Colopexy as a Treatment for Rectal Prolapse in Dogs and Cats: A Retrospective Study of 14 Cases

Colopexy was evaluated as a treatment for recurrent rectal prolapse in eight dogs and six cats. Cases included in the study were from two institutions; the University of Pennsylvania School of Veterinary Medicine and the University of Tennessee College of Veterinary Medicine. Two different colopexy techniques were used: A simple suture technique was used in two cats and four dogs (University of Pennsylvania), and an incisional technique was used in four cats and four dogs (University of Tennessee). Rectal prolapse had not recurred in any of the 14 animals at the time of follow-up. Incisional dehiscence occurred in two animals and in one instance may have been related to the colopexy procedure. Infection at the colopexy site, secondary to suture penetration of the colonic lumen, is a potential complication of this procedure. Colopexy, using either surgical technique described here, was effective in preventing recurrent rectal prolapse.     

Rectal prolapse and cystic calculus in a burro

A 7-year-old burro jack was examined because of recurrent rectal prolapse and severe cough. The prolapse was reduced manually and a cough associated with bronchopneumonia responded to antimicrobial therapy. The rectal prolapse recurred and again was reduced manually. During exploratory celiotomy a cystic calculus was identified and removed. Severe protracted cough and cystic calculus were thought to be contributing factors to recurrent rectal prolapse in this burro.     

Use of negative contrast computed tomography for diagnosis of a colonic duplication in a dog

A 24‐week‐old dog was presented with recurrent rectal prolapse because of colonic duplication. Colonic duplication is an extremely uncommon congenital abnormality, with only six cases reported in veterinary medicine, one diagnosed at necropsy and five after barium enema, colonoscopy, abdominal ultrasound, exploratory laparotomy either alone or in combination. In this case, these techniques failed to identify the abnormality and diagnosis was ultimately achieved via negative contrast computed tomography. The evaluation generated by the computed tomography images allowed a refined surgical approach. To the authors’ knowledge, negative contrast computed tomography has not yet been reported in the veterinary literature to diagnose gastrointestinal pathologies. Colonic duplication in this case was treated by removal of the intercolonic septum via colotomy.     

Laparoscopic colopexy for recurrent rectal prolapse in a Maltese dog

A 2.5-kg castrated male Maltese dog, suspected to be older than 10 y, was presented with a prolapsed mass at the anus. This had occurred on 2 previous occasions within the last 4 mo and had been managed with manual reduction and purse-string sutures. The rectal prolapse had viable tissue and was reducible but resulted in straining and fecal accumulation. Colopexy (with intracorporeal sutures) was performed laparoscopically using 3 ports; the distal colon was retracted cranially and attached to the abdominal wall with 3 simple interrupted sutures in a single row. The dog recovered uneventfully, had good appetite and normal activity, did not strain, and defecated without issues. There were no wound-healing complications and at 12-month post-operative examination, the patient was in good condition without clinical signs. Based on this case report, laparoscopic colopexy is clinically practical for management of rectal prolapse in small-breed dogs.     

Focal eosinophilic proctitis with associated rectal prolapse in a pony

Focal intramural nodules were palpated in the rectal wall of a 12-year-old pony mare presented for rectal prolapse. Eosinophilic proctitis was diagnosed by examination of fine needle aspirates and biopsy of the largest rectal nodule. After treatment with a course of corticosteroids, the rectal nodule and accompanying peripheral eosinophilia resolved. There was no recurrence of the condition during the follow-up period of 20 months. Focal eosinophilic proctitis appeared to be an unusual cause of tenesmus and rectal prolapse in this case.     

Small colon intussusception in a broodmare

A 9-year-old pregnant Standardbred broodmare was evaluated for signs of mild abdominal pain, failure to defecate, and mild abdominal distention. Rectal examination revealed the leading edge of a small colon intussusception, and peritoneal fluid analysis indicated suppurative peritonitis. Surgical management, including reduction of the intussusception and small colon resection with end-to-end anastomosis, resulted in successful outcome (1-year follow-up evaluation). Postoperative complications including dehiscence of the ventral midline surgical incision and simple obstruction at the anastomosis site necessitated a second surgical procedure. Small colon intussusception is an uncommon cause of signs of abdominal pain and is similar to type-IV rectal prolapse.     

Laparoscopic-assisted incisional colopexy by two portals access in a domestic cat with recurrent rectal prolapse

A 2-year-old female mixed-breed cat weighing 2.7 kg presented with recurrent rectal prolapse. The following report describes its treatment by laparoscopic-assisted incisional colopexy using two portals. The procedure was effective and without trans- or postoperative complications. Recurrent prolapses did not recur in the 2 months of postoperative observation.     

Overdose during chemical restraint in a black rhinoceros (Diceros bicornis)

A juvenile female black rhinoceros (Diceros bicornis) was successfully treated after overdose of drugs used for chemical restraint. Subsequent general anaesthesia for surgical reduction of a recurrent rectal prolapse was uneventful. Over a 25-minute period before transportation to the veterinary hospital, the animal received a total dose of 1.225 mg etorphine, 30 mg acepromazine and 30 mg detomidine. Based on an estimated mass of 200 kg, these corresponded to doses of 6.1 microg kg(-1) etorphine, 150 microg kg(-1) acepromazine, and 150 microg kg(-1) detomidine which constitutes considerable overdose for each drug given separately, notwithstanding the synergy that probably resulted when the three drugs were present concurrently. The estimated body mass may have substantially overestimated the actual body mass and exacerbated overdosage. The animal was recumbent and apnoeic on arrival at the hospital. Heart sounds were auscultated and a weak peripheral pulse was palpated; no pulse deficits were detected, although the heart rate was low. The trachea was intubated, inspired breath was enriched with oxygen and the lungs ventilated manually. Diprenorphine (1.5 mg) was given intravenously and spontaneous breathing resumed 11 minutes later. After induction of general anaesthesia using isoflurane, emergency surgery for correction of rectal prolapse was performed, from which the animal recovered uneventfully. The case highlights some of the practical problems that may be encountered in dealing with dangerous and unfamiliar species.     

Rectal prolapse associated with urinary bladder neoplasia in a cat

A case of feline rectal prolapse which appeared to be secondary to transitional cell carcinoma of the urinary bladder is described. The cat was reported to be incontinent and treatment was declined by the owners. Euthanasia was performed and necropsy revealed an extensive nodular thickening of the entire urinary bladder wall. A diagnosis of urinary bladder transitional cell carcinoma was made on histopathological examination.     

Length of docked tail and the incidence of rectal prolapse in lambs

A multistate cooperative study was conducted to study the current issue of tail length in docked lambs and its relationship to incidence of rectal prolapse. A total of 1,227 lambs at six locations were randomly allocated to two or three tail dock treatments: 1) short--tail was removed as close to the body as possible, 2) medium--tail was removed at a location midway between the attachment of the tail to the body and the attachment of the caudal folds to the tail, and 3) long--tail was removed at the attachment of the caudal folds to the tail. Short-docked lambs had a greater (P < 0.05) incidence of rectal prolapse (7.8%) than lambs with a medium (4.0%) or a long (1.8%) dock. Female lambs had a higher (P < 0.05) incidence of rectal prolapse than male lambs. At two stations, lambs were finished either in a feedlot on a high-concentrate diet or on pasture with no grain supplementation. At one station, with a very low incidence of rectal prolapse, there was no difference in incidence between lambs finished in the feedlot or on pasture; however, at the station with a relatively high incidence of rectal prolapse, lambs in the feedlot had a higher (P < 0.05) incidence than lambs on pasture. The half-sib estimate of heritability for the incidence of rectal prolapse was low (0.14). The results of this study strongly implicate short dock length as a cause of rectal prolapse in lambs finished on high-concentrate diets. Furthermore, the results of this study and the only other study known conducted on this issue strongly suggest that docking lambs at the site of the attachment of the caudal folds to the tail will result in a negligible incidence of rectal prolapse.     

Treatment with a combined cystopexy-colopexy for dysuria and rectal prolapse after bilateral perineal herniorrhaphy in a dog

A 9-year-old castrated male Yorkshire Terrier was evaluated for dysuria and rectal prolapse 2 weeks after bilateral perineal herniorrhaphy. Dysuria was secondary to caudal displacement of the bladder, rather than retroflexion of the bladder. Dysuria and rectal prolapse were associated with disruption of supporting ligaments of the urinary bladder and colon, which may have been caused by tenesmus. Combined cystopexy and colopexy were used successfully to treat the dysuria and rectal prolapse.     

Direct preputial hernia associated with a ventral abdominal wall defect in a two‐year‐old gelding

The case of a 2‐year‐old gelding with acute onset of preputial swelling and prolapse is presented. After initiating conservative management using a penile repulsion device, the horse repeatedly displayed signs of mild abdominal discomfort with sudden deterioration to an episode of violent colic after 5 days of hospitalisation. Ultrasonographic examination of the preputial swelling at that time demonstrated the presence of small intestine between the internal and external laminae of the prepuce and led to the diagnosis of a direct preputial hernia. The contents of the hernia were readily reduced through a defect in the ventral abdominal wall after the anaesthetised horse was placed in dorsal recumbency. The historical information, clinical progression and surgical findings were supportive of an acquired ventral abdominal wall defect. To the authors' knowledge, this is the first reported case of a direct preputial hernia associated with an acquired ventral abdominal wall defect.     

Clinical and Surgical Parameters in Dogs with Perineal Hernia Analysis of Results of Internal Obturator Transposition

The results of treatment of 31 dogs with perineal hernia by internal obturator muscle transposition were evaluated by comparing the clinical signs reported by the owner before surgery with those reported 11 or more months following surgery. The severity and frequency of pre- and postoperative clinical signs were categorized numerically, and composite scores were obtained for each dog. In addition, the dogs were examined 11 or more months following surgery. The presence or absence of an externally obvious perineal swelling was noted, and rectal examination was performed to detect rectal sacculation and the integrity of the pelvic diaphragm dorsal and ventral to a line drawn between the center of the anus and the ischiatic tuberosity. These results were correlated with the postoperative composite scores. Postoperative complications included wound infection (2), wound seroma (2), rectal prolapse (4), urinary incontinence (2), and flatus as a new postoperative problem (11). The postoperative composite score was significantly lower (improved function) following surgery. Dogs with worse signs preoperatively or bilateral perineal hernia benefited less from surgery. More dogs showed improvement when the operation was performed by experienced surgeons. Factors detected at follow-up examination that correlated with more severe postoperative clinical signs were perineal swelling, absence of the ventral portion of the pelvic diaphragm, and rectal sacculation. The presence or absence of reformation of the dorsal aspect of the pelvic diaphragm did not correlate with postoperative clinical signs.     

Low serum immunoglobulin concentrations in related Weimaraner dogs

Surgical management of a large colorectal diverticulum in a dog A 10-year-old crossbred dog had a lour month history of intermittent rectal prolapse. Castration and use of stool softeners had been attempted to control tenesmus and obstipation. Examination per rectum was normal. Three months later colopexy was performed and the dog began defecating normally immediately after surgery. After one month, obstipation and tenesmus returned. Initially, faeces were misshapen and ribbon-like, then defecation stopped. Palpation per rectum revealed a band-like ventral mucosal fold approximately 6 cm Irom the anus. A contrast study demonstrated a large (4X2 cm), well-defined diverticulum in the colorectum. Diverticulectomy was performed using a surgical stapling device, which allowed rapid excision and substantially reduced risk of faecal contamination. Recovery was good and the dog remained clinically normal, although a slight narrowing of the colorectum was seen radiographically.     

Treatment of proliferative colitis in ferrets

Proliferative colitis associated with intracellular Campylobacter sp was diagnosed in 10 ferrets. The ferrets had a history of diarrhea (often blood-tinged or mucoid), dehydration, and chronic weight loss. Additional clinical signs included rectal prolapse, lethargy, fever, and a palpably thick colon. In 5 ferrets, the diagnosis was confirmed by colonic biopsy, via endoscopy. Supportive treatment in 5 ferrets did not alleviate the clinical signs or the proliferative intestinal disorder. oral chloramphenicol treatment (50 mg/kg of body weight, q 12 h for 10 to 21 days) resulted in marked clinical improvement and eradication of proliferative intestinal lesions in 5 ferrets.     

Gasterophilosis: a major cause of rectal prolapse in working donkeys in Ethiopia

A retrospective study was conducted to investigate the cause of rectal prolapse in working donkeys in Ethiopia. Analysis of data on rectal prolapse cases obtained from the Donkey Health and Welfare Project clinic at the School of Veterinary Medicine, Addis Ababa University, from 1995 to 2004 revealed that 83.6% (n = 177) of the cases were associated with Gasterophilus nasalis. The rest 10.7% and 5.7% were associated with work-related (overloading) cause and diarrhoea, respectively. The mean and median numbers of G. nasalis recovered from the rectum of infected donkeys were 66 and 64, respectively, with a range of 2–195. Over 100 G. nasalis larvae were recovered from the rectum of 22% of the donkeys. Circular demarcated ulcer-like and deep circumferential pits or ring-like mucosal lesions were found at the larval attachment sites. G. nasalis infection and the associated rectal prolapse were observed year round. However, the intensity of rectal larval infection and incidence of rectal prolapse were significantly higher during the rainy season (P < 0.01). Age and sex of the donkeys had no significant effect on the intensity of rectal larval infection and incidence of rectal prolapse (P > 0.05).     

Disruption of the blood supply to the small colon following rectal prolapse and small colon intussusception in a mare

A coliky and depressed four year old Arabian mare was examined three days after replacement of a rectal prolapse that had occurred during parturition. Fresh blood was present in the rectum and a septic peritonitis was diagnosed based upon the clinical pathological examination of the peritoneal fluid. At laparotomy the terminal 1.3 meters of small colon was found to be necrotic as a result of rupture of the terminal mesocolon and associated blood vessels. Based upon the poor prognosis the mare was euthanized. Rupture of the mesocolon was thought to be a sequel to the rectal prolapse. The anatomy predisposing the horse to these events is discussed.     

Surgical Treatment of an Abdominal Abscess Caused by a Migrating Iron Wire From the Ventral Colon,a Case Report

A 13-year-old mare presented for evaluation of recurrent colic episodes. The horse was diagnosed with a mass within the spleen at the ultrasound examination of the abdomen; the levels of Serum Amyloid A and the fibrinogen were high and so a presumptive diagnosis of an abscess involving the spleen was made base on clinical, ultrasonographic and laboratory findings and it was decided to perform n exploratory laparotomy for a definitive diagnosis and possible treatment. Upon abdominal exploration a mass involving the spleen, the lateral wall of the ventral colon adherent to the left abdominal wall was diagnosed and with an intraoperative ultrasound examination a linear hyperechoic foreign body was diagnosed within the mass. It was removed through an enterotomy of the left ventral colon that allowed the digital exploration of the mass without spilling of pus within the peritoneal cavity. The horse was discharged and the long term follow-up revealed no complications and no more signs of abdominal pain.     

Macro and microstructural organization of the dog's caudal mesenteric ganglion complex (Canis familiaris-Linnaeus, 1758)

The caudal mesenteric ganglion (CMG) is located ventral to the abdominal aorta involving the initial portion of the caudal mesenteric artery. Its macro and microstructural organization was studied in 40 domestic dogs. From the CMG, there were three nerves: the main hypogastric, the left hypogastric and the right hypogastric. The main hypogastric nerve emits two branches: the left colonic nerve and the cranial rectal nerve. Afterwards they give rise to branches to the descending colon (colonic nerves) and rectum (rectal nerves). The cranial rectal nerve, and left and right hypogastric nerves were directed to the pelvic ganglia. The microscopic study permitted the observation of the histological organization of the CMG, which is a ganglionic complex composed of an agglomeration of ganglionic units. Each ganglionic unit is composed of three major cell types: principal ganglion neurones (PGNs), glial cells and small intensely fluorescent (SIF) cells, and they were separated by nerve fibres, septa of connective tissue (types 1 and 3 collagen fibres), fibroblasts and intraganglionic capillaries. Hence, the ganglionic unit is the morphological support for the microstructural organization of the CMG complex. Further, each ganglionic unit is constituted by a cellular triad (SIF cells, PGN and glial cells), which is the cytological basis for each ganglionic unit.