Diffuse leiomyomatosis with circumferential thickening of the gastrointestinal wall, resembling human diffuse leiomyomatosis, in a young miniature dachshund.

Leiomyoma is the most common mesenchymal tumor in the gastrointestinal (GI) tract. Leiomyomas usually have a single or multinodular mass of various sizes, and affected animals can develop alimentary symptoms depending on the location and size. A 3-year old female miniature dachshund died after a history of refractory rectal prolapse, esophagectasis and aspiration pneumonia. At necropsy, the GI wall at the gastroesophageal and anorectal junctions was circumferentially thickened. Histologically, both GI lesions were composed of bundles of well-differentiated smooth muscles without mass formation or invasive growth. The neoplastic cells had little cellular atypia and low proliferative activity, and were positive for α-smooth muscle actin. The lesions were diagnosed as diffuse leiomyomatosis with circumferential thickening of the GI wall and has not been described in the veterinary literature.

A perineal cystic hamartoma causing constipation in an intact female Irish water spaniel.

A perineal fluid-filled structure was discovered in a 6-year-old intact female Irish water spaniel suffering from intermittent constipation. Diagnostic tests revealed the structure was immediately caudal to the vagina and compatible with a cyst. Surgical excision was required for resolution of clinical signs. Histology confirmed the structure was a cyst. The exact origin is unknown; however, the variety of lining epithelia, including sections with mucin production, and a well-differentiated smooth muscle layer, were most consistent with development from the lower hindgut or urogenital sinus during embryonic growth. The histologic and anatomical similarities with human retrorectal cystic hamartomas were key in establishing the diagnosis of a perineal cystic hamartoma. Following removal, constipation resolved, and the cyst did not recur.

Hamartome kystique périnéal causant de la constipation chez une femelle intacte de race épagneul d'eau irlandais. Une structure périnéale remplie de liquide fut découverte chez une chienne intacte de race épagneul d'eau irlandais âgée de 6 ans souffrant de constipation intermittente. Les tests diagnostiques ont révélé que la structure était immédiatement caudale au vagin et était compatible avec un kyste. L'excision chirurgicale était requise pour la résolution des signes cliniques. L'histologie confirma que la structure était un kyste. L'origine exacte est inconnue; toutefois, la diversité de l'épithélium de couverture, incluant des sections avec production de mucine, et une couche bien différenciée de muscle lisse, étaient plus cohérentes avec un développement à partir du tractus digestif postérieur ou du sinus urogénital lors de la croissance embryonnaire. Les similarités histologique et anatomique avec l'hamartome rétro-rectal humain étaient critiques pour établir le diagnostic d'hamartome kystique périnéal. À la suite du retrait, la constipation s'est résolue, et il n'y a pas eu de récurrence du kyste.(Traduit par Dr Serge Messier).

Pubectomy and stereotactic radiotherapy for the treatment of a non-resectable sacral osteosarcoma causing pelvic canal obstruction in a dog.

A pubectomy was carried out to relieve obstruction of the pelvic canal in a 6-year-old dog diagnosed with sacral osteosarcoma. Two days after surgery, the dog was ambulatory with normal urination and defecation. Pubectomy is a viable option to relieve clinical signs in patients with pelvic canal obstruction due to a non-resectable tumor.

Pubectomie et radiothérapie stéréotactique pour le traitement d'un ostéosarcome sacral non réséquable causant un blocage du canal pelvien chez un chien. Une pubectomie a été réalisée afin de soulager un blocage du canal pelvien chez une chienne âgée de 6 ans avec un diagnostic d'ostéosarcome sacral. Deux jours après la chirurgie, la chienne était ambulatoire et avait une miction et une défécation normales. La pubectomie représente une option viable pour soulager les signes cliniques chez les patients ayant un blocage pelvien causé par une tumeur non réséquable.(Traduit par Isabelle Vallières).

Ileo-ceco-rectal Intussusception Requiring Intestinal Resection and Anastomosis in a Tawny Eagle (Aquila rapax).

A 23-year-old male tawny eagle (Aquila rapax) was examined because of sudden onset of lethargy, regurgitation, and hematochezia. An intestinal obstruction was suspected based on radiographic findings, and an ileo-ceco-rectal intussusception was confirmed by coelioscopy. A 14.3-cm section of intestine was resected before an intestinal anastomosis was done. Coelomic endoscopic examination confirmed a postsurgical complication of adhesions between the intestinal anastomosis and the dorsal coelomic wall, resulting in a partial luminal stricture and requiring surgical removal of the adhesions. Rectoscopy was useful in diagnosing a mild luminal stricture related to the second surgery. Complete recovery was observed 2 months after surgery. Lack of further complications in the 2 years after surgery demonstrates good tolerance of intestinal resection and anastomosis of a large segment of bowel in an eagle. This report is the first reported case of intussusception in an eagle and emphasizes the potential use of endoscopic examination in the diagnosis as well as in the management of complications.

[Ulcerative colitis and proctitis in two Swiss Braunvieh cows]. / Ulzerierende Colitis und Proktitis bei zwei Braunviehkühen.

Two Swiss Braunvieh cows were referred to our clinic because of narrowing of the rectum and difficult rectal examination attributable to restricted arm movement within the pelvic cavity. Cow 1 also had perforation of the cranial rectum and cow 2 had multiple small funnel-shaped depressions in the rectal mucosa. Both cows had ultrasonographic evidence of peritonitis with thickening of the intestinal wall and fibrin and fluid accumulation in the abdominal cavity. A diagnosis of peritonitis was made in both cows, most likely caused by rectal perforation; they were euthanized and a post-mortem examination was carried out. Both cows had proctitis and ulcerative colitis with three or four perforated ulcers which were associated with fibrinopurulent peritonitis. The final diagnosis was ulcerative colitis and proctitis of unknown aetiology. Infectious causes of colitis and proctitis, including bovine viral diarrhoea, adenovirus infection and salmonellosis, and trauma and poisoning were ruled out.

Markedly increased expression of interleukin-8 in the colorectal mucosa of inflammatory colorectal polyps in miniature dachshunds.

Inflammatory colorectal polyps (ICRPs) in miniature dachshunds were recently recognized as a major cause of large bowel diarrhea in this dog breed in Japan. ICRPs are characterized by the formation of multiple small polyps and/or space-occupying large polyps in the colorectal area and are thought to be a novel form of inflammatory bowel disease (IBD). To explore key mediators in the pathogenesis of ICRPs, we analyzed several pro-inflammatory cytokine (IL-1ß, IL-6, TNF-α, IL-8, IL-12p35, IL-12/23p40, and IL-23p19) mRNA expressions in colorectal polyps in ICRP dogs by quantitative PCR. Among these cytokines, IL-8 mRNA expression was markedly up-regulated in large polyps. To examine IL-8 protein expression, we analyzed IL-8 protein level and its location in colorectal mucosal specimens of ICRP dogs by ELISA and immunofluorescence microscopy. IL-8 protein was significantly increased in large polyps and serum in dogs with ICRPs compared to controls. By immunofluorescence microscopy, IL-8 was only localized in macrophages, but not in mucosal epithelial cells or neutrophils. IL-8-positive macrophages were significantly increased in large polyps compared to controls. These results suggest that IL-8 is produced mainly by macrophages and may induce neutrophil infiltration in the colorectal area of ICRP dogs.

The role of endoscopic ultrasound in the evaluation of rectal polypoid lesions in 25 dogs.

We investigated the role of endoscopic ultrasound in the evaluation of rectal polypoid lesions in 25 dogs. Twenty-five cases of rectal polypoid lesions in dogs who underwent surgery after endoscopic and EUS assessment were studied. The invasion depth of the polypoid lesion was classified as M stage (lesions in the mucosa only), SM stage (lesions in the mucosa and submucosa), and MP stage (lesions extending to the muscularis propria). Transabdominal ultrasound was performed in nine cases, but not all were evaluated in detail. EUS provided detailed images for all cases and showed a significant correlation with surgical pathology in the T stage (accuracy, 92%; K = 0.77). As per classification by invasion depth, inflammatory polyps were only M polypoid lesions, whereas SM and MP polypoid lesions were only adenocarcinomas (P < 0.05). The average survival time according to specific condition was as follows: 1,235 days for inflammatory polyps, and 804 days for M adenocarcinoma. The survival time of two SM adenocarcinoma cases was 756 and 2,114 days, respectively, and the survival time of two MP adenocarcinoma cases was 16 and 42 days, respectively. EUS were useful for the evaluation of rectal polypoid lesions in dogs, whereas transabdominal ultrasound was not. Determination of the invasion depth of polypoid lesions using EUS may be useful for the evaluation of malignancy and prognosis.

A retrospective study of inflammatory colorectal polyps in miniature dachshunds.

Medical records of dogs with colorectal polyps were retrospectively reviewed, and clinical presentation of inflammatory colorectal polyps in miniature dachshunds was evaluated. Of 33 dogs found to have colorectal polyps, miniature dachshunds were markedly over-represented with 16 dogs (48%), of which 12 (75%) were found to have inflammatory polyps. Multiple polyps localized between the rectum and the descending colon was the most common finding in miniature dachshunds with inflammatory polyps. Twenty dogs (80%) out of 25 miniature dachshunds with inflammatory colorectal polyps responded to immunosuppressive therapy using prednisolone and cyclosporine. The results of this study indicate that miniature dachshunds are predisposed to develop inflammatory colorectal multiple polyps, for which immunosuppressive therapy may be a treatment option.

Oil Red O-positive lipid in peritoneal fluid from a horse with a rectal tear.

A 4-year-old Quarter Horse mare was presented to the Texas A&M University Veterinary Medical Teaching Hospital for evaluation of a rectal tear. On initial evaluation, rectal palpation and colonoscopy revealed a grade IIIb rectal tear. Analysis of peritoneal fluid revealed a modified transudate. Preliminary supportive care included fluid therapy and mineral oil administration via nasogastric tube. Approximately 48 hours after presentation, a second abdominocentesis was performed, and cytologic examination of the fluid revealed a marked suppurative exudate. Round clear nonrefractile material observed within neutrophils and macrophages and in the background stained bright pink to red with Oil Red O, confirming the material as lipid, likely from leakage of mineral oil through the rectal tear. The condition of the mare deteriorated and euthanasia was elected due to the poor prognosis. At necropsy, gross and histologic findings included peritoneal effusion and a full-thickness rectal tear with transmural necrotizing pyogranulomatous colitis and fibrinous peritonitis. To the authors' knowledge, this is the first reported case of Oil Red O-positive lipid vacuoles in the peritoneal fluid of a horse from presumed leakage of mineral oil through a transmural rectal perforation. The frequency of this occurrence in horses is unknown, but it is important for cytopathologists to be familiar with the appearance and significance of lipid-type droplets in phagocytic cells in cytologic fluid analysis specimens.

Rectal duplication cyst in a cat.

Enteric duplication is a rare developmental malformation in people, dogs and cats. The purpose of the present report is to describe the first case of a rectal duplication cyst in a 7-year-old domestic shorthair cat presenting for acute constipation and tenesmus. On rectal palpation a spherical mass compressing the lumen of the rectum could be felt in the dorsal wall of the rectum. A computed tomography (CT) scan confirmed the presence of a well demarcated cystic lesion in the pelvic canal, dorsal to the rectum. The cyst was surgically removed via a perineal approach. No communication with the rectal lumen could be demonstrated. Histopathological examination was consistent with a rectal duplication cyst. Clinical signs resolved completely after excision of this conjoined non-communicating cystic rectal duplicate.

Balloon dilation and intralesional steroid for benign rectal stricture management in a cat.

A 4-year-old castrated male domestic shorthair presented for 1 week of constipation and tenesmus. A rectal stricture had been diagnosed 8 months prior at the time of adoption and the cat had been successfully managed with stool softeners until presentation. A complete diagnostic work-up failed to reveal an underlying etiology for the stricture and colonoscopy was performed. Endoscopic biopsies of the stricture revealed benign non-specific inflammatory changes. Balloon dilation of the rectal stricture was performed during the initial colonoscopy and 3 and 9 days later. Triamcinolone acetonide was injected into the stricture site with endoscopic guidance during the third dilation procedure. The patient has been monitored for over 27 months; follow-up indicates no signs of tenesmus and repeated rectal examinations reveal no stricture recurrence. This case report demonstrates that endoscopic balloon dilation with intralesional steroid injection represented a minimally invasive and effective option for the treatment of a benign rectal stricture in this cat, and deserves further prospective investigation.

Rectocutaneous fistulas.

This article reviews the etiology, diagnosis, and treatment of rectal perforation and rectocutaneous fistula in small animals. In addition, the literature regarding use of enterostomy in small animals is reviewed and comparative aspects of this procedure in humans and horses are presented. A case report of rectal perforation leading to rectocutaneous fistula formation and the use of colostomy in the management of the case is presented.

Acute gaseous peritonitis after rupture of a retroperitoneal rectal diverticulum in a dog.

An 11-year-old, entire male coton de tulear was presented on emergency with acute and severe depression, acute abdominal pain and vomiting of 24 hours duration. Historical complaints included right perineal swelling, dyschezia and tenesmus of 18 months duration. Abdominal ultrasonography and radiography suggested a pneumoperitoneum and positive-contrast colonography showed leakage of contrast medium into the caudal abdomen and the presence of a large retroperitoneal pouch. Exploratory laparotomy allowed the visualisation of faecal leakage from the retroperitoneal space into the peritoneal cavity. Using a perineal approach, a large necrotised rectal diverticulum filled with faeces was found over the retroperitoneal structures. A standard herniorrhaphy was then performed. The dog recovered uneventfully and dyschezia did not recur at the nine month follow-up. Rectal diverticulum rupture associated with peritonitis has not been described in the veterinary literature, to the authors' knowledge, and should be considered as a rare differential diagnosis in dogs being presented with gaseous peritonitis.

Congenital cystic polypoid rectal hamartoma in a newborn foal.

A neonatal foal with signs of rectal bleeding was diagnosed with an intraluminal rectal mass and intussusception on surgical exploration of the abdomen. Histologically, the mass consisted of cystic spaces lined by simple columnar epithelium with numerous goblet cells and was surrounded by thin bands of smooth muscle in a myxomatous stroma. Although the mass shared similarities with retrorectal cystic hamartoma (tailgut cyst) and juvenile polyps, described in human medicine, location and histologic findings were not entirely consistent with either condition.

Use of the carbon dioxide laser for perianal and rectal surgery.

The skin of the perianal region is very thin and sensitive. The carbon dioxide laser is a very effective tool for removing tumors and treating conditions of this area. It offers a "no touch" method of treatment for conditions of the perianal region. There is less bleeding, less pain, less swelling with the use of the carbon dioxide laser. The carbon dioxide laser is an effective tool for excising perianal tumors, rectal tumors, performing anal sacculectomies and treating perianal fistulas.

Use of colostomy to manage rectal disease in dogs.

OBJECTIVE: The purpose of this study was to develop a diverting colostomy technique for use in dogs. STUDY DESIGN: Clinical case series. ANIMALS: Five client-owned dogs presented for diseases requiring diverting colostomy during treatment. METHODS: Diverting colostomy was performed in five dogs. A ventral approach was used in the first dog and the colon was exteriorized adjacent to the linea alba. The technique used in the next four dogs involved creation of a left flank rod-supported loop colostomy in which the colon was exteriorized through a muscle-separating flank approach to the abdomen. RESULTS: Peritoneal leakage of fecal material resulted in the perioperative death of the first dog. The flank colostomies were maintained for times ranging form 3.5 weeks to 7 months. No major complications were observed, but skin excoriation occurred occasionally around the stoma sites in all dogs. CONCLUSION: Diverting colostomy is a technique that is suitable for use in treatment of dogs with obstruction or leakage involving the distal colon or rectum.

Anorectal lymphadenopathy causing colic, perirectal abscesses, or both in five young horses.

Enlarged anorectal lymph nodes can cause colic in young horses by obstructing the caudal aspect of the rectum. Dyschezia and clinical signs consistent with abdominal pain were the predominant reasons for evaluation of the 5 young (3 to 15 month old) horses of this report. Digital transrectal palpation revealed a firm mass obstructing the caudal aspect of the rectum in each horse. Results of cytologic evaluation of the masses revealed a lymphoid population of cells in 4 of 5 horses. These nodes regressed over time or became abscesses and drained into the rectum. In 1 horse, detection of a mature abscess and concomitant dysuria necessitated immediate surgical drainage of the mass; however, the other 4 horses were successfully managed medically, thereby avoiding risks associated with surgery of the perirectal area. Anorectal lymphadenopathy should be considered as a differential diagnosis in young horses with colic.

Rectal hemorrhage associated with vascular ectasia in a young dog.

Rectal bleeding in a 7-month-old 13-kg sexually intact female mixed-breed dog was determined to be associated with vascular ectasia of the small intestine, descending colon, rectum, and anus. Microscopically, the telangiectasia was associated with lymphangiectasia and focal ulceration. Surgical intervention resulted in incomplete resection of the lesion and only temporary amelioration of clinical signs. The dog's age was compatible with a congenital origin for the defect, but an acquired cause could not be excluded.

Standing rectal and tail surgery.

A variety of rectal, perirectal, and coccygeal surgeries can be performed in the standing equine patient if appropriate chemical and physical restraints are available and adequate regional anesthesia can be achieved. Some rectal tears and most rectal prolapses, mass lesions, perirectal abscesses, rectal biopsies, and selected injuries of the tail can be managed without prohibitive difficulty. Severe injuries that compromise the small colon cranial to the peritoneal reflection may require flank laparotomy, midline celiotomy, or humane euthanasia to manage the disease process effectively and appropriately. The foremost perioperative consideration beyond the use of effective restraint is the management of tenesmus in horses with rectal tears or prolapses. Medications to control bowel motility, epidural anesthesia, antiinflammatory analgesics, and topical compounds adequate to soothe and lubricate inflamed rectal tissues are an important adjunctive therapy in the aftercare of these surgical patients. Of nearly equal importance is the requirement that a loose fecal consistency be maintained with laxative diets, psyllium, and mineral oil. Failure to maintain a loose consistency of stool after treatment of these conditions may lead to rectal impaction or incisional dehiscence and surgical failure.

An immunofluorescence test to determine the occurrence of type II collagen in muscle biopsies from cattle with rectovaginal constriction.

Type II collagen occurs in the muscles of rectovaginal constriction (RVC) affected and carrier cattle but not in normal cattle. Muscle biopsies from known RVC affected and carrier cattle and normal cattle were examined for the presence of Type II collagen using affinity purified goat anti-collagen II serum in a fluorescent antibody test. Type II collagen was consistently found in RVC affected animals (22 of 23 samples score positive). Rectovaginal constriction carrier animals had variable staining for the Type II collagen (25 of 47 samples scored positive). Some positive staining was also observed in the control animals (8 of 34 samples scored positive). Because of the variable occurrence of Type II collagen, the value of fluorescent antibody staining to identify RVC carrier animals is uncertain.