Anal and rectal conditions Flashcards
where are anal sacs in dogs
Located at 4 and 8 o’clock in between external and internal anal sphincters
why does anal gland abscessation or impaction happen
Due to a change in consistency of secretion or interference with normal duct emptying
what is the most common sign of anal gland disease
perineal irritation ‘scooting’, licking
What should you do if you see blood tinged material/ pus in anal gland secretions after expressing
lavage and pack with local antibiotic
- cow mastitis tubes/ear drops normally under GA
List 2 indications of anal sacculectomy
Recurrent impaction
Neoplasia
List 5 complications of anal sacculectomy
draining sinus (some gland left)
infection
dehiscence
tenesmus
faecal incontinence
what are Anal furunculosis
Suppurative, progressive, deep ulcerating tracts in the perianal tissues
predisposition of anal furunculosis
GSD
low tail carriage and increased density of apocrine glands in the perineum
Desribe how to treat anal furunculosis
Cyclosporin (“Atopica”) for 12 weeks- very expensive
hypoallergenic diet and immunosuppressive doses of preds can help in mild cases
Where do Perianal sebaceous gland adenoma tend to occur
Hairless area of anal ring most common location, can see at tail base, prepuce and ventrum
which animals are most prone to Perianal sebaceous gland adenoma
male dogs - entire
older patients
Features of a perianal adenoma
benign
testosterone driven, slow growing and resolve with castration
what do you need to differentiate Perianal sebaceous gland adenoma from
anal adenocarcinomas
describe the surgical management of anal adenocarcinomas
Aggressive surgical removal + adjunctive radiotherapy
which animals tend to get anal sac adenocarcinoma
Generally older female dogs (over 10 yr)
Describe a anal sac adenocarcinoma
tumour secretes PTH- like substance and causes a paraneoplastic syndrome
this causes hypercalcaemia- causes PU/PD, depression, weakness, weight loss
describe how to treat anal sac adenocarcinoma
- Treat hypercalaemia prior to surgery
- Treatment
○ excision of primary mass
○ Metastectomy
adjunctive chemotherapy
- Treatment
which animals do perineal ruptures tend to happen
normally entire older male dog
describe how to treat perineal rupture
empty bladder first
IVFT
herniorrhaphy
what is rectal prolapse associated with
Associated with endoparasites/enteritis in young animals and tumours or perineal hernias in middle aged/older animals
describe a incomplete rectal prolapse
mucosa only prolapsed
describe a complete rectal prolapse
all layers of rectal wall in entire circumference
describe how to treat rectal prolapse - acute presentation
lavage
lubricate
reduce and place purse string suture
describe how to treat rectal prolapse - Non-reducible or severely traumatised
amputation
describe how to treat rectal prolapse- recurrent
colopexy
what does rectal stricture normally occur secondary to
proctatitis
chronic anal sacculitis
penetrating FB’s
as complication of anorectal sx
List the clinical signs of rectal stricture
dyschezia
constipation
tenesnus
describe how to treat a rectal stricture
superficial strictures can be stretched
corticosteroids can help
extensive strictures may need resection
clinical sign of rectal polyp
blood/mucus in faeces
tenesmus
polyp prolapsing - sometimes
rectal prolapse- secondary
describe how to treat rectal polyps
small= electrocautery or excision and suture placement
Larger= intestinal resection
list the clinical signs of rectal adenocarcinomas
tenesmus, dyschezia, weight loss and lethargy with advanced malignancy
what is atresia ani
congenital
failure of development of the anus
describe how to treat Atresia ani
involves creation of an anus by excision of skin and terminal rectal mucosa and careful suturing
what are some general considerations we should be thinking about prior to doing surgery in the anal area?
infection risk
haemorrhage
faecal incontinence risk
why are we especially worried about the infection risk in anal/rectal surgery?
area contains lots of faeces + bacteria (mixed population, esp anaerobes)
why is haemorrhage a worry with anal surgery
very vascular site
how might we end up with faecal incontinence following anal surgery
disrrupting the external anal sphincter muscles (either by excision or damage to nerve supply)
what should you do if you need to do a anal sac removal but the patient has recently had a ruptured anal abscess
delay surgery (let abscess settle down first)
how can we differentiate between perianal adenoma and adenocarcinoma
biopsy
testosterone dependent benign masses
what is the treatment for perianal adenomas
castration (and should shrink)
Surgical removal if ulcerated (best to remove as dog may traumatise them more)
what are rectal adenocarcinomas
aggressive rectal tumours
infiltrative, ulcerative, proliferative
invades rectal wall -> fibrosis and stricture
what are the 3 possible sites for rectal adenocarcnimas
colorectal junction and cranial 1/3 of rectum
middle 1/3 of rectum
caudal 1/3 of rectum and anal canal
describe the treatment for rectal adenocarcinomas
surgery options:
- colorectal resection and anastomosis
- dorsal perineal approach
- rectal pull-through (if in caudal 1/3 of rectum/anal canal)
