Anal and rectal conditions

Question 1

where are anal sacs in dogs

Answer 1

Located at 4 and 8 o’clock in between external and internal anal sphincters

Question 2

why does anal gland abscessation or impaction happen

Answer 2

Due to a change in consistency of secretion or interference with normal duct emptying

Question 3

what is the most common sign of anal gland disease

Answer 3

perineal irritation ‘scooting’, licking

Question 4

What should you do if you see blood tinged material/ pus in anal gland secretions after expressing

Answer 4

lavage and pack with local antibiotic
- cow mastitis tubes/ear drops normally under GA

Question 5

List 2 indications of anal sacculectomy

Answer 5

Recurrent impaction
Neoplasia

Question 6

List 5 complications of anal sacculectomy

Answer 6

draining sinus (some gland left)
infection
dehiscence
tenesmus
faecal incontinence

Question 7

what are Anal furunculosis

Answer 7

Suppurative, progressive, deep ulcerating tracts in the perianal tissues

Question 8

predisposition of anal furunculosis

Answer 8

GSD
low tail carriage and increased density of apocrine glands in the perineum

Question 9

Desribe how to treat anal furunculosis

Answer 9

Cyclosporin (“Atopica”) for 12 weeks- very expensive

hypoallergenic diet and immunosuppressive doses of preds can help in mild cases

Question 10

Where do Perianal sebaceous gland adenoma tend to occur

Answer 10

Hairless area of anal ring most common location, can see at tail base, prepuce and ventrum

Question 11

which animals are most prone to Perianal sebaceous gland adenoma

Answer 11

male dogs - entire
older patients

Question 12

Features of a perianal adenoma

Answer 12

benign
testosterone driven, slow growing and resolve with castration

Question 13

what do you need to differentiate Perianal sebaceous gland adenoma from

Answer 13

anal adenocarcinomas

Question 14

describe the surgical management of anal adenocarcinomas

Answer 14

Aggressive surgical removal + adjunctive radiotherapy

Question 15

which animals tend to get anal sac adenocarcinoma

Answer 15

Generally older female dogs (over 10 yr)

Question 16

Describe a anal sac adenocarcinoma

Answer 16

tumour secretes PTH- like substance and causes a paraneoplastic syndrome

this causes hypercalcaemia- causes PU/PD, depression, weakness, weight loss

Question 17

describe how to treat anal sac adenocarcinoma

Answer 17

• Treat hypercalaemia prior to surgery
  
  • Treatment
    ○ excision of primary mass
    ○ Metastectomy
    adjunctive chemotherapy

Question 18

which animals do perineal ruptures tend to happen

Answer 18

normally entire older male dog

Question 19

describe how to treat perineal rupture

Answer 19

empty bladder first
IVFT
herniorrhaphy

Question 20

what is rectal prolapse associated with

Answer 20

Associated with endoparasites/enteritis in young animals and tumours or perineal hernias in middle aged/older animals

Question 21

describe a incomplete rectal prolapse

Answer 21

mucosa only prolapsed

Question 22

describe a complete rectal prolapse

Answer 22

all layers of rectal wall in entire circumference

Question 23

describe how to treat rectal prolapse - acute presentation

Answer 23

lavage
lubricate
reduce and place purse string suture

Question 24

describe how to treat rectal prolapse - Non-reducible or severely traumatised

Answer 24

amputation

Question 25

describe how to treat rectal prolapse- recurrent

Answer 25

colopexy

Question 26

what does rectal stricture normally occur secondary to

Answer 26

proctatitis chronic anal sacculitis penetrating FB’s as complication of anorectal sx

Question 27

List the clinical signs of rectal stricture

Answer 27

dyschezia constipation tenesnus

Question 28

describe how to treat a rectal stricture

Answer 28

superficial strictures can be stretched corticosteroids can help extensive strictures may need resection

Question 29

clinical sign of rectal polyp

Answer 29

blood/mucus in faeces tenesmus polyp prolapsing - sometimes rectal prolapse- secondary

Question 30

describe how to treat rectal polyps

Answer 30

small= electrocautery or excision and suture placement Larger= intestinal resection

Question 31

list the clinical signs of rectal adenocarcinomas

Answer 31

tenesmus, dyschezia, weight loss and lethargy with advanced malignancy

Question 32

what is atresia ani

Answer 32

congenital failure of development of the anus

Question 33

describe how to treat Atresia ani

Answer 33

involves creation of an anus by excision of skin and terminal rectal mucosa and careful suturing

Question 34

what are some general considerations we should be thinking about prior to doing surgery in the anal area?

Answer 34

infection risk haemorrhage faecal incontinence risk

Question 35

why are we especially worried about the infection risk in anal/rectal surgery?

Answer 35

area contains lots of faeces + bacteria (mixed population, esp anaerobes)

Question 36

why is haemorrhage a worry with anal surgery

Answer 36

very vascular site

Question 37

how might we end up with faecal incontinence following anal surgery

Answer 37

disrrupting the external anal sphincter muscles (either by excision or damage to nerve supply)

Question 38

what should you do if you need to do a anal sac removal but the patient has recently had a ruptured anal abscess

Answer 38

delay surgery (let abscess settle down first)

Question 39

how can we differentiate between perianal adenoma and adenocarcinoma

Answer 39

biopsy testosterone dependent benign masses

Question 40

what is the treatment for perianal adenomas

Answer 40

castration (and should shrink) Surgical removal if ulcerated (best to remove as dog may traumatise them more)

Question 41

what are rectal adenocarcinomas

Answer 41

aggressive rectal tumours infiltrative, ulcerative, proliferative invades rectal wall -> fibrosis and stricture

Question 42

what are the 3 possible sites for rectal adenocarcnimas

Answer 42

colorectal junction and cranial 1/3 of rectum middle 1/3 of rectum caudal 1/3 of rectum and anal canal

Question 43

describe the treatment for rectal adenocarcinomas

Answer 43

surgery options: - colorectal resection and anastomosis - dorsal perineal approach - rectal pull-through (if in caudal 1/3 of rectum/anal canal)