Q: My 13-year-old cat has had on-and-off episodes of constipation for two years. He had to undergo manual removal of his faeces on a few occasions as he’s sometimes unable to poop for up to five days. This requires general anaesthesia and the risks worry me. What could be causing his constipation?

A: In TCM, constipation is defined as absent or infrequent defecation, and is classified as a condition caused by obstruction. When the faeces is not passed, it remains in the colon for a longer time and gets drier, harder and even more difficult to pass out. Normally, the large intestine is the one responsible for this mechanism. When food is ingested, the spleen transports nutrients to the lungs where it is distributed to the whole body, and the stomach sends the rest to the large intestines as waste. Then, it is eliminated.

The retention of poop in the large intestine can be due to internal heat, which adversely affects the fluid levels in the body. Internal heat may be caused by an accumulation of heat in the body, hot weather, or eating food that is difficult to digest and subsequently builds up in the gastrointestinal tract. As for internal dryness, it can be caused by a blood or yin deficiency. When the colon lacks moisture, constipation will follow. A qi deficiency refers more to the lack of internal energy—when there is insufficient energy in the large intestine, it cannot move the faeces towards the rectum to be pushed out.

Your cat sounds like he may have both yin and qi deficiency, for which acupuncture and herbal medication are most effective. Many of my furry patients respond after several weekly acupuncture sessions and a few months of herbal medication.