Narrowing of Pyloric Canal in Cats

Though rare in cats, the condition can be serious if left untreated. Young Siamese cats have a greater risk of developing the condition than other breeds.

The pyloric canal is a component of the cat's gastrointestinal system. Food passes from the stomach into the pyloric canal, where it then moves into the duodenum, the first part of the small intestines. When muscle overgrowth causes the pyloric canal to narrow, pyloric stenosis or chronic hypertrophic pyloric gastropathy results. Consumed food can no longer pass into the intestines. This causes vomiting, poor growth and weight loss in cats.

Depending on how much the pyloric muscle has narrowed, symptoms can range from mild to severe. These symptoms include:

• Chronic vomiting that may occur hours after the cat has last eaten
• Vomit that contains undigested food without bile
• Loss of appetite
• Weight loss
• Stunted growth
• Distended abdomen
• Abdominal pain
• Breathing difficulties, which will include coughing, rapid breathing and fast pulse, due to aspiration pneumonia

Most cases of chronic hypertrophic pyloric gastropathy are congenital, which means the narrowing occurred during fetal development. The condition may also be acquired later in the cat's life due to the following causes:

• Stomach ulcers
• Chronic gastritis
• Gastrointestinal tumors
• Chronic stress
• Chronic increase of the hormone gastrin, which is responsible for stimulating the secretion of HCL in the stomach
• Megaesophagus, difficulty transferring food from the pharynx to the stomach due to a dilated esophagus

The veterinarian will need to know the cat's complete health history. This will include any other gastrointestinal conditions the cat has been diagnosed with, a list of symptoms and when symptoms first began. The veterinarian will examine the cat, listening to its stomach and intestines with a stethoscope for signs of digestion, gently feeling the cat's abdomen for distension, and listening to its lungs for signs of aspiration pneumonia.

Several labs, which will include a complete blood count, biochemical profile, electrolyte panel and a urinalysis, will be performed. These labs will be used to rule out other gastrointestinal conditions that present with the same symptoms as pyloric canal narrowing.

Radiography will be needed to confirm a diagnosis of pyloric stenosis. X-rays may show stomach distension due to the condition. An ultrasound may be performed to confirm narrowing of the pyloric muscle. The veterinarian may also perform a gastrointestinal barium contrast study. During this test, the cat will be given an oral solution of barium sulfate or barium-impregnated polyethylene spheres (BIPS). X-rays will then be used to locate the narrowing or monitor the delayed emptying of the barium solution.

If other tests haven't been able to give a definitive diagnosis, the veterinarian may use an endoscope to look at the gastrointestinal organs from the inside of the cat. A flexible tube with an attached camera will be inserted into the cat's stomach and duodenum through the cat's mouth. The veterinarian will look for signs of narrowing and other gastrointestinal conditions, such as ulcers, that could have caused pyloric stenosis to occur.

Fluid Therapy

Cats with pyloric stenosis often become dehydrated as a result of not being able to digest food and liquids. Fluids will be given to the cat intravenously in order to correct the dehydration.

Surgery

The veterinarian will perform a pylorectomy to relieve the pyloric canal narrowing. The cat will be placed under general anesthesia prior to surgery. The veterinarian will make an incision in the cat's abdomen and remove the pyloric canal. A gastroduodenostomy will then be performed in order to create a connection between the stomach and duodenum. A gastrostomy tube will be placed in the cat while he or she recovers from surgery. The abdomen will then be closed with sutures.

Medication

The cat will be placed on antibiotics in order to prevent infection from developing after surgery. The cat will also be given pain relievers to help reduce the pain level from the surgery.

Specialized Diet

The veterinarian may recommend that the cat eats a low fat or all-liquid diet in order to encourage proper digestion.

An Elizabethan cone will need to be worn to prevent the cat from biting its sutures following surgery. The cat will need to follow up with the veterinarian to check for signs of infection around the incision site and to remove the gastronomy tube. The cat will need to continue to be monitored for any signs of gastrointestinal problems, such as vomiting and diarrhea. It's important to remove stress from the cat's environment while it heals, such as young children or other animals.

If the cat was placed on a special diet, it's important to follow the dietary guidelines in order to help the cat digest its food properly. Any other conditions that are present, such as stomach tumors or ulcers, will also need to be treated and followed-up with the veterinarian.