You Make The Diagnosis: Abnormal Bowel Function In Cavalier King Charles Spaniel

Pictured below is an X-ray of a Cavalier King Charles Spaniel. The dog’s belly was distended and painful. This patient was also having problems walking.  The dog had been normal up until a few days ago. Study the film and then answer the following questions: 1) What is the gastrointestinal condition seen in this X-ray? 2) Does the dog have any orthopedic or neurological conditions? 3) What sex is this dog? 4) Does this dog suffer from anorexia?

Whidby ConstipationIVD Xray before

Whidby ConstipationIVD Xray before annotated


  1. Constipation – The colon is distended with feces. It is so full that gas is accumulating in the small bowel causing bloating. (Marked with yellow lines that extend from side to side.)
  2. Intervertebral Disc Disease – Look closely at the vertebra between the ribs and pelvis. The disc spaces between lumbar vertebra 2-3, 3-4 and 4-5 are narrowed which indicates a disc problem. (The disc space marked with a red circle is L3-4.  L2-3 is to the left of the circle and L4-5 is the the right.)
  3. Bridging Spondylosis – On the bottom of the 3rd and 4th lumbar vertebra, an abnormal outgrowth of bone is forming. The bone is trying to bridge the gap between the two vertebrae to stabilize the joint. (Marked with the red circle.)
  4. Male – Dogs have a bone in their penis that shows up on X-rays. Look at the right side of the X-ray just in front of the femur to see a long narrow bone lying under the abdominal wall. (Marked with a blue box.)
  5. This dog has a great appetite. His stomach is full of food with a little gas. (Marked with white star.)

Treatment of this dog started with an injection of an opioid to relieve pain and an enema to evacuate the colon. After two enemas, the bloating and feces were gone. Although there was still gas in the intestines, the little guy felt so much better. I think his constipation occurred because his disc disease was either making it too painful to defecate and/or it was interfering with nerve function in the colon. He was discharged with medication to soften his stools as well as medication for his back.

Here is the X-ray taken after the enema. Now his intestines are filled with gas which looks black on X-rays.

Whidby Constipation IVD Xray After


Published by kristennelsondvm

Dr. Kristen Nelson grew up on a farm in Watertown, Minn., where she developed a deep love for animals of all kinds. She received a Doctor of Veterinary Medicine degree from the University of Minnesota, College of Veterinary Medicine. Kris then completed a small-animal internship at the prestigious Animal Medical Center in New York City. In addition to writing and speaking, she cares for small and exotic animals in Scottsdale, Az. Dr. Nelson is widely quoted in the media. Her credits include Ladies’ Home Journal, USA TODAY, the Los Angeles Times and numerous radio and television interviews. Dr. Nelson has written two books, Coated With Fur: A Vet’s Life and Coated With Fur: A Blind Cat’s Love. Kris and her husband Steve share their home with rescued cats, birds and a dog.