Acta Veterinaria (Beograd), Vol. 60, No. 2-3, 273-284, 2010.

DOI: 10.2298/AVB1003273P UDK 619:616.348.61:636.7

ETHIOPATHOGENESIS, DIAGNOSIS AND THERAPY OF ACQUIRED MEGACOLON IN DOGS

PROKI] B*, TODOROVI] VERA**, MITROVI] OLIVERA**, VIGNJEVI] SANJA**

and SAVI] STEVANOVI] VERA*

*University of Belgrade, Faculty of Veterinary Medicine, Serbia

**University of Belgrade, Institute for Medical Research, Serbia

(Received 5th September 2009))

Megacolon refers to an abnormal dilatation of the colon. This

condition occurs in both humans and animals. Although it seems to be
more common in cats, megacolon may also occur in dogs. However,
data regarding the etiopathogenesis, clinical course and outcome of
canine megacolon are scarce. The aim of this study is to present the
experience of our team in diagnosis and therapy of canine acquired
megacolon, with particular reference to etiopathogenetic aspects.
The prospective study included 28 dogs affected with
megacolon, aged 5-9 years. The 26 animals underwent a surgical
procedure (colonotomy followed by manual extraction of faeces), and
were followed up for a period of 28 days. On the basis of anamnestic
data, clinical and radiographic findings, 7 dogs (25%) were presented
with idiophatic acquired megacolon, while 75% of cases had
secundary acquired megacolon of different etiology (including pelvic
canal stenosis, lumbar and sacral spinal injuries or back leg fractures,
in 46% od cases; keeping the animals in the backyard and
irresponsibility of their owners, in 11%; non-adequate nutrition, in 11%;
and decreased physical activity and keeping animals in small flats, in
7%). During early postoperative period, the medical treatment and
dietary regimen enabled defecation in 65% of cases. The remaining
35% of cases were treated with Cisapride in order to establish
spontaneous defecation. All dogs recovered completely during the 28-
days follow-up period. According to the results of interviews with dog
owners, all animals were in good condition six months after the surgical
procedure.

Key words: acquired megacolon, dog, etiology, surgery

INTRODUCTION

Megacolon is a condition that is uncommonly described in dogs. It refers to

an abnormal dilatation of the colon that may be acute, chronic or toxic. Chronic
megacolon can be classified as congenital (also known as Hirschsprung's
disease in humans) or acquired, and may be either primary or secondary. The
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Proki} B et al.: Ethiopathogenesis, diagnosis
and therapy of acquired megacolon in dogs

cause of primary megacolon is unknown, so it is also termed idiopathic. The

pathogenesis of idiopathic megacolon is still a subject of controversy, although it
has been historically attributed to a primary neurogenic or degenerative
neuromuscular disorder (Meier-Ruge et al., 2006). Secondary megacolon can
occur as the result of intestinal wall lesions or various conditions that prevent
defecation for a prolonged period of time (Bharucha, 1999).
Two pathological mechanisms are implicated in megacolon development:
dilatation and hypertrophy. Dilated megacolon represents the end-stage of
colonic dysfunction in idiopathic cases. On the other hand, hypertrophic
megacolon refers to the functional disorder that develops as a result of chronic
obstructive lesions (stenosis of the pelvic canal, tumor, foreign body, etc.)
(Washabau and Hasler, 1996).
Diagnosis of megacolon is based on medical history and clinical
examination and is confirmed with native radiographs of the abdomen. The
patients are usually presented with a history of lethargy, decreased appetite and
failure to defecate over a long period of time (Colin, 1995; Gattuso and Kamm,
1997). Clinical examination commonly reveals dehydration, abdominal pain and
mild mesenteric lymphadenophaty (Washabau and Hasler, 1996). Complete
neurologic examination should be performed in order to identify neurologic
causes of constipation, for example, spinal cord injury or nerve trauma. The
diagnostic work-up should also include laboratory findings to rule out any
metabolic abnormalities. Radiographs can confirm the presence of a large colon
and can also be used to determine if there are any old pelvic fractures, masses or
spinal deformities. It's important to emphasize that radiographic examination
using barium sulfate is usually contraindicated. Taking into consideration that the
final diagnosis of megacolon is usually made by excluding all other causes of
constipation and/or obstipation, several studies emphasized the importance of
differential diagnosis (Burrows, 1991; Washabau and Hall, 1997).
The therapy for megacolon depends on several factors including the
severity of constipation and fecal impaction and the underlying cause. The initial
treatment is aimed to establish and/or maintains a fluid and electrolyte balance, as
well as to eliminate the possible causes of constipation. In addition, medical
therapy with stool softeners is the first-line treatment for this condition. In this
respect, animals should be appropriately hydrated and then an enema should be
performed. Thereafter, medical management with laxatives (Bisacodyl),
procinetics (Cisapride) and cathartics (lactulose) should be initiated. Cisapride
has been frequently used in the management of the gastric empting disorders,
intestinal transit and other motility disorders in both dogs and cats (Wiselman and
Faulds, 1994; Washabau, 2003). When medical therapy is no longer effective,
surgery is recommended. Although surgery is usually referred to as a subtotal
colectomy, in some cases colonotomy with fecal mass removal may also be
considered as the treatment of choice (Webb, 1985). Postoperatively, parenteral
antibiotic and vitamin therapy should be continued. Prognosis depends on early
recognition and management of megacolon (Nemeth et al., 2008).
Megacolon has been widely described in cats and majority of literature data
on this condition refers to cats. Megacolon can occur at any age, breed, or sex of
Acta Veterinaria (Beograd), Vol. 60, No. 2-3, 273-284, 2010. 275
Proki} B et al.: Ethiopathogenesis, diagnosis
and therapy of acquired megacolon in dogs

cat; however, most cases are seen in middle-aged male cats. Although there are
few studies describing canine megacolon, data regarding the pathogenesis,
clinical course and outcome in this condition are scarce.

MATERIAL AND METHODS

Animals
This prospective study included 28 dogs diagnosed with secondary
acquired megacolon/ idiopathic megacolon, aged 5-9 years. Over the period
1996-2000, the dogs were examined and treated at the Faculty of the Veterinary
Medicine, University of Belgrade.
The group of 28 examined dogs with megacolon consisted mainly of males
(21 dogs, 75%), and most of them was at the age of 8 years (14 dogs, 50%). The
basic information's on breed, sex and age of examined dogs with megacolon are
shown in Table 1.

Table 1. Breed, gender and age of examined dogs with acquired megacolon

Gender Age (years) Number

Dog breed
male female 5 6 7 8 9 of dogs
German shepherd 6 3 1 - - 6 2 9
Rottweiller 4 1 - - 3 2 - 5
Giant Schnauzer 4 - - 1 - 2 1 4
Sharr Mountain dog 5 2 1 1 2 2 1 7
Mix-breed dog 2 1 - 1 0 2 - 3
Total 21 7 2 3 5 14 4 28

The diagnosis of megacolon was established on the basis of detailed

anamnestic data, clinical examination, abdominal radiographic findings and
pathohistological findings. After the diagnosis was established, euthanasia was
performed on two animals with very poor health condition. The other animals were
subjected to the surgical procedure, and were followed up for a period of 28 days
after surgery, until complete recovery.

Preoperative treatment
Immediately after the diagnosis was established, over a period of 2-3 days,
all dogs were subjected to an initial treatment for restoration of their general health
condition and for surgical procedure preparation. In order to correct electrolyte
and energy imbalance, the animals were treated with infusions of Ringer's lactate
solution (500 mL), 5% glucose solution (500 mL) and aminosteril solution (30 mL).
In addition, once a day for three days, all animals were treated with preoperative
antibiotics and vitamin therapy (penicillin G, 800,000 U i.v.; Vitoligam, 3 mL s.c.;
and vitamin-B complex 3-5 mL s.c.). Before surgery, the animals were
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Proki} B et al.: Ethiopathogenesis, diagnosis
and therapy of acquired megacolon in dogs

premedicated with Atropine sulphate (s.c.), Acepromazine (i.v.) and Formidal

(s.c.), and then anesthetized with Ketamine hydrochloride (i.v. and i.m.).

Operative procedure
All animals underwent a median laparotomy and extra-abdominal
colonotomy with a longitudally placed incision on the transversal part of the colon,
followed by manual extraction of the intestinal contents. Closure of the incision
was accomplished by a continuous absorbable, synthetic, braided suture (Vicryl
4-0), followed by a second row interrupted Lembert type suture and standard
abdominal closure technique (Vicryl 3-0, 2-0, – peritoneal, muscular,
subcutaneous suture; Dexon 2-0 – skin suture).

Postoperative care
During the early postoperative period (7 days after surgery), antibiotics,
electrolyte solutions and vitamin therapy (penicillin G, Ringer's lactate, glucose,
aminosteril, vitamin C and vitamin-B complex) were continued and dogs were
closely monitored for infection. The animals were treated with topical iodine
preparations and appropriate topical antibiotics in order to prevent a possible
wound infection. The plastic collar was placed around the animal's neck to
prevent them from licking or biting wounds. The animals were deprived of water
for two days after surgery. On the third postoperative day, all animals were given
water only (3 x 200 mL). In addition to water, for the next three days (4th - 7th
postoperative day), animals were fed with chicken or beef soup (2 x 200 mL,
concentrate). Thus, the daily amount of fluid, given per os, was 1000 mL. During
this period, the animals were deprived of solid food. Seven days after surgery,
both medicamental and vitamin therapy were interrupted. Starting from the 8th
postoperative day, solid food (raw minced beef 2 x 150 g, and wheat bran 2 x 50 g,
per day) was introduced to the diet and dogs were allowed ad libitum access to
water. Skin sutures were removed on the 7th postoperative day, while the
protective collar was removed two days later.
During the third postoperative week, in addition to raw beef, fresh bread (2 x
50 g, per day) was introduced to the diet. After this period, in some animals
defecation did not occur. These animals received Cisapride, 10 mg per os, three
times a day. Cisapride was discontinued on 21st postoperative day, and all
animals were given an incresed amount of food (meat 2 x 200 g, toasted bread 2 x
50 g, wheat bran 50 g and soup concentrate 2 x 200 mL). Animals were fed twice a
day, during the period of 28 days after surgery. Thereafter, all animals were
submitted to clinical and radiographic control examinations. According to control
examinations, all animals showed complete recovery and dog owners were
advised to feed the animals once a day. The younger dogs were allowed to eat
bone six months after surgery, while eating bones was strictly prohibited for older
dogs.
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and therapy of acquired megacolon in dogs

RESULTS

Diagnostic data
All 28 dogs (age range: 5 to 9 years; mean age: 7.53±0.21 years, median: 8
years) with megacolon were clinically examined. Prior to physical examination,
dog owners provided us with anamnestic data. According to medical history, 45%
of dogs were presented with diarrhoea, 35% with prolonged constipation, and in
10% of cases the owners reported the assumption that the dog swallowed a
foreign body. In some cases (10%), the owners did not pay attention to the
physiological activities of their dogs and the animals were clinically examined for
serious deterioration of their general health condition.
The physical examination revealed deterioration in health status, lethargy,
significant weight loss, ataxia, bowed body posture (regarding the head and neck
position), serous/purulent eye discharge or dry eye, dry skin, loss of skin elasticity
and a markedly distended abdomen. Abdominal palpation confirmed the
presence of large faecal mass within the colon. Colonic impaction was hard,
stone-like consistency on palpation. Abdominal pain and tenderness on
abdominal palpation were registered in extremely severe cases (the absence of
defecation even up to 60 days). Except for two severe cases, haematological and
biochemical blood parameters were within reference ranges. The laboratory
findings of these two animals revealed anaemia, hypokalemia and
hypocalcaemia. In addition, subfebrile condition and bradicardia were registered
in 3 of 28 dogs (8.1%).
Abdominal radiography of all examined dogs showed colonic distension
with stool retention. Markedly dilated colon with a diameter up to 20-30 cm was
evident on all radiographic images (Figure 1). In most cases, enlarged colon
extended from the epigastric region to the pelvic canal.

Figure 1. Radiographic image of markedly dilated colon in a dog with idiopathic megacolon
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Proki} B et al.: Ethiopathogenesis, diagnosis
and therapy of acquired megacolon in dogs

Based on anamnestic data, clinical and abdominal X-ray findings, in 7 of 28

dogs (25%) the cause remained unknown, and those cases were classified as
idiopathic acquired megacolon. Medical history, clinical and radiographic
findings of remaining animals with secondary acquired megacolon revealed that
in 7% of cases the possible cause was decreased physical activity and keeping
animals in small flats, while in 11% the predisposing factor was keeping the
animals in the backyard and irresponsibility of their owners. Additionally, non-
adequate nutrition was a possible cause of megacolon in 11% of cases, while 13
animals (46%) had both clinical and radiographic signs of pelvic canal stenosis,
lumbar and sacral spinal injuries or back leg fractures (Figure 2). There was no
difference in the age distribution of these predisposing factors. However, at the
age of 5 years no case with the above mentioned predisponing factors was
registered (Table 2).

5
1 2 Figure 2. Distribution of potentional
3 etiological factors of megacolon
1. Decreased physical activity and
4
keeping the animals in small flats;
2. Keeping the animals in the backyard
and irresponsibility of their owners;
3. Non-adequate nutrition;
4. Pelvic canal stenosis, lumbar and
sacral spinal injuries or back leg
fractures;
5. Idiophatic acquired megacolon

Table 2. Predisposing factors for the development of megacolon – age distribution

Predisposing factors of megacolon

Age Decreased activity/ Negligence of Non-
(years) keeping dogs in dog owners / LSS* injuries/
adequate Unknown
keeping the dogs leg fractures
small flats nutrition
in backyards
5 - - - - 2
6 - 1 1 - 1
7 - 2 - 3 1
8 2 - 1 8 2
9 - - 1 2 1
Total
2 3 3 13 7
number

*LSS – lumbosacral spine

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Proki} B et al.: Ethiopathogenesis, diagnosis
and therapy of acquired megacolon in dogs

Surgical findings and postoperative treatment results

Following a ventral midline laparotomy, the intraoperative diagnosis of
megacolon was established based on the presence of a markedly dilated colon,
filled with hard faecal masses. Subsequently, the longitudinal colonotomy with
manual extraction of faeces was performed. Some details regarding the surgical
intervention are shown in Figure 3.

Figure 3. Gross apearance of megacolon before colonotomy followed by manual

extraction of faeces

During colon surgery, full thickness tissue specimens from the dilated
transversal colon were taken for pathohistological examination. Pathohistological
findings of all tissue specimens, including immunohistochemical findings of
enteric nervous system and VIP-eregic innervation of affected colon segment
were presented in our previous report (data not shown) (Prokic et al., 2009).
No intraoperative complications were observed. The medical treatment
during early postoperative period (1-7th postoperative day), followed by gradual
introduction of solid foods (7th-14th postoperative day) enabled defecation in 65%
of cases. The remaining 35% operated dogs were treated with Cisapride in order
to establish a regular defecation. Thus, the complete recovery of all operated
dogs with megacolon was evident during the 28-day postoperative period.
According to the data obtained from dog owners, all animals were in good
condition six months after the surgical procedure.

DISCUSSION

Megacolon is a condition that occurs in both humans and animals. This

condition seems to be more common in cats, but may also occur in dogs.
However, the exact incidence and prevalence of canine megacolon are unknown.
Considering a small number of publications dealing with canine megacolon,
usually in case report forms, majority of literature data originates from the
numerous studies referring to the feline megacolon.
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Proki} B et al.: Ethiopathogenesis, diagnosis
and therapy of acquired megacolon in dogs

It was previously thought that megacolon commonly affects older cats.

However, recent studies show that both feline and canine megacolon may be
seen at any age (Washabau and Hall, 1997b). According to a review of 120 cases
published in English veterinary literature, most cases of megacolon are observed
in middle-aged, male cats (70%). These data also suggest that megacolon
commonly affects domestic shorthair (46%), domestic longhair (14%) and
Siamese breeding (Washabau and Hasler, 1996).
In cats the disease is characterised by repeated episodes of constipation or
prolonged obstipation that may result in complete absence of defecation.
Affected cats are presented with anorexia, dehydration, weight loss, vomiting, and
lethargy. Occasionally, chronically constipated cats have intermittent episodes of
diarrhea. Cats affected with idiopathic dilated megacolon usually have a history of
recurrent constipation culminating in obpstipation. On the contrary, animals
affected with hypertrophic megacolon usually have a history of automobile or
other trauma (Burrows, 1996; Washabau and Holt, 1999).
An extensive list of differential diagnosis for the obstipated cat includes
numerous factors associated with a prolonged constipation, such as:
neuromuscular, mechanical, metabolic, endocrine, inflammatory, and
environmental factors. Although in some cases differential diagnosis may be of
critical importance the majority of cases of obstipation are accounted for
idiopathic megacolon (62%), pelvic canal stenosis (23%), nerve injury (6%) or
Manx sacral spinal cord deformity (5%). In addition, in a small number of cases,
obstipation was a result of complications of colopexy (1%) or colonic neoplasia
(1%), while hypoganglionosis / aganglionosis was suspected in 2% of cases, but
not proven (Washabau and Hasler, 1996; Washabau and Hall, 1997). However,
the importance of differential diagnoses for the obstipated dog is not well
documented.
In the present study, 28 dogs affected with megacolon, aged 5-9 years, were
examined and 26 of them were surgically treated for this condition. To the best of
our knowledge, there is no published data referring to canine megacolon that
involves such a large number of subjects. On the basis of anamnestic data,
clinical and radiographic findings, 7 dogs (25%) were presented with idiopathic
aquired megacolon, while 75% of cases had secondary acquired megacolon of
different etiology.
The results of our study concerning the breed, age and gender of examined
dogs are in accordance with literature data showing that both feline and canine
megacolon occurred in animals of any age or breed, but they are often seen in
middle-aged male animals. The common causes of obstipation are well described
in veterinary literature. However, data referring to etiology and pathogenesis of
megacolon are very scarce. Data on potential etiological factors, obtained in the
present study, are not entirely consistent with previously reported data regarding
feline obstipation. In the present case series, nearly half of these cases developed
megacolon secondary to lumbosacral spine injuries or leg fractures (13/28 dogs,
46%), while in 25% of cases the cause remained unknown and these cases were
classified as idiopathic acquired megacolon. The differences in distribution of
etiological factors, between data obtained in our study and literature data, are
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Proki} B et al.: Ethiopathogenesis, diagnosis
and therapy of acquired megacolon in dogs

probably due to the fact that obstipation and megacolon are not the same entity,
as well as to species differences and the sample size. Some authors emphasized
the role of environmental/ behavioral factors in colonic motility disorders (Nemeth
et al., 2008; Zoran, 2008). Data obtained in the present study showing that 28% of
examined dogs with megacolon had environmental and behavioural underlying
causes are consistent with the emphasized role of these factors in veterinary
literature.
Some guidelines were used in establishing the diagnosis of megacolon in
humans (Berens et al., 1986; Basilico et al., 1997). Similarly to humans, the
diagnosis of canine megacolon is based on detailed anamnesis, physical
examination with special regard to abdominal palpation and rectal examination,
as well as on abdominal radiography and histopathological findings of colon
biopsies. The results of the present study confirmed the diagnostic significance of
detailed anamnestic data obtained by dog owners. Detailed anamnesis revealed
lethargy, anorexia, frequent vomiting and diarrhea, which are the symptoms
commonly described in these patients. Interestingly, the majority of dog owners
reported that diarrhea was the main symptom of the disease. In fact, diarrhea was
a result of the mucosal irritant effect of dehydrated faeces. Clinical findings of 28
dogs, included in this study, were fairly consistent with the findings described by
other authors (Burrows, 1996; Washabau and Stalis, 1996).
All dogs included in this study had normal laboratory findings, except two
severe cases. Laboratory findings within the normal reference range rule out
metabolic and endocrine underlying causes. The present study confirmed the
crucial importance of radiographic findings in the diagnosis of megacolon. Plain
abdominal radiography revealed a pathognomonic sign of megacolon
(abnormally dilated colonic section filled with hard faeces) in all examined dogs.
In the present case series, a grossly dilated colon extended from pelvis to
epigastrium causing the displacement of abdominal organs. However,
radiographic findings of colonic impaction cannot be used to distinguish between
constipation, obstipation and megacolon in idiopathic cases (Washabau and Hall,
1997b). In our case series, the diagnosis of idiopathic cases was supported by
histopathological findings. In addition, immunohistochemical findings showed
the alterations of VIP-ergic innervation in affected colon segments, more severe in
idiopatic subjects, as we have previously reported (Proki} et al., 2008).
The goal of treatment is to maintain a soft stool and to improve colonic
motility. In this respect, stimulant laxatives and procinetics are usually
administered initially. Recent studies confirmed that feline megacolon is
characterized by a generalized dysfunction of colonic smooth muscle, and that
treatments aimed at stimulating colonic smooth muscle contraction might
improve colonic motility (Washabau and Stalis, 1996). Thus, treatment with the
procinetic drug Cisapride can improve the propulsive motility of the
gastrointestinal organs, including the colon (Summers and Flatt, 1988; Cucchiara,
1996; Hasler and Washabau, 1997). Cisapride (substituted piperidinyl
benzamide) is a gastroprokinetic agent which acts as a serotonin 5-HT4 receptor
agonist (Mine et al., 1997). In animal practice it is usually recommended that
Cisapride should be given orally at dose of 0.1-0.5 mg/kg, every 8-12h (Orihada
282 Acta Veterinaria (Beograd), Vol. 60, No. 2-3, 273-284, 2010.
Proki} B et al.: Ethiopathogenesis, diagnosis
and therapy of acquired megacolon in dogs

and Sarma, 1994). It is shown that some cases of megacolon respond poorly to
medical therapy. In these patients, surgery is a treatment of choice. Surgical
intervention is also recommended with persistent colonic dilatation and
associated complications. However, it is important to emphasize that there are
many treatment options and the most successful therapy usually involves a
combination of treatment interventions.
All dogs included in our study underwent colon surgery followed by an
intensive postoperative medical treatment. Several surgical techniques for the
management of feline idiopathic megacolon have been described, including
coloplasty and partial or subtotal colectomy (White, 2002). The current gold-
standard surgical treatment of feline idiopathic megacolon is subtotal colectomy
(Colopy-Poulsen, 2005). In a recent study Nemeth et al. reviewed the clinical data
of eight dogs treated by subtotal colectomy for acquired hypertrophic megacolon
during a 5-year period (Nemeth et al., 2008). Their results emphasised the long-
term effectiveness of subtotal colectomy with preservation of the ileocolic
junction. This procedure involves the removal of a large portion of the colon and
only a short distal colonic segment is spared to allow anastomosis. However,
some authors demonstrated that the entire colon is likely histologically affected
and any amount of colon remaining following subtotal colectomy may continue to
dilate, potentially resulting in recurrence of clinical signs (White, 2002). Thus,
failure to resects a significant length of grossly normal-appearing colon may result
in therapeutic failure. In the present study we performed a colonotomy with
manual extraction of faeces in order to avoided a potential therapeutic failure as
well as to reduce the rate of both intraoperative and postoperative complications.
Postoperativelly, a combination of dietary regiment and intensive medical
treatment with antibiotics and vitamin therapy resulted in defecation in the
majority of cases. Cisapride treatment in remaining 35% of cases improved the
propulsive motility of colon and enabled spontaneous defecation. Diet was also
an important part of postoperative treatment. Constipated patients are usually fed
a standard diet high in fiber to help attract water to the stool, improving its
consistency (Foxx-Orenstein et al., 2008). Consumption of high-fiber foods
contributes to optimal surgery outcome and helps to prevent postoperative
constipation. Starting after the first postoperative week, all dogs included in our
study were fed with wheat bran, which is a natural source of fiber. All 26 operated
dogs affected with megacolon (19 with secondary and 7 with idiopathic)
recovered completely during the follow-up period. According to the results of
telephone interviews with dog owners, all animals were in good condition six
months after the surgical procedure.
In conclusion, our results show the long-term effectiveness of colonotomy
with manual extraction of retained faeces in combination with intensive
postoperative treatment in canine megacolon.

ACKNOWLEDGEMENT:
These study was supported in part by the Serbian Ministry of Science and Technological Development
(Grant No145064).
Acta Veterinaria (Beograd), Vol. 60, No. 2-3, 273-284, 2010. 283
Proki} B et al.: Ethiopathogenesis, diagnosis
and therapy of acquired megacolon in dogs

Adress for correspodence:

Dr Branislav Proki}
Universty of Belgrade
Faculty of Veterinary Medicine
Clinic of Veterinary Surgery
Bulevar Oslobodjenja 18
11000 Beograd
E-mail: prokaªvet.bg.ac.rs

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ETIOPATOGENEZA, DIJAGNOZA I TERAPIJA STE^ENOG MEGAKOLONA PASA

PROKI] B, TODOROVI] VERA, MITROVI] OLIVERA, VIGNJEVI] SANJA

i SAVI] STEVANOVI] VERA

SADR@AJ

Megakolon ozna~ava abnormalnu dilataciju kolona. Javlja se i kod ljudi i

kod `ivotinja. Iako je oboljenje ~e{}e kod ma~aka, javlja se i kod pasa. Me|utim,
podaci o etiopatogenezi, klini~kom toku i ishodu bolesti megakolona kod pasa su
oskudni. Stoga je cilj ove studije da se iznesu sopstvena iskustva o dijagnostici i
terapiji ste~enog megakolona kod pasa, sa posebnim naglaskom na etiopato-
genetski aspekt oboljenja.
Studija je bila prospektivnog karaktera i obuhvatila je 28 pasa sa megako-
lonom, starosti 5-9 godina. Dvadeset {est `ivotinja podvrgnuto je hirur{koj inter-
venciji (kolonotomija sa manuelnom ekstrakcijom fecesa) i pra}eno postopera-
tivno u toku 28 dana. Na osnovu anamnesti~kih podataka dobijenih od vlasnika
pasa, klini~kog i radiografskog nalaza, 7 pasa (25%) imalo je idiopatski ste~eni
megakolon, dok je kod 21 psa (75%) bolest okarakterisana kao sekundarni
ste~eni megakolon uzrokovan razli~itim etiolo{kim faktorima (uklju~uju}i stenozu
pelvi~nog kanala, o{te}enje lumbalne i sakralne ki~me ili frakturu zadnjih ek-
stremiteta, kod 46% pasa; ~uvanje `ivotinja u dvori{tu i nedovoljni nadzor od
strane vlasnika, kod 11%; neadekvatna ishrana, kod 11%; smanjenja fizi~ke aktiv-
nosti i ~uvanje `ivotinja u sku~enom prostoru, kod 7%). U ranom postoperativnom
periodu, terapija i re`im ishrane doveli su do uspostavljanja defekacije kod 65%
pasa. Kod preostalih 35% slu~ajeva spontana defekacija je uspostavljena prime-
nom terapije Cisapridom. Sve `ivotinje su se u toku 28-dnevnog nadzora kom-
pletno oporavile, a odli~no op{te stanje zabele`eno je, na osnovu intervjua sa
vlasnicima i 6 meseci nakon hirur{ke intervencije.