Symptoms & Treatment of Feline Intestinal Volvulus: Qui
Intestinal volvulus in cats occurs when the small intestine twists, causing it to be compressed between the liver, the distal esophagus, and the bottom of the stomach, leading to a blockage at the esophageal opening (the area where the stomach connects to the esophagus). This condition is sudden and severe, characterized by a rapid swelling of the abdomen and intense abdominal pain. Affected cats are unable to eat, rapidly decline, and may experience shock, leading to a quick and tragic death. Therefore, Dr. Oxygen, a pet veterinarian, emphasizes that surgery is necessary for treatment.
The primary cause of intestinal volvulus is often a sudden, vigorous movement after eating. This can also occur following abdominal surgery in cats, where abnormal adhesions of the peritoneum during the recovery period or complications from diaphragmatic hernia may contribute.
Symptoms include a sudden cessation of eating during meals, a rapid loss of appetite, and a rapid, progressive swelling of the abdomen. The abdomen may become tense and hard, with gas retention upon palpation. Cats may exhibit increased respiratory and heart rates, abdominal pain, rapid exhaustion, and occasionally, vomiting. Shock symptoms may also occur, leading to a rapid demise.
Intestinal volvulus can lead to conditions such as intestinal distension, necrosis, and bleeding, as well as infection and absorption of toxins. It is a type of闭袢性绞窄性肠梗阻, where the mesentery twists, causing a blockage in blood supply to the intestines. This results in a rapid twisting of the intestines into a strangulated state, with a rapid increase in internal pressure, obstructing the return of venous blood from the intestinal wall, leading to rapid necrosis and diffuse intestinal distension.
Bowel necrosis and mesenteric torsion prevent the normal return of venous blood to the intestinal wall, causing blood to quickly enter the intestinal lumen, resulting in a large amount of blood clots. When the intestines lose vitality, toxins and bacteria can pass through the intestinal wall into the abdominal cavity, absorbed by the peritoneum into the bloodstream, leading to septicemia.
Torsion of the intestines and mesentery can disrupt blood circulation, causing bowel necrosis and massive bleeding. The severe pain caused by intestinal volvulus can trigger shock, leading to a decrease in the function and resistance of all organs in the body. After the absorption of toxins from the intestines, they reach all organs and tissues, damaging the heart, lungs, and other organs. Acute blood loss can cause the body to lose a significant number of red blood cells in a short period, leading to severe oxygen deficiency. The body's compensatory functions increase the burden on the heart and lungs, exacerbating pulmonary hemorrhage, edema, and heart failure. Therefore, hypovolemic shock, toxic shock, and heart failure are the direct causes of death.
Differential diagnosis includes: intestinal spasm, acute pancreatitis, abdominal organ rupture, intestinal obstruction, intussusception, and ileus, which have similar symptoms to intestinal volvulus.
Treatment: Conservative therapy is ineffective for intestinal volvulus. Since intestinal volvulus often leads to bowel necrosis, bleeding, perforation, and endotoxin toxicity in a short period, it is advisable to perform surgery as soon as the condition is diagnosed or suspected. Surgery is the only effective method, and the key is early and timely surgery.
Preoperative preparation requires a short and quick process. In the absence of contraindications, rapid antishock treatment, blood volume supplementation, correction of acidbase imbalances, and electrolyte disturbances should be carried out to ensure a smooth transition to surgery and anesthesia. It is crucial not to prioritize surgery over antishock measures and to wait for the improvement of shock symptoms before proceeding with surgery.
Preoperative and intraoperative management is essential for the success of surgery. The shorter the onset time, the greater the chance of preserving the intestinal tract. Conversely, the longer the onset time, the more severe the necrosis, perforation, and toxic shock, reducing the possibility of preserving the intestinal tract and even posing a threat to the animal's life. Postoperative administration of a large amount of effective antibiotics to prevent infection, strengthening nutrition, and ensuring the healing of the anastomosis are crucial for a successful postoperative period.
When resetting the twisted intestines, it is important to be gentle and careful. After opening the abdominal cavity, the right hand should be inserted to explore the root of the mesentery to understand the direction and extent of the twist. The intestines should be gently rotated in the opposite direction of the twist to reset them, until the mesentery root is smooth and free of twists, avoiding inadequate or excessive resetting. It is important to prevent excessive traction on the mesentery to avoid tearing the mesentery and its blood vessels.
Accurate assessment of the viability of the intestines is crucial. This can be determined by examining the presence of congestion and bleeding points in the intestines and mesentery, the normal color of the mesenteric layer, the presence of peristalsis, the presence of thrombosis in the mesentery, and the pulsation of the mesenteric and intestinal artery. If the following signs are present after resetting the intestinal volvulus, it indicates that the intestines have lost their vitality: 1) The intestinal wall has turned black and collapsed; 2) The intestinal wall has lost tension and peristalsis, and the intestines are paralyzed, enlarged, and unresponsive to stimulation; 3) The terminal small arteries of the corresponding mesentery have no pulsation. If there is any suspicion, warm saline gauze can be applied, or 0.5% procaine solution can be used for mesenteric root blockage. If there is no improvement after 15 to 30 minutes, it indicates that the intestines have necrotized, and an intestinal resection should be performed. For cases of intestinal necrosis, the mesenteric vessels should be cut before the intestinal resection to reduce the absorption of toxins.
Prevention: Wait for at least half an hour to an hour after a cat eats before playing with it, allowing it to digest properly. Feed your cat on a regular schedule and avoid overeating due to extreme hunger, which can also cause gastric volvulus. After a cat has undergone abdominal surgery, pay close attention to the postoperative care and follow the doctor's instructions carefully to prevent abnormal adhesions of the peritoneum that may lead to gastric volvulus.
