Share this resource or email it to a friend!
What Is Rectal Prolapse in Kittens?
Rectal prolapse, which may develop when kittens repeatedly strain to defecate or urinate, occurs as two main types, which involve both the rectum and the anus, the last parts of the digestive tract through which feces pass.
Incomplete/intermittent prolapse occurs when some of the inner rectal tissue protrudes through the anus while straining to defecate. When straining stops, the rectal tissue will usually retract and no longer be visible.
Complete/Persistent prolapse occurs when all of the inner rectal tissue everts (turns inside out) and protrudes through the anus. Initially, the prolapsed tissue resembles a dark pink tube, but as rectal tissue continues to protrude from the anus, it will become dark red and swollen. Sores, crusts and discharge may also be seen, and the tissue may begin to dry out. Death of the tissue, necrosis, will result in a blackened appearance. What begins as a local secondary infection can then spread throughout the body, a condition known as sepsis.
There are no home treatments for complete/persistent rectal prolapse; any therapy is to keep the rectal tissue moist and injury free while waiting for the care of a veterinarian. Keep the tissue moist by gently covering it with a clean cloth saturated with warm water, a commercially available eye, nasal or other irrigating saline solution, petroleum jelly or a water-based lubricating jelly. Prevent the kitten from licking or chewing the tissue in order to prevent damage to the tissue and to give the prolapse the best chance for repair. A quick and easy Elizabethan collar can be made with some duct tape and a paper plate or bowl.
What Are the Causes of Rectal Prolapse in Kittens?
Rectal prolapse in kittens may be due to conditions that cause straining when defecating or urinating, some of which include:
- Intestinal parasites
- Diarrhea
- Constipation
- Dehydration
- Obstruction of the colon or rectum by the ingestion of a foreign object
- Urinary stones, though less likely in kittens
Rectal prolapse may affect kittens of any age, breed or sex. Some pedigreed cats, such as Manx, may be more prone to rectal prolapse due to genetic mutations causing them to be tailless. Kittens who suffer from trauma to the tail may be more prone to rectal prolapse if the nerves to their rectum and anus were affected.
Rectal prolapse is most common in kittens less than 6 months of age. They often have intestinal parasites which lead to diarrhea, increasing the number of bowel movements and straining. Their anal area may become red and swollen. Any rectal tissue that continues to protrude from the anus is of concern as their condition may worsen rapidly.
What Are the Symptoms of Rectal Prolapse in Kittens?
The symptoms of rectal prolapse may include:
- Spending a lot of time in the litter box
- Straining to defecate
- Vocalizing when defecating, an indication of pain
- Defecating frequently
- Defecating feces that are small and dry, looser than usual or covered with intestinal parasites
- Licking the anus frequently
- Swelling and redness around the anus
- Tube-like tissue outside the anus
- Depression
- Lethargy
- Loss of appetite
How Is Rectal Prolapse Diagnosed in Kittens?
A complete physical exam will be performed, including a rectal exam to feel for prolapsed tissue, hardened feces, a foreign object or tumor. When the exam does not reveal an obvious cause for the prolapse, further diagnostics may be needed, including:
- Examining a fecal sample to rule out intestinal parasites
- Performing blood work
- Performing urinalysis
- Taking abdominal x-rays or performing an abdominal ultrasound to determine if there is an obstruction and/or the extent of internal damage to the rectum
Prompt treatment for a complete rectal prolapse is critical in order to keep as much of the tissue alive, prevent further trauma and increase the chance of a successful recovery. Unfortunately, rectal prolapse is often complete by the time most cases are seen by a veterinarian.
How Is Rectal Prolapse Treated in Kittens?
A complete prolapse is usually painful, especially if the tissues are infected, and sedation or anesthesia is necessary to surgically correct the prolapse. In all cases, it is imperative that the cause of the prolapse be addressed to avoid recurrence of the prolapse. There are three surgical techniques to treat complete rectal prolapse:
Perianal purse-string suture is usually chosen when the tissues appear to still be alive and minimally traumatized. The veterinarian will first clean the tissue and apply medications or solutions to both shrink and lubricate the tissue before trying to manually reset the prolapse by pushing it back into its normal position. A purse-string suture is placed around the anus tight enough to prevent the tissues from prolapsing again, but loose enough to allow feces to pass. This suture is generally removed after 48 hours.
If the rectal prolapse cannot be reset manually because the tissues are too damaged or the prolapse returns after being manually reset and despite appropriate therapy, colopexy surgery is considered if the rectum is not irreversibly affected and the prolapse appears reducible. Colopexy involves abdominal surgery to attach the rectum to the abdominal wall.
Resection surgery may be recommended as a last resort to save the kitten’s life as there is more danger of serious post-surgical complications. It is considered if the tissues are necrotic, if the prolapse cannot be reduced or if the primary cause, such as a tumor, needs to be removed. Resection surgery involves removing the necrotic rectal tissues, reattaching healthy tissues and attaching the rectum to the abdominal wall.
In addition to treating complete rectal prolapse as described above, post-surgical treatment may include deworming for intestinal parasites, antibiotics to treat a secondary bacterial infection, pain medications, a high-fiber diet, a stool softener and an e-collar to prevent the kitten from licking or chewing the anal area.
What Is the Prognosis for Rectal Prolapse in Kittens?
Incomplete/intermittent rectal prolapse is common in kittens with intestinal parasites, and the prognosis is good as it will most often resolve with proper deworming. The prognosis becomes more guarded if surgical intervention is indicated; potential complications from manual resetting or colopexy include a recurrence of the prolapse, fecal incontinence and infections. Kittens treated with resection surgery have a guarded to poor prognosis.
