Rectoanal diseases

What are the primary clinical signs of Rectal Polyps in dogs?

Hematochezia (fresh blood in stool) and tenesmus (straining to defecate).

What are the main differential diagnoses for Rectal Polyps?

Rectal adenocarcinoma, lymphoma, and anal sacculitis.

How are Rectal Polyps diagnosed, treated, and what is the prognosis?

• Diagnosis: Rectal palpation and colonoscopy

• Treatment: Surgical resection

• Prognosis: Usually good

How does Rectal Adenocarcinoma differ from Rectal Polyps regarding diagnosis, treatment, and prognosis?

Rectal Adenocarcinoma presents with clinical signs similar to polyps, but diagnosis requires a biopsy. Treatment is primarily palliative, and the prognosis is poor to grave.

What is the underlying cause and predisposed signalment for Anal Sacculitis?

Duct blockage followed by opportunistic bacterial infection of the anal sacs. Small breeds (e.g., Chihuahuas, Miniature Poodles) are predisposed.

What are the most common bacterial isolates in Anal Sacculitis?

Escherichia coli, Streptococcus faecalis, Clostridium spp., and Proteus.

What are the clinical signs of mild versus severe Anal Sacculitis?

• Mild/General: Scooting, licking/biting the perianal area, hematochezia, and dyschezia/constipation.

• Severe: Pyrexia, obvious pain, visible swelling, and draining tracts.

What is the treatment regimen for Anal Sacculitis based on disease severity?

• Mild/Impaction: Manual expression of anal glands.

• Active Sacculitis: Cannulation, saline or 0.5% chlorhexidine flushing, and topical +/- systemic antibiotics.

• Non-draining Abscess: Lance, flush, apply warm compresses, and perform daily lavage.

• Recurrent/Chronic: Anal sacculectomy.

What signalment and classic paraneoplastic syndrome are associated with Anal Sac Adenocarcinoma?

Older female dogs; the classic paraneoplastic effect is hypercalcemia.

What are the metastatic behavior, treatment, and prognosis for Anal Sac Adenocarcinoma?

• Characteristics: Palpable mass with high rate of metastasis to regional (sublumbar) lymph nodes and lumbar vertebrae.

• Treatment: Surgical removal.

• Prognosis: Guarded.

What cell type does Perianal Adenoma arise from, and what is the predisposed signalment?

Arises from hepatoid cells in the circumanal glands; seen most commonly in intact older male dogs.

Is Perianal Adenoma invasive or metastatic, and how is it treated?

It is non-invasive and non-metastatic. Treatment consists of surgical removal, cryosurgery, or radiation therapy combined with castration. Prognosis is excellent (except for non-resectable cases).

What type of disorder is Perianal Fistula (Anal Furunculosis), and which breed is strongly predisposed?

It is a chronic, progressive, immune-mediated dermatologic condition strongly predisposed in German Shepherd Dogs.

What are the key clinical signs and physical findings of Perianal Fistula?

Single or multiple ulcerated sinus tracts around the anus, malodorous mucopurulent discharge, severe pain, dyschezia, reduced anal tone, rectal stricture, fecal incontinence, and concurrent diarrhea/colitis.

How should physical and rectal examinations be performed for suspected Perianal Fistula, and what should be evaluated?

Examination should be performed under sedation to assess tissue extent, evaluate anal sacs, and check for rectal strictures and reduced anal tone.

What are the main differential diagnoses for Perianal Fistula?

Ruptured anal sac abscess, perianal adenocarcinoma, and trauma.

What are the medical options and supportive measures for managing Perianal Fistula?

• Immunosuppression: Cyclosporine, Prednisolone, Azathioprine, or topical Tacrolimus.

• Supportive Care: Daily perianal cleaning, analgesics, stool softeners, and a novel or hydrolyzed protein diet.

What is the prognosis for Perianal Fistula, and what major complication can prompt euthanasia?

Prognosis is overall guarded because recurrence is common (managed rather than cured). Severe fecal incontinence can lead to euthanasia.