Rectal and Vaginal Prolapse Flashcards
What kind of prolapses are males prone to?
Rectal and preputial
What kind of prolapses are females prone to?
Rectal, vaginal and uterine
What are some important questions to ask a farmer is they think they have a prolapse?
Male or female?
Pregnant? (not uterine prolapse hopefully)
Top hole or bottom hole?
Lot or a little tissue coming out?
Is it smooth or bumpy?
What is a rectal prolapse?
Protrusion of rectal mucosa
Who gets it and what are risk factors?
Cattle, sheep and swine
Staining, tenesmus, dysuria, neuropathy, chronic coughing, genetics, neoplasia, diet, obesity, hormone treatment
What is one management factor common in sheep for rectal prolapse?
Tail docking and obesity
Is a rectal prolapse and emergency?
No but the sooner you see it the easier it is to go back in
-May change treatment (amputation versus stich)
What is the treatment for rectal prolapses?
Grade 1 and 2 - good prognosis with prompt treatment (suture in)
grade3-4 - vascular injury descending colon requires surgical resection and poor prognosis
What are the grades of rectal prolapse?
Grade 1: small rectum and intermittent
Grade 2: complete prolapse all layers can be intermittent
Grade 3: prolapse large colon into rectum, longer and painful
Grade 4: prolapse but anal sphincter intact and constricting the rectum and colon
How can you decrease straining?
Epidural with % lidocaine (60-120min) or lidocaine and xylazine (180-240min)
-Cattle caudal epidural (1st intercoccygeal space)
How do you manage a rectal prolapse?
Cull
Treat respiratory or diarrhea
Replace with purse string and umbilical tape
-Hypertonic saline, or dextrose to get back in , lubricate, remove suture in 5-10 days - injcet lidocaine to cause adhesion at 12, 3 and 9)
-Remove if cant replace, pig whistle and band or submucosal resection
-Should slough off 7-10 days
What are possible complications with cutting off circulation?
Strictures, peritonitis and abscesses
What is a vaginal prolapse and who gets it?
Protrusion of vaginia
Cattle, sheep, swine and goat (fall and late preg)
-late preg
-estrogenic agents 9forage, growth stimulus, mold, superovulation
-Genetics
Is vaginal prolapse and emergency?
No but evaluate asap
-Grade 1: intermittent out when lay down ok
-Grade 2: vaginal mucosa protrude continuously (retention suture ok)
-Grade 3: trapped urinary bladder, cervical mucus plug - replace or induce partuition
-Grade 4: necrotic and fibrosed - bad cull
What are risk factors that lead to vaginal prolapse?
Late gestation- increase concentrate and reduce hay (less fillling)
-Resp disease
-Poor tail dock
-Dont keep dam or offspring for breeding
-Epidural for rectal (causal)
How can you treat vaginal prolapse?
Hydroscopic agent, retention harness, prolapse paddle, caslicks suture (non-pregnant), Buhner stich
When do uterine prolapses commonly occur?
3rd stage of labor - placental expulsion
(few hours after parturition)
-cow and sheep
Is uterine prolapse an emergency?
Yes, do not move…could tear uterine artery
What are risk factors for a uterine prolapse?
Multiparous animals
estrogenic substances’weather change and pasture composition
uterine inertia, hypocalcemia, recumbency, dystocia, retained fetal membrane and uterine tears
What is scary about a uterine prolapse?
Animal may be bleeding inside and you push back in and releases and she dies fast
How do you replace a uterine prolapse?
Epidural
standing or recumbent
Remove fetal membrane if can
have people lift uterus
lots of lube and hydroscopic bandage for 10-15 min
reduction of nongravid first
stead pressure with closed fist
Make sure to evert everything (extend arm or tool)
NSAID, Antibiotic, oxytocin, ca
retention suture
Is uterine amputation an option?
Sever necrosis and lacerations
-ligate vessels
-time and money
-closed ligate and leave to fall off in 10-14 days
Who has preputial prolapses?
Bulls (genetic with pendulous sheath, injury during copulation
How do you medically manage a preputial prolapse?
Sepsis control - clean, flush, debride and antibiotics
Edema reducaiton - application and bandage
Return damaged tissue to preputial cavity
Surgical- referral - avulsion, circumcision, amputation
