Are cat colons shrinking?

JVIM 2024

February 13, 2025

King, Donovan, Cohen, Marin, Le Roux

Background:
Short colon syndrome (SCS) is a condition identified in cats, marked by a non-iatrogenic reduction in colonic length. Its pathogenesis is unclear, though congenital and acquired origins are hypothesized. The study aims to define the clinical, imaging, endoscopic, and histological characteristics of SCS in cats.

Methods:
This multi-institutional, retrospective case series analyzed 93 cats diagnosed with SCS via ultrasonography, CT, endoscopy, or autopsy. Clinical records and imaging data from 2005 to 2021 were reviewed. Histopathology included colonic and small intestinal biopsies where available.

Results:

Clinical Signs: Diarrhea (65%), vomiting (39%), weight loss (39%), and inappetence (26%) were common. Thirteen percent exhibited no gastrointestinal symptoms.
Diagnostics: Ultrasonography identified SCS in 94% of cases, with CT and endoscopy contributing to diagnosis in fewer cases. Colonic shortening, wall thickening, and displaced ileocecocolic junctions were typical findings.
Histopathology: Lymphoplasmacytic colitis was nearly universal. Some cases had concurrent small cell lymphoma.
Imaging Findings: Wall thickening primarily affected the submucosa. Concurrent mesenteric lymphadenopathy and altered cecal appearance were noted.
Outcome: Median survival after diagnosis was 2.3 years, with cats generally reaching normal lifespans.


Limitations:
The retrospective design and reliance on imaging or partial biopsies might bias the findings. Comorbidities and incomplete records could affect interpretations.

Conclusions:
SCS appears increasingly common due to advanced diagnostic imaging. While a congenital basis is possible, findings suggest chronic colitis may lead to acquired SCS. Future research should investigate the potential for progressive shortening and its clinical implications.

Sonogram of a cat with short colon. (A) Composite sagittal image of the colon. The colon is severely decreased in length,measuring 5-10 cm maximum. The ileocecocolic junction and distal portion of the ileum (arrow) are located within the left hemiabdomen, withabsence of the transverse and ascending segments of the colon. There is mural thickening (up to 4 mm, yellow double-sided arrow), characterizedby thickening of the submucosa and muscularis layers. The urinary bladder (asterisk) is seen ventral to the most caudal portion of the colon.(B) Transverse image of the colon. A mildly enlarged caudal mesenteric (formerly “left colic”) lymph node (arrowheads) is dorsal to the colon. Themesentery surrounding the colon is hyperechoic.

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