Term
| What are indications for biopsy? |
|
Definition
| -mass lesion: anal sac, rectum, distal colon |
|
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Term
| How does our behavior change w/ benign lesions in rectum? |
|
Definition
| -benign lesions can transform tomalignanc |
|
|
Term
| What is a perianal gland adenoma? |
|
Definition
-bening
-arises from circumanal glands
-older, intact males: due to androgen concentrations |
|
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Term
| How do we treat perianal gland adenomas? |
|
Definition
|
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Term
| What are adenomatous polyps? |
|
Definition
-benign intramural mass w/in the rectum
-malignant transformation occurs in up to 50% |
|
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Term
| How do we treat adenomatous polyps? |
|
Definition
| -earlys surgical excision |
|
|
Term
| What are the two types of rectal prolapses? |
|
Definition
-Incomplete: protrusion of rectal mucosa from anus
-Complete: protrusion of all layers of rectal wall |
|
|
Term
| What usually causes rectal prolapse? |
|
Definition
| -straining or recent perineal surgery |
|
|
Term
| What is the typical signalment of rectal prolapse? |
|
Definition
-dogs and cats
-usually younger
-manx cats |
|
|
Term
| How do we treat a rectal prolapse? |
|
Definition
-address underlying cause
-manual reduction: acute cases w/ minimal edema + warm saline + purse-string anus over a tube (keep suture in 2w)
-sx amputation: chronic cases or necrotic tissues |
|
|
Term
|
Definition
-paired, locates at 4 and 8 o'clock
-lie b/n fibers of anal sphincter
-ducts open into cutaneous zone of the rectum
-lined w/ squamous epi, contain sebaceous and apocrine gland |
|
|
Term
| What is the most common tumor of anal sacs? |
|
Definition
| -apocrine gland adenocarcinoma |
|
|
Term
| What are apocrine gland adenocarcinomas of the anal sacs? |
|
Definition
-highly malignant
-met to sublumbar LN
-causes significant paraneoplastic syndrome |
|
|
Term
| How do we treat apocrine gland adenocarcinomas of anal sacs? |
|
Definition
| -sx excision of anal sac +/- sublumbar LN |
|
|
Term
|
Definition
| -inflammation of anal sacs |
|
|
Term
| What is the typical signalment of anal sacculitis? |
|
Definition
-toy and small breed
-rare in cats
-may be assoc w/ seborrheic dermatitis |
|
|
Term
| What are the CS of anal sacculitis? |
|
Definition
-soft stool, diarrhea
-irritation of perineum
-tenesmus, constipation, dyschezia |
|
|
Term
| What usually causes anal sacculitis? |
|
Definition
-obstruction/infection
-fistualtion can occur w/ crhonic obstruction |
|
|
Term
| How do we medically manage anal sacculitis? |
|
Definition
-regular expression
-abx/warm compresses in abscessation
-management of underlying cause |
|
|
Term
| What are the indications for sx management of anal sacculitis? |
|
Definition
-failure of med management for anal saccultiis
-neoplasia
-control inflamm/infection before surgery |
|
|
Term
| What are the two types of anal sac surgery? |
|
Definition
-open anal sacculectomy: incise longitudinally
-closed anal sacculectomy: infese anal sac w/ paraffin |
|
|
Term
| Which anal sac is more common? |
|
Definition
| -closed anal sacculectomy |
|
|
Term
| What are the disadvantages to open anal sacculectomy? |
|
Definition
| -greater risk of infection and incontinence |
|
|
Term
| What is the major specific indication for closed anal sacculectomy? |
|
Definition
|
|
Term
| What is the genral procedure for closed anal sacculectomy? |
|
Definition
-incise sac at lateral aspecte of anal sac
-dissect sac from sphincter fibers
-avoid caudal rectal nerve (beind sac)
-ligate duct at irifice |
|
|
Term
| What happens w/ a perineal hernia? |
|
Definition
-caudal pelvic diaphragm (coccygeus m + levator ani m) loses its integrity
-also issues w/ sacrotuberous lig (NOT IN CATS) where the sciatic n runs
-intra-abdominal contents heriate outside the abdominal cavity |
|
|
Term
| What are the locations of perineal hernias? |
|
Definition
-caudal due to atrophy of levator ani m: MOST COMMON
-dorsal
-ventral
-combos |
|
|
Term
| What is the typical signalment of perineal hernias? |
|
Definition
-male >>>> cats
-dogs > cats
-Breeds: corgi, boxers, poodle, pekingese, boston terrier, old english sheepdog |
|
|
Term
| What is the feline signalment of perineal hernias? |
|
Definition
-older
-male or female
-neutered or intact
-DSH |
|
|
Term
| What are some common comorbidities w/ perineal hernias in cats? |
|
Definition
-megacolon
-perineal urethrostomy
-trauma
-perineal masses |
|
|
Term
| What do we see on exam w/ perineal hernias? |
|
Definition
-perineal bulge: non-painful, incompletely reducible, right > left
-tenesmus
-constipation
-irregular bowel movements |
|
|
Term
| What are our major differentials w/ perineal hernia? |
|
Definition
-neoplasia
-perianal gland hyperplasia
-anal gland neoplasia
-vaginal neoplasia |
|
|
Term
| What do we do for bladder entrapment w/ perineal hernia? |
|
Definition
-foley catheterization
-cystocenesis
-evaluate renal function
-operate when stable |
|
|
Term
| How do we medically manage perineal hernias? |
|
Definition
-palliative: finances or poor anesthetic candidate
-stool softeners
-enemas
-diatary fiber |
|
|
Term
| How do we surgically manage perineal hernias? |
|
Definition
-GOLD STANDARD
-castration
-herniorrhaphy: take muscles and suture it to spincter, take mm and make wall to block hole
-adjunctive procedures: cystopexy, colopexy, vasopexy |
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