A young adult male cat presented to Cornell University Hospital for Animals (CUHA) with a history of chronic constipation. For the three weeks prior to presentation, the patient needed an enema approximately every four days in order to defecate. Ancillary diagnostics at Cornell revealed Toxocara cati eggs on fecal floatation and a low baseline thyroxine level. Colonic histopathology showed signs consistent with chronic inflammation. Chronic constipation in young cats is highly uncommon. Congenital disorders such as congenital hypothyroidism, hypoganglionosis and smooth muscle dysfunction (idiopathic megacolon) must be considered. A recommendation to submit a free T4 to rule out congenital hypothyroidism was made, however, it has not been performed to date. Full thickness gastrointestinal biopsies are needed to rule out hypoganglionosis. A diagnosis of idiopathic megacolon is one made by clinical signs and imaging. After fluid therapy and multiple enemas at Cornell, the patient is being medically managed and has not exhibited recurrence of constipation to date.