Colonic Resection and Anastomosis in Cats

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.

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.

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.

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. 

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.

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. 

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.