Dyschezia, Tenesmus and Constipation

Question 1

what is dyschezia

Answer 1

Difficult or painful defaecation +/- blood

Question 2

List 6 possible causes of Dyschezia

Answer 2

Colonic impaction- bones/tumour
Perineal hernia and rectal diverticulum
Rectal stricture
Anal neoplasia
Severe prostatomegaly
Obstipation

Question 3

List 5 possible causes of tenesmus

Answer 3

Colitis
Bone ingestion
Rectal/anal tumours
Post operatively following perineal surgery
Prostatomegaly

Question 4

List 3 possible causes of constipation

Answer 4

A lot have tenesmus and dyschezia however
* Eat bones
* Pelvic fractures
* Rectal /Anal tumours

Question 5

describe what to look at in clinical exam with case of constipation

Answer 5

nose to tail exam
assess abdomen- for any gas or faecal excess-colon
check temp
RECTAL exam- cats likely require seadtion/ GA

Question 6

why should you do urinialysis in a constipated cat

Answer 6

some owners assume constipation when the animal is actually straining to urinate- esp cats

Question 7

what is the only true cause of constipation in cats

Answer 7

feline idiopatic megacolon

Question 8

describe history seen with feline idiopathic megacolon

Answer 8

straining to past motions
often overweight cats- with lazy lifestyle
feel huge colon on abdo palpation

Question 9

how big is mega colon on radiograph

Answer 9

1.5 x length of 7th lumbar vertebra

Question 10

describe how to treat feline idiopathic megacolon

Answer 10

Laxatives, enemas, high fibre feed- will reoccur within weeks-months

How to fix = subtotal colectomy

Question 11

what can tenesmus lead to

Answer 11

rectal prolapse

Question 12

List 5 clinical signs of colitis

Answer 12

Tenesmus
Soft stools
Mucus in stool
Fresh blood
Generally well animals

Question 13

If there is mucus in the stool, what organ is responsible

Answer 13

colon
when irritated over produces mucus

Question 14

How is colitis treated

Answer 14

Metronidazole
Suphasalazine
High fibre
Steroids

Question 15

T/F constipation is rare in dogs

Answer 15

True

Question 16

What contrast can be used to asses GI motility

Answer 16

barium enema (per rectum)

Question 17

Do you need to carry out an enema before a colonscopy

Answer 17

Yes

Question 18

If you suspect a small intestine issue, what parameters on blood work will you focus on?

Answer 18

Cobalamin
Folate
TLI

Question 19

If an enema has been used or bone material has been passed, what type of diet would you use?

Answer 19

Low residue diets (gives bowel rest as little wastage)

Question 20

What anal/rectal surgery can improve passage of faeces?

Answer 20

Perineal herniorrhaphy
Anal sacculectomy
Subtotal colectomy
Rectal pull through

Question 21

Are antibiotics used for a subtotal colectomy

Answer 21

Yes
Metronidazole
Cephalosporin

Question 22

Why are large colons a struggle to operate on

Answer 22

Prolonged lag phase of healing
Put under high intraluminal pressure which increases the risk of dehiscence
High risk of infection due to bacterial content