Spotlight on Cisapride
Drs. Foster & Smith Educational Staff

Spotlight on Cisapride
A FEW DAYS SHORT OF CAPP’S NINTH BIRTHDAY, his owner happened to notice that he was standing still in his litter box. She went about her household tasks. Later, returning to the utility room where the litter box was kept, she noticed that he was still in the box, this time hunched up, straining, and whining ever so faintly.

She knew her aging cat had become more sedentary and that his appetite had fallen off, so she gave little thought to the weight he had lost and the reduced amount of waste in his box. Witnessing now what was obviously painful elimination, she called her veterinarian and was given an afternoon appointment.

Cisapride CapsulesThe veterinarian took a detailed history on Capp and then conducted a physical and neurological examination. A complete blood count, chemistry panel, urinalysis, and thyroid test were performed to rule out a few specific health problems. By x-ray, it was determined that there was nothing foreign lodged in the cat’s intestine. The doctor then explained that Capp was suffering from constipation, a condition that often plagues older cats. Veterinarians suspect constipation when ingested food has a long transit time through the digestive system, resulting in infrequent and difficult-to-pass bowel movements. It is not a disease, per se, but it does signal a problem in the gastrointestinal tract. Other signs of constipation include the passing of mucus, blood, and diarrhea due to irritation in the intestine. Additionally, the cat may vomit while straining to pass the stool. Veterinarians often cannot determine the actual cause of the condition. It is sometimes thought to be an abnormality in the smooth muscle of the large intestine. Untreated, constipation is a serious disorder.

Capp’s treatment involved a twofold approach, medical and dietary. It included several enemas, administered by the veterinarian, to remove hardened fecal material. Cisapride was prescribed to stimulate the movement of food through the cat’s digestive tract. In addition, the doctor recommended adequate water intake and a special diet. High fiber diets are useful for simple constipation, but, in Capp’s case, which was more severe, a low-fiber, canned food was advised so that the stool would be smaller and easier to pass. Lactulose, a stool softener, was also prescribed.

Fortunately Capp’s condition was discovered before the development of the more serious condition, megacolon, which is characterized by a colon that is distended with dry, impacted, and hardened fecal material. Surgery to remove part of the colon is often the only option. The procedure is highly successful and generally allows the cat to resume a normal lifestyle after healing. Avoiding surgery is, however, always preferable.

Capp made a complete recovery with the enemas and medication in conjunction with the recommended changes to his diet. His owner was careful to monitor his litter box habits and the amount of fecal material passed so as to not miss a recurrence of the problem. He regained the weight he had lost and soon started behaving like a younger cat again.

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