Constipation: Fiber to the Rescue?

The causes of constipation include diet, environmental disturbances, colonic obstruction, electrolyte imbalances, iatrogenic disease, and neuromuscular disease. Treatment involves identifying and eliminating the cause, along with medical (laxatives, enemas, prokinetic agents) and/or surgical management.

Incorporation of insoluble and/or soluble fiber into the diet is commonly recommended, either as a purpose-formulated high-fiber diet or by supplementing the existing diet with fiber. Psyllium is a soluble fiber with low fermentability; the husk contains polysaccharide and nonpolysaccharide components that exude a hydrophilic mucilaginous gel on lubrication, thereby increasing fecal bulk. Additional water-holding properties also increase stool bulk.

Two prospective, uncontrolled, open-label field trials were conducted to assess the efficacy of a fiber-supplemented food containing psyllium husks as the principal fiber source for managing constipated cats. Cats refractory to previous therapy were included. In trial 1 (n = 15), no additional therapy was used; in trial 2 (n = 51), additional therapy was initially allowed but subsequently withdrawn if possible. Cats were assessed 1 and 2 months after starting the diet. Response to therapy was determined by changes in fecal scores and reported response to therapy, as judged by the owner. Results from both trials indicated that the test diet was palatable and well tolerated, that clinical remission was noted in the majority of cats, and that other symptomatic therapy was either not required or could often be discontinued or reduced without recurrence of clinical signs.

CommentaryNothing is worse than being presented with an obstipated cat that needs an enema. Addressing the underlying cause—often renal disease with associated dehydration—and selecting a long-term management plan to prevent future episodes can vary on a case-by-case basis.

Typically, I recommend starting affected cats on either a low-residue diet to decrease fecal production or a canned formula to increase water intake before trying a fiber supplement. However, any dietary therapy must be introduced gradually to prevent food-avoidance behavior. If fiber therapy is found to be helpful and the cat does not need to be on a therapeutic diet for another problem (eg, renal disorder), a psyllium-enriched, palatable diet may be the solution.—Sandra Sawchuk, DVM, MS

SourceUncontrolled study assessing the impact of a psyllium-enriched extruded dry diet on faecal consistency in cats with constipation. Freiche V, Houston D, Weese H, et al. J FELINE MED SURG 13:903-911, 2011.

For more information, see Treatment of Chronic Gastrointestinal Disease by Dr. Alexander J. German