Rectal Prolapse In LARGE Animals Flashcards
What can cause rectal prolapses?
- anything that increases pressure gradient between abdominal cavity and anus
1) straining (parturition
2) colitis/diarrhea
3) increased abdominal fill
4) Cystitis
5) inadequate tone of anal sphincter
- this normally maintains pressure gradient
6) obesity
What normally maintains the pressure gradient to prevent rectal prolapse?
The Anal sphincter
What species is more prone to recall prolapses and why?
Ruminants > horses
- most common in sheep
- short tail docking—> damage to nerve of the peritoneum
What type of Cattle are most affected by rectal prolapse?
Feedlot cattle
How do you classify Rectal prolapse?
Type 1 (mucosa and submucosa prolapse)
Type 2 (All layers)
Type 3 (type 2 + SC intusecepts rectum)
Type 4 (Rectum and SC intuscepects through anus) -associated with dystocia in MARES
Which types of rectal prolapse are most common?
Type 1 + Type 2
What are the clinical signs of rectal prolapse?
1) mucosal mas protruding through anus
2) palpation:
- type 1 -3: continuous with mucocutaneous junction of anus
- type 4: Chanel between prolapsed tissue and anus
3) assess prolapse type, edema/ hemorrhage and depth of erosion
How would you treat a type 1/2 prolapsed rectum?
1) stop straining (caudal epidural anesthesia)
2) clean mucosa and reduce mucosal edema
3) Resolve prolapse manually
4) purse string anus with umbilical tape (1week)
5) low bulk diet for 10 days
What can be used to reduce mucosal edema for a type1/2 rectal prolapse?
Topical application of HYPERosmotic formulation:
Glycerin + Sugar + MgSO + lidocaine jelly
How long should you leave a purse string for rectal prolapse?
Leave for 1 week
- 2 fingers width in cattle to allow deification
- Open every 2-4 hrs in horses (defication/removal)
When manually resolving a prolapsed anus, how is it held in place?
Purse string anus with umbilical tape
How often do we need to manually evcuate the rectum of a horse treated for prolapsed anus?
Every 2-4hours
When would you use a SUBMUCOSAL resection to treat a rectal prolapse?
- Mainly Type 1/2
- Damaged mucosa/healthy underlying tissue
Epidural, cleaning, reduce edema—>Sx evaluation
Describe submucosal resection (rectal prolapse)
-needles at right angles to each other 1cm from anus (in healthy tissue)
-2 circumferential incision (ONLY through submucosa)
——CRANIAL and CAUDAL to damaged mucosa
-connect circumferential incision with longitudinal incision (and dissect out) SIMILAR TO REEFING
Is submucosal resection (kinda reefing) commonly done?
No, Rare.
Normally you get there early and it has just prolapsed….OR…….you get there late and most tissue is damaged so you need to amputate
