What are Colonic Resection and Anastomosis?
A resection and anastomosis surgical procedure may be performed anywhere along the gastrointestinal tract from the esophagus to the rectum, however colonic resection specifically refers to the procedure in the large bowel. Colonic resection is a surgical procedure performed by your veterinarian to remove a section of your cat’s large intestine. Attaching the remaining ends of the bowel together is an anastomosis procedure. This procedure is performed when a section of your cat's intestinal tract becomes damaged.
Common causes of such damage in cats that may make such a procedure necessary are neoplasia (cell growth) or ingestion of a foreign object that has caused trauma or blockage. The amount of large bowel tract removed depends on the damage or condition being addressed, but can be a very small amount of tract or quite a large amount. The condition requiring such a procedure is often discovered during exploratory surgery to determine the cause of gastrointestinal distress in your cat, or may be recommended as a result of a medical condition discovered through radiography, such as x-ray or ultrasounds. This procedure requires a qualified veterinary surgeon with experience in such procedures as there are several risks associated with gastrointestinal surgery.
Colonic Resection and Anastomosis Procedure in Cats
Prior to colonic resection and anastomosis your veterinarian will perform a complete physical exam of your cat and conduct tests to diagnose the condition requiring this procedure. Tests may include radiographs with dye, x-rays and abdominal ultrasound. In addition, abdominocentesis, a procedure in which a sample of fluid is removed from your cat's abdomen using a needle, may be conducted and fluid sent to a lab for analysis. Evidence of abnormal cells or infection may be revealed. Often exploratory surgery is performed on a cat experiencing gastrointestinal distress and the condition requiring treatment may be discovered during this procedure.
Prior to colonic resection and anastomosis, you will be required to fast your cat the day before the surgery. In addition, your veterinarian may prescribe a laxative to clear your cat's bowels. If necessary, antibiotics may be prescribed prior to surgery.
On the day of surgery, your veterinarian will perform an examination to ensure your cat does not have any conditions that would complicate anesthetization or surgery, such as infection.
Your cat will be put under general anesthetic for this procedure. A sedative will be given followed by intravenous anesthetic, intubation by an esophageal tube and anesthesia maintained by gas.
The area for the surgical incision on the lower abdomen will be shaved and cleaned antiseptically prior to surgery. Surgical drapes will be used to maintain a sterile surgical site.
Your veterinarian will make an incision in the abdominal wall, isolate the damaged section of large bowel, litigate blood vessels at the site where resection is to occur and close off the healthy sections of bowel using non-crushing surgical instruments to prevent contents from leaking into the abdominal cavity and avoid causing damage to the healthy sections of the bowel. The diseased tissue will be removed. Healthy tissue will be reconnected (anastomosis) using hand sutures or staples, and the clamping removed to allow bowel contents to flow through repaired bowel.
Your veterinarian will ensure that anastomotic leakage is not occurring prior to closing up the abdominal cavity. Sometimes intestinal anastomosis procedures use patches and grafts to reduce the risk of postoperative leakage. Depending on the cause for resection, diseased tissue may be sent to a laboratory for analysis, especially if cancerous tissue may be present. Your cat's abdomen will be closed and sutures put in place. Hospitalization for one to two days is usually recommended following intestinal surgery.
Efficacy of Colonic Resection and Anastomosis in Cats
Colonic resection and anastomosis is an effective treatment for the removal of diseased colonic tissue. Prognosis depends on the condition being treated. For removal of foreign bodies, obstruction, or benign conditions, prognosis is very good. If peritonitis or spreading tumors have occurred, or blood supply has been compromised in conditions of torsion, prognosis is guarded. Cancerous growths may recur.
Colonic Resection and Anastomosis Recovery in Cats
Your cat will require hospitalization for a few days post surgery. During this time your pet will be put on intravenous fluid to keep them hydrated without adding stress to the intestinal system. Antibiotics and pain medication will also be administered this way. Your cat will be introduced to water and small amounts of bland fluid in the hospital. Once this is tolerated your cat may be discharged. At home, activity should be restricted for several weeks. Your cat should be provided with a warm, stress-free environment with limited exposure to other pets, your cat may require cage rest at home for the first few days. An Elizabethan collar to prevent him/her from licking or biting the wound is usually required. The surgical wound must be monitored for signs of bleeding or infection. Check carefully for discharge, redness, soreness or fever and get veterinary attention to address any of these conditions. Your cat may be restricted from eating for a few day post-surgery and then given a modified diet to address gastrointestinal sensitivity post-surgery. Long-term diet changes to address any condition present such as colitis may also be recommended. Your veterinarian will conduct a follow up appointment to ensure healing is progressing and remove abdominal sutures.
Cost of Colonic Resection and Anastomosis in Cats
The surgery is invasive and hospitalization care is required post surgery. The cost of this surgery including anesthesia and postoperative care can be $1,500 to $3,000 depending on your cat's condition and cost of living in your area.
Cat Colonic Resection and Anastomosis Considerations
As with any surgery, risk from anesthesia and infection are present. With abdominal surgery, the risk from infection due to peritonitis, which may occur from bowel leakage during surgery or post-surgery from anastomotic leakage, is a particular danger. Surgical procedures to mitigate leakage and antibiotics to address infection will mitigate this risk.
There is also a risk of scar tissue building up and causing blockage (stricture) after large bowel surgery. This is less of a risk in the large bowel than in other parts of the digestive tract and the risk is minimal in the colon.
Colonic Resection and Anastomosis Prevention in Cats
Ensuring that your cat does not have small objects to play with that could accidentally be ingested and cause blockage or trauma to the gastrointestinal system will help prevent the need for surgical resection and anastomosis. Addressing lower bowel conditions such as colitis and feline megacolon and treating with appropriate medication will help control these conditions and minimize damage to the large intestine.
Colonic Resection and Anastomosis Questions and Advice from Veterinary Professionals
I don't see anything about what happens to the cat's quality of life after this surgery. My cat has just been diagnosed with probable carcinoma in the descending bowel. If I opt for surgery, they may find they can't get it all but no way to know unless I choose the surgery.
It seems a lot to put a cat through when there isn't a very high chance of good outcome. I am most concerned with her quality of life AFTER, not longevity. I thought the IM vet said something about fecal incontinence and chronic diarrhea after this surgery.
Nothing about quality of life after, in the long term, is mentioned in this article, and that is what I want to know. Thank you.
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Good writers are quite familiar with the expression “Show, don’t tell.” Unfortunately, when it comes to a beloved pet that’s fallen ill, telling is exactly what you wish they could do!
“What’s wrong, little one?” “Why are you upchucking your meals?” “Did you swallow something you shouldn’t have?” “Where does it hurt?” “Why are you losing weight?”
The pet to whom these questions were addressed was our lovely little Tuxedo kitty, Bonkers. She definitely earned her name in a number of adorable ways. Now she was worrying us to no end.
Our long-established local vet tried to get to the bottom of her distress with barium x-rays, palpitations, blood work, observation but found nothing definitive, other than a distended, inflamed stomach, and gas pockets throughout her intestines. Desperate to find the cause, we reached out to the other vet in town to seek an additional perspective and left a message with the receptionist asking for a call back from the doctor. That vet never responded.
Our five-year-old feline was getting worse by the day. We took her once again to the main vet to repeat the tests but still came up with one big goose egg. We felt temporarily better when, with the stomach soother and appetite stimulant they gave her, she acted ravenous when she got home and ate almost a full meal. But within two hours, it was obvious she was in pain again. And three hours after that, everything came up, worsening her now-starving condition. Our main vet suggested taking her to an animal hospital in Portland, but that advice was too distressing to consider after doing the same thing years earlier with another sick cat in a situation that did not come out well.
After two more days of lost sleep, sick ourselves with anguish over Bonkers, we broadened our search to possible facilities in Washington. On Sunday, Feb. 3, we left Goldendale at 6 a.m. to drive two hours to Horse Heaven Hills (H3) Pet Urgent Care in Kennewick.
This place was amazing.
It was pricy—thank you, CareCredit cards—but if we had to go through such an experience, this was definitely the place to do it.
The technician, Kayla, and the owner of the business, Dr. Sheila Erickson, were competent, caring, and compassionate. First, there were two more hours of non-invasive procedures that found nothing other than her condition worsening, so Erickson suggested exploratory surgery. The idea of anesthetizing little Bonkers, let alone opening her up in her condition, was a very hard decision. We were left alone for a few minutes and prayed for guidance as to what was best for this cherished family member we’d had since she was three weeks old. The answer came: surgery it was, despite the steep expense if more extensive surgery were required. Minutes after the initial incision was made, the tech was back to tell us the vet found a foreign object. Wow. We were relieved that the cause for her distress was found, and we granted permission to remove the object. Kayla returned 15 minutes later to explain that it had become deeply embedded in Bonkers’ upper intestine and had completely blocked her intestinal track. A portion of her small intestines had become infected and was dying off. That 2” section had to be removed, along with the object, and the clean ends sewn back together in a procedure called resection and anastomosis. The object was a small black piece of plastic that looked like a plug. It was ¼” in diameter and ¼” high. We had no idea what it was or where it came from, but the little stinker—did we mention her name was Bonkers?—had found, chewed, and swallowed it. We also had no idea something so small could do so much damage.
With the surgery complete and the patient in recovery, Dr. Erickson explained that she also thoroughly flushed out Bonkers’ entire intestinal tract to remove any possible remaining unhealthy microbes and immediately administered a strong antibiotic.
But let us explain why this experience, besides how it turned out and meeting these great people, was so extraordinary. The pricy nature of the clinic included a sizable private room for us to meet the vet , have her first examination with our cat, and for us to stay in during the entire process, which in total was some 14 hours from first entrance to taking Bonkers away. Was it worth the cost? You bet. The room was well appointed, more like a living room than a waiting room. There was a comfortable couch. A large screen TV. A place to set our meals when we left to bring in some take-out chow. There aren’t people doctors with facilities like this. The comfortable, home-like surroundings made the entire experience much more manageable.
So as we write this, we’re nine days post-op, and the little girl is doing great. Her appetite is back; she eats almost as much as she did before this incident, spread out over eight small meals a day, so she’s gaining back her lost weight, and, most importantly: she is pain free with no more vomiting. The collar she has to wear to keep her away from the incision has a cute side effect: goose-stepping! It’s just wide enough (and she small enough) that she kicks each of her front legs out in front of her as she walks to keep from stepping on it.
So Bonkers is as bonkers does. We’re “child” proofing the entire house, now knowing this cat will eat anything smaller than a tire, or so it seems. The price of doing that is also well worth it.
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My cat came home today after having bowel resection surgery (megacolon, cat is 10 years old) yesterday. Although he has peed half a dozen times, he hasn't pooped yet (and he hadn't pooped for a long time prior to surgery). How long is too long? Also shouldn't he have a pain medication?
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Lump in colon.
Had poop removed 3 times.
Still eating drinking acting normal.
Doctor did biopsy and its cancer but did not do a resection for lack of experience.
Charged us 5000 dollars tho.and said feed him lentils.
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