Ever noticed how things happen in 3s?
After going for years without seeing a rectal prolapse, I’ve seen 2 in the past month: 1 in a dog, the other in a cat. Weird.
This, of course, means I’m now on high alert for case number 3.
Rectal prolapse occurs when the animal’s rectum (the last part of the digestive tract, where poop sits before it’s launched onto an unsuspecting world) pops out of the anus.
There’s little mistaking a rectal prolapse because it looks like a long, pink sausage or pink donut hanging out of the patient’s backside. Apart from the obvious inconvenience, this is a serious problem because the delicate lining of the bowel is exposed to the elements.
With prompt action, the prolapse can be popped back into place and there are steps to take to stop it from happening again. Without treatment, the prolapsed tissue can develop serious, life-threatening complications.
Pink, Frilly Bottoms
You may notice that occasionally your cat or dog has a “pink rosette” of tissue around the anus just after they’ve toileted. This is most likely what’s called “everted rectal mucosa” — in other words, a frill of moist mucosa that popped out to say hello.
Everted rectal mucosa is usually a temporary affair — it pops back inside once the pet has pushed out the poop (egads, this isn’t a glamorous topic, is it?). It usually happens because the poop drags on the lining of the rectum. If this regularly happens to your pet, then check that their poop isn’t too hard.
If your pet with a pink bottom has hard poop, then take steps to soften their stool. Options for this include:
- Switch from dry kibble to wet food.
- Add fiber to the diet (especially dogs):
- Encourage the pet to drink more water:
- Give access to a pet drinking fountain.
- Have multiple water bowls throughout the house.
- Have a water bowl next to the pet’s bed.
- Offer mineral water (this often tastes nicer than tap water).
- Add water to the pet’s food.
A Full Rectal Prolapse: Immediate Action
OK, so the worst happens: You come home to find a pink sausage sticking out of your pet’s rear. What do you do?
Your pet needs immediate veterinary treatment. Don’t delay — contact an emergency vet and hightail it to the clinic, but take steps to prevent damage to the delicate tissue of the rectum:
- Stop the animal from licking the area.
- Keep the prolapse moist:
- Saturate some cotton swabs in saline solution (such as contact lens solution). Gently wrap this around the prolapse to protect the tissue. Then wet the swabs some more so they stay moist.
- Don’t feed the pet: The pet will need an anesthetic, so an empty stomach is essential.
Now get to the vet.
Risk Factors for Prolapse
Prolapses are most common in young animals, such as puppies and kittens, perhaps because the valve (anal ring) guarding the anus is weak. It’s also strongly linked to straining, so the pet may have severe constipation, diarrhea or urinary problems.
Common causes of straining that lead to prolapse include:
- Severe diarrhea, caused by infection
- Intestinal parasites
- Food allergy or intolerance
- Foreign bodies in the rectum (such as bone shards)
- Colitis (inflammation of the large bowel)
- Cystitis or urinary tract disease
- Straining to give birth
Help your pet by making sure they are dewormed on a regular basis, and get prompt treatment for diarrhea.
Treating a Rectal Prolapse
What happened to the dog and cat on my recent prolapse cases?
Both had an anesthetic and the prolapsed tissue gently replaced. There’s a risk of immediate re-prolapse, so a purse-string suture was placed so this physically can’t happen.
This suture is exactly what it sounds like: It tightens the anus in the same way a drawstring closes a shoe bag. A small hole is left so that soft poop can pass through, and the suture is removed after around 7 days.
The vigilant among you will spot that a normal poop won’t pass through a small hole. This makes it necessary to use a gentle laxative, such as lactulose, to keep things soft and squidgy. Unfortunately for my feline patient, the parent overlooked giving the lactulose, and the cat became very uncomfortable indeed.
This meant intervention with an enema — which enhanced the reputation of Fridays at the clinic as being “Fecal Fridays.” Now we’re waiting for things to settle down before removing that purse-string suture and keep everything crossed that the rectum stays in place.
What happens if the purse-string suture doesn’t work? Then things get very serious. This means radical surgery to amputate the prolapsed tissue. But, as you can imagine, this is high-risk surgery that’s prone to complications, so it’s best avoided.
Take-home message: Monitor your pet for straining, and get help if things aren’t right. Not to do so risks complications such as a rectal prolapse, which, although rare — take it from me — does happen.
This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed Jan. 19, 2018.