Changes

Grade 3 and 4 tears are acute, life-threatening emergencies and should be referred to a surgical facility. Before transportation it is essential that appropriate emergency care is provided and measures are taken to prevent faecal contamination. Epidural anaesthesia should be performed using either xyalzine alone or xylazine in combination with lidocaine or mepivicaine. The rectum should be packed with an antiseptic tampon positioned cranially to the tear and extending to the anus. A length of stocking filled with betadine-soaked cotton has been recommended for this. Following this a purse-string suture should be placed in the rectum to prevent expulsion of the tampon. Broad-spectrum antibiotics, flunixin meglumine and appropriate tetanus prophylaxis should also be administered.  

Grade 3 and 4 tears are acute, life-threatening emergencies and should be referred to a surgical facility. Before transportation it is essential that appropriate emergency care is provided and measures are taken to prevent faecal contamination. Epidural anaesthesia should be performed using either xyalzine alone or xylazine in combination with lidocaine or mepivicaine. The rectum should be packed with an antiseptic tampon positioned cranially to the tear and extending to the anus. A length of stocking filled with betadine-soaked cotton has been recommended for this. Following this a purse-string suture should be placed in the rectum to prevent expulsion of the tampon. Broad-spectrum antibiotics, flunixin meglumine and appropriate tetanus prophylaxis should also be administered.  

At the referral facility, abdominocentesis is performed to check for peritonitis. A number of surgical techniques have been described for the repair of Grade 3 and Grade 4 tears. These include suturing the tear closed via a rectal or ventral midline approach, or the use of a faecal diversion technique such as temporary colostomy to eliminate the passage of faeces throught the rectum. Surgical repair of rectal tears is associated with a failure rate and consideration  

At the referral facility, abdominocentesis is performed to check for peritonitis. A number of surgical techniques have been described for the repair of Grade 3 and Grade 4 tears. These include suturing the tear closed via a rectal or ventral midline approach, or the use of a faecal diversion technique such as temporary colostomy to eliminate the passage of faeces throught the rectum. Surgical repair of rectal tears is associated with a failure rate and consideration to the welfare and finance should be given before surgery is carried out.

==Prognosis==

==Prognosis==

The prognosis for rectal tears depends on the size, location and grade of the tear and the length of time between occurrence and treatment. and Grade 1 and Grade 2 tears generally have a good prognosis and  

The prognosis for rectal tears depends on the size, location and grade of the tear and the length of time between occurrence and treatment. Grade 1 and Grade 2 tears generally have a good prognosis and usually heal without complication. Grade 3 and Grade 4 tears are associated with a poor prognosis. If peritonitis is present the prognosis is grave and euthanasia is usually required.

==References==

==References==