Rectal prolapse, commonly known as prolapse, is a disease in which the posterior mucosa or muscularis of the rectum or a part of the rectum is turned outward and cannot retract by itself. Rectal prolapse is caused by a variety of reasons, mainly due to the relaxation and dysfunction of rectal ligament and sphincter. It is often secondary to digestive tract diseases caused by bacteria, viruses and parasites. In addition, long-term malnutrition, constipation and intestinal foreign bodies can also cause rectal prolapse. Severe cases can be accompanied by intussusception, mucosal necrosis and adhesion, and even rectal rupture. The prognosis of simple rectal prolapse is generally good, but the prognosis of rectal prolapse caused by other diseases is poor. The disease can occur in cats of all ages, but most of them occur in emaciated and malnourished kittens. The author of the school animal hospital treated a case of cat rectal disease, diagnosis and treatment experience as follows, hope to bring help to you.
1¡¢ Case introduction
Garfield is depressed
The sick cat was Garfield. A few days ago, due to enteritis and acute diarrhea, the patient was hospitalized for a period of time, which also led to the relaxation of the sphincter. The rectum prolapsed into a cylindrical ham sausage (as shown in Figure 2). The prolapsed rectum could not retract into the rectum. Due to the short time of prolapse, the rectal mucosa is hyperemia, edema, bright red and glossy. Due to the better care of the cat owner, the lateral side of the intestine is not contaminated with other pollutants. This case belongs to the early stage of anal prolapse. The mucosa was not damaged and necrotic. Conservative treatment was used first. However, the rectum prolapsed again on the same day after the rectal reduction. In order to prevent the deterioration of the disease, the surgical method was adopted.
Figure 2 rectal prolapse is cylindrical
2¡¢ First, the hind limbs of the sick cat were lifted up and 1% procaine was used for nerve conduction anesthesia at Houhai point. Then wash the diseased intestine with 40 ¡æ warm normal saline, wash and disinfect with 1% Bromogeramine solution (as shown in Fig. 3), and apply warm gauze to reduce edema and facilitate reduction (as shown in Fig. 4). Then, with long forceps wrapped with warm saline gauze, starting from the opening of the intestinal cavity, carefully put the detached intestinal tube back into * * to completely reset the rectum (as shown in Fig. 5). After returning, put the finger into the intestinal cavity, repair the deep rectal plica, and explore the intestinal reset to prevent incomplete reduction and intussusception (as shown in Figure 6). In this process, proper amount of lubricating oil can be coated to prevent the intestinal wall from being scratched. After restoration, purse string suture should be carried out around * * with fine suture to reduce the hole of * * and prevent it from falling out again. Pay attention not to sew the hole tightly. After putting a tube into the hole, tighten the suture line and tie it into a loose knot. Then pull out the tube to keep the tightness of the mouth of the mouth, so as not to affect the defecation. After suturing, apply the preheated erythromycin ointment at * * to prevent inflammation.
After operation, diet should be paid attention to and a small amount of digestible food should be fed. Intravenous injection of 5% glucose and sodium chloride, gentamicin, atropine or 654-2, to regulate intestinal bacteria, prevent secondary infection and relieve intestinal smooth muscle spasm; intravenous injection of 5% glucose and sodium chloride, vitamin C, inosine, adenosine triphosphate, coenzyme A to supplement energy; intravenous injection of condensed glucose and sodium chloride, adding sodium bicarbonate to adjust body fluid balance It can relieve acidosis.
Three days later, the cat gradually returned to normal. On the seventh day, the purse string suture was removed and the sick cat recovered.
Fig. 3 washing the effluent with warm normal saline
Fig. 4 removing intestinal tube with warm gauze
Fig. 5 reduction of detached bowel with long forceps
Fig. 6 intestinal reduction by finger exploration
3¡¢ Rectal prolapse is the result of a variety of factors, most of which are secondary to other diseases, and simple rectal prolapse is relatively rare. The direct cause is due to the relaxation and dysfunction of rectum ligament and sphincter in young and old cats. The inducements include enteritis, gastritis, long-term acute diarrhea, proctitis, prostatitis, increased abdominal pressure, constipation, rectal laceration, delayed dystocia, new organisms in the rectum, foreign bodies, etc., and lack of protein, water and vitamins in feeding It is characterized by multifibrous food, malnutrition, physical weakness and serious infection with parasitic diseases. Such as cat’s gastroenteritis and hair ball obstruction often cause rectal prolapse. In addition, intussusception is one of the main causes of rectal prolapse. Therefore, under the guidance of doctors, cats should be regularly deworming and vaccinated according to epidemic prevention procedures. Usually should take the cat food as the staple food, in order to ensure the cat’s nutritional balance, physical strength, prevent the occurrence of disease. If rectal prolapse is found, treatment should be carried out as soon as possible.
For mild rectal prolapse, conservative therapy should be taken first, and then surgery should be used to avoid unnecessary injury. For intractable rectal prolapse, internal fixation can be used to prevent prolapse again.