Chronic intermittent dyschezia in a 10-year-old spayed female domestic shorthair cat

A 10-year-old 4.3-kg spayed female domestic shorthair cat presented to the primary veterinarian for a 1-month history of intermittent dyschezia. Physical examination findings at that time were unremarkable, except for palpation of a moderate amount of hard fecal material in an otherwise soft, apparently nonpainful abdomen. The primary veterinarian (not available) performed 3-view abdominal radiography, which reportedly showed constipation. An enema was performed, removing 5 to 6 inches of firm stool. The patient was conservatively managed with stool softeners and appetite stimulants. Four days later, the cat was referred to the University of Florida Small Animal Hospital for evaluation of continued dyschezia and inappetence. A CBC was clinically unremarkable. A serum biochemistry panel showed mild hyperglycemia (212 mg/dL; reference range, 72.1 to 156.1 mg/dL), slight hypermagnesemia (2.9 mg/dL; reference range, 1.9 to 2.6 mg/ dL), and moderately elevated creatine kinase (893 IU/L; reference range, 20 to 440 IU/L). Three-view abdominal radiographs were obtained (Figure Formulate differential diagnoses, then continue reading.