Difference between revisions of "Rectal Prolapse - Cat and Dog"
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| − | + | ==Introduction== | |
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'''Rectal prolapse''' is defined as the protrusion of the rectal mucosa from the anus. It can be classified as complete or incomplete. A complete prolapse involves all layers of the rectal wall whereas an incomplete prolapse only involves the mucosal layer. | '''Rectal prolapse''' is defined as the protrusion of the rectal mucosa from the anus. It can be classified as complete or incomplete. A complete prolapse involves all layers of the rectal wall whereas an incomplete prolapse only involves the mucosal layer. | ||
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|Gastrointestinal disease | |Gastrointestinal disease | ||
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| − | |[[Parasites| | + | |[[Parasites|Parasites]] |
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|[[Neoplasia - Pathology|Tumours]] | |[[Neoplasia - Pathology|Tumours]] | ||
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|Colitis | |Colitis | ||
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| − | |Megacolon | + | |[[Megacolon|Megacolon]] |
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|Urogenital disease | |Urogenital disease | ||
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|Dystocia | |Dystocia | ||
|- | |- | ||
| − | |Extensive [[ | + | |Extensive [[Bladder Neoplasia# Transitional cell carcinoma|transitional cell carcinoma]] of the bladder in cats |
|} | |} | ||
| − | Endoparasite and enteritis are more common in young animals whereas tumours or [[Perineal Hernia|perineal hernias]] are more common in middle-aged to older animals. | + | [[WikiWords#Endoparasite|Endoparasite]] infestations and enteritis are more common in young animals whereas tumours or [[Perineal Hernia|perineal hernias]] are more common in middle-aged to older animals. |
==Signalment== | ==Signalment== | ||
| − | + | No breed,sex, or age predisposition but occurs more commonly in younger animals with endoparasitic infections. Also occurs more often in Manx cats due to anal laxity. | |
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==Diagnosis== | ==Diagnosis== | ||
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Protrusion of a red, elongated, swollen cylindrical mass from the [[Anus - Anatomy & Physiology|anus]] is seen. It is vital to differentiate a rectal prolapse from an ileocolic [[Intussusception|intussusception]]. This can be done by passing a probe adjacent to the anus. With a rectal prolapse, the probe cannot be successfully passed. | Protrusion of a red, elongated, swollen cylindrical mass from the [[Anus - Anatomy & Physiology|anus]] is seen. It is vital to differentiate a rectal prolapse from an ileocolic [[Intussusception|intussusception]]. This can be done by passing a probe adjacent to the anus. With a rectal prolapse, the probe cannot be successfully passed. | ||
| − | The everted tissue becomes [[Oedema | + | The everted tissue becomes [[Oedema|oedematous]], which prevents it from being retracted back into the pelvic canal. The exposed tissue is vulnerable, and depending on the duration of the prolapse, this can lead to inflammation, haemorrhage, [[Venous Congestion|congestion]] and ulceration. |
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===Laboratory Tests=== | ===Laboratory Tests=== | ||
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==Treatment== | ==Treatment== | ||
===Medical=== | ===Medical=== | ||
| − | This may be suitable for acute prolapse with good tissue viability where it is amenable to manual reduction under general or [[Epidural|epidural]] [[Anaesthesia|anaesthesia]]. A loose purse-string suture should be placed around the anus after reduction for a period of 3-5 days. Prior to manual reduction, the protruded mass should be treated with warm saline lavages, massages and lubrication or hypertonic saline sugar solution to relieve oedema. Tenesmus can be reduced by laxative such as lactulose, faecal softener, and a moist diet. Complications | + | This may be suitable for an acute prolapse with good tissue viability where it is amenable to manual reduction under general or [[Epidural|epidural]] [[Anaesthesia|anaesthesia]]. A loose purse-string suture should be placed around the anus after reduction for a period of 3-5 days. Prior to manual reduction, the protruded mass should be treated with warm saline lavages, massages and lubrication or hypertonic saline sugar solution to relieve oedema. Tenesmus can be reduced by a laxative such as [[Lactulose|lactulose]], a faecal softener, and a moist diet. Complications include tenesmus, dyschezia, haematochezia and recurrence. |
===Surgery=== | ===Surgery=== | ||
| − | Rectal resection and anastomosis may be needed in cases where manual reduction is not possible or if the tissue is severely traumatised, devitalised or necrotic. | + | Rectal resection and anastomosis may be needed in cases where manual reduction is not possible or if the tissue is severely traumatised, devitalised or necrotic. A colopexy procedure which fixes the rectum and colon in place can be considered in recurrent cases where multiple attempts of manual reduction have failed. Complications such as anal stricture, faecal incontinence, dehiscence, haemorrhage and infection can occur following surgery. |
==Prognosis== | ==Prognosis== | ||
| − | Prognosis is poor in untreated cases of chronic rectal prolapse. | + | Prognosis is poor in untreated cases of chronic rectal prolapse. The prognosis for surgical patients is good provided the underlying cause is appropriately addressed. |
| + | {{Learning | ||
| + | |literature search = [http://www.cabdirect.org/search.html?q=title%3A%28rect*%29+AND+title%3A%28prolapse%29+AND+%28od%3A%28dogs%29+OR+od%3A%28cats%29%29 Rectal Prolapse in cats and dogs publications] | ||
| + | |Vetstream = [https://www.vetstream.com/canis/Content/Disease/dis00656.asp Rectal prolapse] | ||
| + | }} | ||
==References== | ==References== | ||
| − | + | Fossum, T. W. et. al. (2007) '''Small Animal Surgery (Third Edition)''' ''Mosby Elsevier'' | |
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| − | + | Merck & Co (2008) '''The Merck Veterinary Manual''' | |
| − | + | Slatter, D. (2003) '''Textbook of Small Animal Surgery''' (Volume 1, Third Edition) ''Saunders'' | |
| − | + | ||
| − | + | ||
| − | + | {{review}} | |
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| − | + | ==Webinars== | |
| + | <rss max="10" highlight="none">https://www.thewebinarvet.com/gastroenterology-and-nutrition/webinars/feed</rss> | ||
[[Category:Recto-Anal - Pathology]] | [[Category:Recto-Anal - Pathology]] | ||
| − | [[Category: | + | [[Category:Rectal and Anal Diseases - Dog]] |
| + | [[Category:Rectal and Anal Diseases - Cat]] | ||
| + | |||
| + | [[Category:Expert_Review]] | ||
Latest revision as of 15:55, 5 January 2023
Introduction
Rectal prolapse is defined as the protrusion of the rectal mucosa from the anus. It can be classified as complete or incomplete. A complete prolapse involves all layers of the rectal wall whereas an incomplete prolapse only involves the mucosal layer.
Any conditions which cause tenesmus can cause rectal prolapse, this includes:
| Cause |
|---|
| Gastrointestinal disease |
| Parasites |
| Tumours |
| Foreign bodies |
| Colitis |
| Megacolon |
| Urogenital disease |
| Cystitis |
| Prostatic disease |
| Perineal hernia |
| Dystocia |
| Extensive transitional cell carcinoma of the bladder in cats |
Endoparasite infestations and enteritis are more common in young animals whereas tumours or perineal hernias are more common in middle-aged to older animals.
Signalment
No breed,sex, or age predisposition but occurs more commonly in younger animals with endoparasitic infections. Also occurs more often in Manx cats due to anal laxity.
Diagnosis
Clinical Signs
Protrusion of a red, elongated, swollen cylindrical mass from the anus is seen. It is vital to differentiate a rectal prolapse from an ileocolic intussusception. This can be done by passing a probe adjacent to the anus. With a rectal prolapse, the probe cannot be successfully passed.
The everted tissue becomes oedematous, which prevents it from being retracted back into the pelvic canal. The exposed tissue is vulnerable, and depending on the duration of the prolapse, this can lead to inflammation, haemorrhage, congestion and ulceration.
Laboratory Tests
There are no specific tests required. A faecal analysis can be done to check for an underlying parasitic disease as the cause.
Diagnostic Imaging
This may be used to identify the cause of the prolapse.
Treatment
Medical
This may be suitable for an acute prolapse with good tissue viability where it is amenable to manual reduction under general or epidural anaesthesia. A loose purse-string suture should be placed around the anus after reduction for a period of 3-5 days. Prior to manual reduction, the protruded mass should be treated with warm saline lavages, massages and lubrication or hypertonic saline sugar solution to relieve oedema. Tenesmus can be reduced by a laxative such as lactulose, a faecal softener, and a moist diet. Complications include tenesmus, dyschezia, haematochezia and recurrence.
Surgery
Rectal resection and anastomosis may be needed in cases where manual reduction is not possible or if the tissue is severely traumatised, devitalised or necrotic. A colopexy procedure which fixes the rectum and colon in place can be considered in recurrent cases where multiple attempts of manual reduction have failed. Complications such as anal stricture, faecal incontinence, dehiscence, haemorrhage and infection can occur following surgery.
Prognosis
Prognosis is poor in untreated cases of chronic rectal prolapse. The prognosis for surgical patients is good provided the underlying cause is appropriately addressed.
| Rectal Prolapse - Cat and Dog Learning Resources | |
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Rectal Prolapse in cats and dogs publications |
References
Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition) Mosby Elsevier
Merck & Co (2008) The Merck Veterinary Manual
Slatter, D. (2003) Textbook of Small Animal Surgery (Volume 1, Third Edition) Saunders
 |
This article has been peer reviewed but is awaiting expert review. If you would like to help with this, please see more information about expert reviewing. |
Webinars
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