Gastrointestinal Resection and Anastomosis in Cats

Gastrointestinal resection and anastomosis is a surgical procedure used in cats to treat tissue necrosis, perforation, and masses in the small and large intestines. The resection will involve removing a diseased portion of the small or large intestine. Anastomosis is the process of reconnecting the open ends of the healthy tissues. This procedure is usually reserved for cases in which tissue damage or injury is irreversible and cannot be treated with other methods.

The approach to this surgery will vary based on the location of the diseased tissue. A surgeon may use staples, sutures, or specialized anastomotic devices to perform this procedure. Sutures are most commonly used.

1. Blood work will be done prior to surgery to ensure anesthetization is safe for the cat.
2. The surgeon will administer general anesthesia and analgesics intravenously. The operative area will be cleaned, shaved, and draped.
3. The surgeon will make the initial incisions into the skin, subcutaneous tissues, and abdominal cavity.
4. The mesenteric and arcuate arteries are then ligated.
5. The affected section of the intestines will be packed off with surgical sponges. The surgeon will then “milk” the contents of the gastrointestinal tract out of the affected section.
6. The section is then clamped on either side, and the vessels supplying blood to this section are ligated to prevent hemorrhage.
7. The affected section is then cut and removed.
8. The healthy, open ends are then sutured together.
9. Before adding additional sutures, the surgeon will ensure the gastrointestinal contents will not leak from the suture site.
10. A graft patch may be sutured over the incision site to protect it and promote healing. This graft is called an omental patch. It is taken from the fat in the abdomen.
11. The surgeon will flush the surgery site with a sterile saline solution.
12. The sponges are removed and the abdomen is flushed prior to closure of the abdomen and skin.
13. The cat will be hospitalized after surgery.

Gastrointestinal resection and anastomosis is generally effective in managing gastrointestinal conditions. The efficacy of this procedure will vary based on how quickly the underlying condition was diagnosed and treated and the overall health of the cat. Cases involving the removal of foreign bodies are more likely to involve anastomotic leakage. Additionally, cats that have a previous history of peritonitis or other gastrointestinal conditions also have a higher risk for experiencing postoperative complications.

After surgery, cats may be hospitalized for 48 hours or more to ensure leakage does not occur. During this time, fluid and nutritional therapies will be administered in addition to analgesics. Upon discharge, the cat will be prescribed oral analgesics and antibiotics. Cats should be encouraged to eat a bland diet and drink water within four to twelve hours after discharge. The surgeon will provide the owner with specific dietary guidelines for the first few days of the recovery period. Normal bowel movements will generally resume within twenty-four hours. Cats typically return to a normal diet within three days after surgery. Antibiotics should be administered for five to seven days, or according to surgeon instructions.

If fever, vomiting, or weight loss occurs, the owner should consult their veterinarian immediately as this can be a sign of peritonitis. The owner should check the surgery site daily to make sure no leakage, swelling, or drainage has occurred. The cat may need to wear an Elizabethan collar to avoid irritating the sutures.

A follow-up appointment will be scheduled for ten to fourteen days after surgery to remove the sutures and monitor healing. Additional appointments may be scheduled if the cat requires more treatment.

The cost of gastrointestinal resection and anastomosis will vary based on standards of living and the condition it is used to treat. On average, the cost of gastrointestinal resection and anastomosis ranges from $300 to $700.

Complications associated with gastrointestinal resection and anastomosis may include:

• Wound rupture
• Peritonitis: Inflammation of the peritoneum, usually a result of infection or rupture
• Ileus: Obstruction of the ileum in the intestine
• Recurrence of the condition
• Short-bowel syndrome
• Infection
• Shock
• Hemorrhage
• Stenosis: Narrowing of the intestines
• Anesthetic death

Short-bowel syndrome occurs when more than 70% of the small or large intestine is removed. This will result in improper digestion and nutrient absorption. Cats with short-bowel syndrome are unable to pass feces normally and will suffer from chronic weight loss. This can be managed through dietary changes.

Some of these complications will need to be resolved with a second surgical procedure. The rate of postoperative complication ranges from 3% to 16%.

Certain conditions, particularly cancer and congenital defects, are difficult to prevent. Owners should monitor their cat’s outdoor activity to make sure they do not ingest foreign bodies. Immediate veterinary attention should be sought for cats experiencing chronic constipation. Cats should be given a complete, commercial diet to reduce the risk of gastrointestinal disorders.