An 8-year-old neutered male, Wood constitution, Maine Coon cat was presented with a 22-month history of severe constipation and megacolon. With conventional medications and an enema every 2-3 months, he could produce a soft, wet, large stool on average once every 14-16 days. Clinical exam findings included an animal with weight loss, bilateral deep weak pulses, a wet pink tongue and radiographs demonstrating a large, stool-impacted descending colon. A TCVM Pattern of Spleen Qi Deficiency was diagnosed. Due to his Wood constitution attitude about prolonged handling, a small number of acupuncture points at easily accessible locations were chosen for his treatment. Acupuncture techniques used included dry needle, aqua-acupuncture and electro-acupuncture. Over a 4-month period with 5 acupuncture sessions, the severe constipation slowly resolved. This case is an excellent clinical example of using TCVM treatment to address a difficult, poorly responsive clinical condition frequently seen in geriatric cats.