Changes

*No breed predisposition but may occur more often in [[Feline Breeds - WikiNormals#British|Manx]] cats due to anal laxity

|[[Perineal Hernia|Perineal hernia]]

|-

|Extensive [[Bladder Neoplasia# Transitional cell carcinoma|transitional cell carcinoma]] of the bladder in cats

[[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.

'''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:

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.

 

Endoparasite and enteritis are more common in young animals whereas tumours or [[Perineal Hernia - WikiClinicalperineal hernias]] are more common in middle-aged to older animals.

==Diagnosis==

==Diagnosis==

===Clinical Signs===

===Clinical Signs===

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 - WikiClinical|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 - Pathology|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 - Pathology|inflammation]], haemorrhage, [[Venous Congestion and Hyperaemia - Pathology|congestion]] and ulceration.  

===Laboratory Tests===

===Laboratory Tests===

==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 such as tenesmus, dyschezia, haematochezia and recurrence can occur.

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.  Colopexy can be considered in recurrence cases where multiple attempts of manual reduction have failed.  Complications such as anal stricture, faecal incontinence, dehiscence, haemorrhage and infection can occur following 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==

Prognosis is poor in untreated cases of chronic rectal prolapse. The prognosis for surgical patients is good provided the underlying cause is appropriately addressed.

Prognosis is poor in untreated cases of chronic rectal prolapse. The prognosis for surgical patients is good provided the underlying cause is appropriately addressed.

==References==

==References==

*Fossum, T. W. et. al. (2007) '''Small Animal Surgery (Third Edition)''' ''Mosby Elsevier''

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''

Merck & Co (2008) '''The Merck Veterinary Manual'''

 

Slatter, D. (2003) '''Textbook of Small Animal Surgery''' (Volume 1, Third Edition) ''Saunders''