Prolapes Flashcards
If it is a female that has a possible prolapse, what 3 questions do you need to ask the farmer/producer to determine what type of prolapse it is?
- is she pregnant or have she recently calved?
- which hole is it coming from?
- is it long, short, smooth, or bumpy?
What are (8) risk factors for rectal prolapses?
- straining (tenesmus from colitis or coccidiosis; or dysuria/cystitis/uroliths/dystocia)
- neuropathy – tail docking, alcohol epidural, spinal lymphoma
- chronic coughing (resp dz)
- genetics
- neoplasia
- diet (estrogenic feedstuff)
- obesity
- hormone treatment
T/F: rectal prolaspse is an emergency
false – just should be addressed sooner rather than later.
What is the prognosis of rectal prolapse?
it depends on the severity and chronicity
grade I and II: good with prompt tx
grade III and IV: there is risk for severe vascular injury to descending colon and these types require surgical correction.
T/F: Type I and II rectal prolapses are uncommonly seen. When rectal prolapse occurs, its usually severe (type III or IV)
false – type I and II are most common
for reference:
(type I = prolapse of rectal mucosa only, small, intermittent; type II = prolapse of all layers (mucosa–>serosa); type III= prolapse of all layers and large colon; type IV = all layers, large colon, and anal sphincter is intact causing constriction of rectum and colon)
If an animal has a rectal prolapse and they are still straining, what should you do?
Epidural analgesia with 2% lidocaine, lidocaine + xylazine, OR morphine.
An alcohol epidural is a salvage procedure and can predispose to prolapsing again. You would NOT want to do this if you want the animal around long-term.
T/F: you should cull if a production animal experiences a rectal prolapse
true because its going to happen again.
How do you treat rectal prolapse?
if the mucosa appears healthy, then lubricate it replace it and apply a purse string or umbilical tape. Ensure to leave 2-4 finger-wide space so that the animal can still defecate.
You might need to reduce the swelling first with hypertonic saline/dextrose/sugar.
The sutures should be removed in 5-10 days.
You can also inject iodine around the rectum to cause adhesions.
If rectal prolapse replacement is NOT an option, how do you treat?
submucosal resection
or
place prolapse ring and band/suture to amputate the area (sloughs in 7-10d)
What are the risk factors for vaginal prolapse?
- advanced stage pregnancy (intraabdominal pressure, multiparous)
- exposure to hyperestrogenic agents causing vaginal tissue relaxation (growth stimulants, mold, superovulation)
- genetics/breed (herefords)
Is vaginal prolapse an emergency?
no but should be evaluated promptly.
How would you treat Grade I or II vaginal prolapse?
- grade I is characterized by small, intermittent protrusion of the mucosa, usually when the animal is lying down; tx is neglect or retention suture
- grade II is characterized by mucosa protruding continuously and therefore tx is to replace and apply retention suture
How do you treat grade III or IV vaginal prolapses?
Grade III is characterized by the entire vaginal mucosa and cervix protruding continuously and therefore tx is cystocentesis (to relieve trapped bladder), replacement, and retention sutures; if shes pregnant, induce parturition
Grade IV is characterized by chronic eversion that has resulted in necrosis and fibrosis of the vaginal tissue; you could replace it and put the animal on antibiotics, but in most cases euthanasia is warrented.
How could you prevent a late-gestation ewe from having vaginal prolapse?
INCREASE concentrate consumption
DECREASE hay consumption
MONITOR management factors (resp dz, improper dail docking, etc.)
T/F: sugar is irritating to the vaginal mucosa and is not the best hydroscopic agent to use to reduce edema prior to replacement
true
better alternatives include hypertonic saline, epsom salt, glycerol, and dextrose
