contents into the small intestine and so some surgeons believe that removing this structure can predispose to small intestinal bacterial overgrowth,steatorrhoea and deconjugation of bile salts,sup>. The rationale for excision of the

of the colon. There are two variations of the technique depending

on whether the ileocaecocolic valve is preserved or removed. This

structure prevents reflux of colonic contents into the small intestine;

therefore, some surgeons consider that removing the valve will predispose

to bacterial overgrowth in the small intestine, steatorrhoea

and deconjugation of bile salts. The rationale for excision of the

valve is that it minimises the recurrence of segmental megacolon

valve is that it minimises the recurrence of segmental megacolon

and associated constipation. For the surgeon, an added complication

and associated constipation. For the surgeon, an added complication