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'''Type I (or 'incomplete' prolapse)''' involves the rectal mucosa and submucosa only, appearing as a large 'doughnut' shaped soft tissue swelling at the rectum.  

Rectal prolapse in the horse is associated with conditions causing tenesmus (straining). These may include dystocia, constipation, neoplasia, foreign body obstruction, urethral obstruction or diarrhoea. Occasionally there is no apparent underlying cause.  

Rectal prolapse is classified according to the type of tissue involved. Type I (or 'incomplete' prolapse) involves the rectal mucosa and submucosa only, appearing as a large 'doughnut' shaped soft tissue swelling at the rectum. Type II ('complete' prolapse) involves the entire rectal wall. Type III involves complete prolapse of the rectum in addition to intussusception of the peritoneal rectum. Complete intussuseption of the peritoneal rectum beyond the anus occurs with type IV rectal prolapse.

'''Type II ('complete' prolapse''') involves the entire rectal wall.  

 

'''Type III''' involves '''complete prolapse''' of the rectum in addition to '''intussusception of the peritoneal rectum'''.  

 

'''Type IV''' involves '''complete intussuseption of the peritoneal rectum beyond the anus''' .

==Signalment==

==Signalment==

Treatment should be aimed at reducing the prolapse as well as identifying and correcting the underlying cause of tenesmus. Affected horses should be prevented from becoming recumbent before the prolapse has been replaced.  

Treatment should be aimed at reducing the prolapse as well as identifying and correcting the underlying cause of tenesmus. Affected horses should be prevented from becoming recumbent before the prolapse has been replaced.  

Treatment depends on the type of prolapse. A simple prolapse of the rectum or rectal mucosa may be easily replaced providing minimal soft tissue trauma, contamination or dessication has occurred. In order to reduce any oedema, glycerin or dextrose combined with petroleum jelly may be applied topically. The prolapse may be replaced under epidural anaesthesia and a purse string suture placed in the anus. If the prolapse cannot be manually reduced, surgical amputation or resection of exposed tissue may be required. In the case of Type III and Type IV rectal prolapse, coeliotomy of the intussuscepted segment must be performed. It is important to provide faecal softeners following reduction of a prolapse due to the possibility of recurrence.

Treatment depends on the type of prolapse. A simple prolapse of the rectum or rectal mucosa may be easily replaced providing minimal soft tissue trauma, contamination or dessication has occurred. In order to reduce any oedema, glycerin or dextrose combined with petroleum jelly may be applied topically. The prolapse may be replaced under epidural anaesthesia and a purse string suture placed in the anus. If the prolapse cannot be manually reduced, surgical amputation or resection of exposed tissue may be required. In the case of Type III and Type IV rectal prolapse, reduction of the intussuscepted segment may be possible as long as no ischaemia has occurred. If disruption to the blood supply has occurred, amputation of the affected segment may be required with subsequent colorectal anastamosis or colostomy.  

==Prognosis==

==Prognosis==

The prognosis is good for Type I and Type II prolapse, and guarded for Type III and Type IV.  

The prognosis varies depending on the underlying cause but is generally good for Type I and Type II prolapse, and guarded for Type III and Type IV.  

 

==References==

==References==

 

* Mair, T. S., Divers, T. J., Ducharme, N. G. (2002) '''Manual of Equine Gastroenterology''' ''Elsevier Health Sciences''

* Mair, T. S., Divers, T. J., Ducharme, N. G. (2002) '''Manual of Equine Gastroenterology''' ''Elsevier Health Sciences''

* Orsini, J. A., Divers, T. (2007) '''Equine Emergencies: Treatment and Procedures''' ''Elsevier Health Sciences''

* Orsini, J. A., Divers, T. (2007) '''Equine Emergencies: Treatment and Procedures''' ''Elsevier Health Sciences''