Fecal Incontinence in Cats

What Is Fecal Incontinence in Cats?

Our cat family members learn to use the litter box at an early age. It’s intuitive. Usually, they prefer to dig and bury their business, which suits indoor life well, yet it can be frustrating for pet parents when bowel movements are found outside the litter box. Fecal incontinence is a condition that occurs when a cat is no longer able to control when they defecate.

Fecal incontinence is a loss of bowel control. With any normal stool there are three phases: the storage phase, the awareness of the need to defecate, and then the defecation phase. Most problems with fecal continence occur either because there is an issue with the rectum preventing stool from being stored normally, or with the anal sphincter itself, allowing feces to leak out.

Fecal incontinence is uncommon in both dogs and cats, but it occurs more frequently in senior pets as they age and lose control of their bodily functions; they may not be aware of the need to defecate or do not have the sphincter tone (sphincter able to stay tightly closed) needed to prevent stools from dropping. 

Symptoms of Fecal Incontinence in Cats

• Bowel movements outside the litter box

• Stool dropping without awareness

• Soft stool or diarrhea

• Stool staining around the rectum

• Stool leakage

• Redness or inflammation of the anus

• Frequent licking of the anus

• Changes in how the tail is carried

• Weakness in the hind end

• Standing near the litter box to defecate, but they couldn’t “make it in time”

Causes of Fecal Incontinence in Cats

Fecal incontinence can be caused by a variety of conditions.

Diarrhea can lead to incontinence, as the bowel movements come on so fast that a cat is unable to make it to the litter box in time. This is commonly seen in cats with IBD (inflammatory bowel disease). Certain cancers, like gastrointestinal (GI) lymphoma, can look like IBD and also lead to diarrhea and loss of bowel control.

Wounds, trauma, or tumors that affect the anal sphincter can also lead to a loss of bowel control. This is seen occasionally in cats with a ruptured anal gland, laceration, or abscess (a tear or open wound) near their anus. Sometimes it is observed following perianal surgery, like a perineal hernia repair or anal sac removal. Cancer of the rectum and surrounding region can also lead to sphincter or nerves involved in normal defecation.

Prolonged constipation or straining to defecate can also lead to fecal incontinence, as nerve damage can occur. Cats that are chronically constipated or those that develop megacolon (an abnormal expansion of the colon) can struggle to control their bowel movements.

Intervertebral disc disease and lumbosacral stenosis are both conditions that lead to compression of the spinal cord. While they are more common causes of fecal incontinence in dogs, cats can also experience loss of control of their bowel movements because of spinal cord damage and disruption of the nerves needed for bowel control.

Some cats are born without a fully developed spinal cord and with poor control of their bowel movements. This is more common in tailless Manx cats due to a recessive gene that can lead to poor development of the nerves that control bowel movements.

A loss of bowel control can also occur with age, as the anal sphincter muscles become thinner and it can be difficult for a cat to keep stool from falling out. Some senior cats also develop cognitive dysfunction, or dementia. This can affect their awareness of the need to defecate or make them forget where the litter box is in their home.

How Veterinarians Diagnose Fecal Incontinence in Cats

A diagnosis of fecal incontinence starts with a thorough history of your cat’s health. Your veterinarian will want to know how often your cat is having bowel movements outside the litter box, if the bowel movements are solid, soft, or diarrhea, and if you have witnessed any stool falling out of the rectum without your cat noticing. Try to bring a fresh stool sample to your cat’s appointment.

Next, a complete physical exam will be done. Your vet will examine your cat’s anus closely to look for any abnormalities of the sphincter and surrounding area. They will likely do a rectal exam, palpate (examine by feeling) your cat’s abdomen, and perform a neurological exam to ensure all the nerves that travel to their back end are functioning properly.

A fecal exam of your cat’s stool, X-rays, and blood work may be recommended depending upon what is found on the physical exam. If IBD or GI lymphoma are suspected, they may recommend additional special blood work, an abdominal ultrasound, or intestinal biopsies. If spinal disease is suspected, a CT scan or MRI may be recommended.

Treatment of Fecal Incontinence in Cats

Treatment depends upon the underlying cause of the loss of bowel control. Your veterinarian will guide you on treatment options available after an underlying cause is identified.

If your cat is diagnosed with IBD, GI lymphoma, or another condition that is affecting their ability to store feces, they will likely be put on long-term oral medications. If another cause of diarrhea is identified, it will be treated accordingly. But if chronic constipation is leading to fecal incontinence, your cat may be put on stool softeners and prescribed medications, and placed on a special long-term diet such as Royal Canin® Gastrointestinal Fiber Response Food or Hill®’s Prescription Diet Gastrointestinal Biome.

Spinal cord and nerve issues may respond to medical management or surgery, but the condition might be so advanced that no treatment is possible. Some conditions, like tumors, may lead to surgery recommendations, while post-operative incontinence complications may resolve with time or be untreatable.

Fecal incontinence related to age and sphincter issues is rarely something that can be treated—only managed. But some cats can benefit from a low-fiber diet to decrease the frequency of their bowel movements. 

Recovery and Management of Fecal Incontinence in Cats

While some underlying causes of fecal incontinence can be cured, others can only be managed. Some cannot be treated at all.

If your cat is experiencing a loss of control of their bowel movements, it may be helpful for you to keep them confined to a smaller region of the home that is easy to clean. House soiling can be frustrating for pet parents, but minimizing the cleanup to a smaller space can help. Be sure to keep your cat’s bedding clean and dry.

It is also important that you keep your cat clean. With stool dropping or diarrhea, there may be some feces left behind on the surrounding skin and fur. Be sure to keep your cat’s hind end clean so that they don’t develop secondary infections. Daily grooming wipes are helpful for quick cleanups on a cat.

Some pet parents find cat diapers helpful, but sanitary concerns and routine bathing and drying of the backside are very important to avoid secondary urinary tract infections and skin infections. Keeping your cat’s back end shaved regularly may also be helpful for easier cleaning.