Rectal Prolapse in Cats: Symptoms and Treatment

Rectal prolapse in cats occurs when some or all of the rectal tissue protrudes through the anus. An incomplete prolapse may appear only while a cat is straining, while a complete prolapse remains exposed and requires immediate veterinary attention.

Rectal prolapse is a serious condition that should be treated by a veterinarian to prevent tissue damage and other complications.

What Is Rectal Prolapse in Cats?

Rectal prolapse in cats occurs when some or all of the rectal tissue protrudes through the anus. The exposed rectal tissue is usually dark pink or dark red.

The rectum is the part of the intestinal tract that connects the large intestine to the anus. There are two main types of rectal prolapse: incomplete and complete.

Incomplete Rectal Prolapse

With an incomplete rectal prolapse, the rectal tissue protrudes when your cat is straining to pee or poop, usually without producing much.

After your cat is done straining, the rectal tissue returns to its normal position and is no longer visible. However, this is a serious condition because it can get worse and should be treated.

Complete Rectal Prolapse

With a complete rectal prolapse, all layers of the rectum protrude through the anal opening. The prolapse looks like a tube, with the inner lining of the rectum visible on the outside (everted).

A complete rectal prolapse requires immediate veterinary attention.

What Are the Symptoms of Rectal Prolapse in Cats?

Symptoms of rectal prolapse in cats can include visible rectal tissue, significant discomfort, reduced movement, licking at the rectum, and continued posturing and straining to poop, pee, or give birth, depending on the cause of the prolapse.

What Does Rectal Prolapse Look Like in Cats?

The color of the exposed rectum is important. A recently prolapsed rectum will be dark pink but will quickly turn dark red as swelling and exposure progress.

If the rectal prolapse is not treated quickly, the rectum may turn very dark red to black. Darker colors may be a sign of tissue death (necrosis). This is very serious and may result in long-term complications.

The wall of the prolapsed rectum may also break (ulcerate) and swell.

Causes of Rectal Prolapse in Cats

Rectal prolapse in cats can be caused by medical conditions that make a cat strain too hard while peeing or pooping. Straining weakens the tissue that supports the rectum.

Conditions that can cause rectal prolapse in cats include:

• Intestinal parasites
• Diarrhea
• Constipation
• Obstruction of the colon or rectum because of a foreign object
• Rectal or vaginal mass
• Urinary obstruction
• Giving birth

In kittens, diarrhea due to intestinal parasites is the most common cause of rectal prolapse.

Certain cats, such as Manx cats or cats that have had tail amputations, may be more prone to rectal prolapse if the nerves to their rectum and anus were affected.

How Is Rectal Prolapse in Cats Diagnosed?

Rectal prolapse in cats is diagnosed with a physical examination. By the time most cases are seen by a veterinarian, the prolapse is often complete, meaning the rectum is constantly exposed rather than only visible when a cat is pooping.

A completely prolapsed rectum looks like a long, tubular mass protruding from the anus. Rectal masses may sometimes look like rectal prolapses.

If you see any type of tissue protruding from your cat's anal opening, see your veterinarian right away.

Diagnosing the Underlying Cause

Once rectal prolapse is diagnosed, your veterinarian will try to determine whether there is an underlying cause. Treating the underlying cause can sometimes resolve the condition.

Underlying causes may include intestinal parasites, rectal masses, stenosis of the rectum (narrowing), or an enlarged prostate. These conditions can cause a cat to strain while pooping, which can lead to rectal prolapse.

A stool sample should be checked to rule out intestinal parasites. Blood work and X-rays of the abdomen may also be recommended if the underlying cause of the prolapse is not obvious based on the physical examination alone.

How Is Rectal Prolapse in Cats Treated?

Treatment for rectal prolapse in cats depends on the condition of the rectal tissue. A simple rectal prolapse may be manually reduced, while damaged or necrotic tissue may require surgery to remove part of the rectum. The underlying cause of the prolapse must also be treated.

Simple Rectal Prolapse

Treatment of a simple rectal prolapse usually requires your cat to be anesthetized. Reducing a prolapsed rectum can be painful, and a cat with a prolapse will already be in pain and distress.

After your cat is safely sleeping, the rectal tissue will be carefully and thoroughly cleaned. If there is swelling, your veterinarian may use medications or hypertonic saline (a special type of saline solution with a higher salt concentration than regular saline solution) to help decrease the swelling.

A rectal exam should also be performed to rule out a rectal mass or other abnormality.

If the rectal tissue is still healthy, your veterinarian can usually manually reduce the prolapse after thoroughly flushing the rectum with sterile saline. Once clean, the rectum will be lubricated and gently replaced inside the pelvic cavity.

Once the prolapse is reduced, a technique known as a purse-string suture is used to make the anal opening smaller so the rectum cannot prolapse again while your cat heals.

Rectal Prolapse Surgery

If the rectum has been prolapsed long enough for the tissue to become necrotic (black and dying), the dying portion of the rectum must be surgically removed. Healthy rectal tissue is then surgically reattached to healthy tissue.

Depending on how much of the rectum must be removed, surgery can result in fecal incontinence (inability to control bowel movements) or other elimination issues. These may be temporary or long-term.

Colopexy

If a cat has a history of repeat rectal prolapses, or if surgery is required to remove dead tissue, a procedure called a colopexy may be performed.

During a colopexy, the rectum is attached to the abdominal wall using an internal suture (stitch). This is an extensive abdominal surgery, but it can help prevent repeat prolapse events.

Treating the Underlying Cause

To help avoid recurrence of rectal prolapse, the underlying cause must also be treated. Treatment will depend on the cause.

If the prolapse is due to birthing kittens, your cat must be spayed so it won't happen again.

Intestinal parasites can be treated by deworming, while a urinary stone or obstruction will require its own treatment.

Recovery and Management of Rectal Prolapse in Cats

If your cat has diarrhea during the healing period, contact your veterinarian right away. Your cat will likely need additional treatment because diarrhea increases the risk of another rectal prolapse.

After surgery, most cats will be prescribed pain medication, stool softeners, and possibly antibiotics. Medications depend on the health of the rectal tissue at the time of surgery.

Epidurals are sometimes used to eliminate the urge to strain when your cat goes to the bathroom and as a form of pain control.

Cats that receive an epidural and/or have surgical repair of their rectal prolapse may require hospitalization for one to three days, depending on how they are doing. If your cat receives a purse-string suture, they may be sent home the day of the procedure.

The period of rest after rectal prolapse repair depends on whether a purse-string suture was performed or part of the rectum had to be surgically removed. The more serious the repair, the longer and stricter the rest period will be.

Recovery After a Simple Rectal Prolapse

Recovery from a simple rectal prolapse, where the rectal tissue was healthy and could be reduced without complication, requires the purse-string suture to remain in place for five to seven days while your cat heals.

During recovery, your cat must wear an E-collar to prevent licking, which can cause the suture to fall out early and increase the risk of infection.

Soft foods and stool softeners will be prescribed to reduce pressure on the purse-string suture while your cat poops. After your cat has healed, the purse-string suture should be removed by a veterinarian, who will clear your cat for regular food.

Recovery After Rectal Prolapse Surgery

Recovery after a prolapse repair that requires surgical removal of part of the rectum will take longer. After surgery, most cats will need to wear an E-collar and be on soft food and stool softeners for 10–14 days or longer.

Potential complications of prolapse repair include recurrence of the prolapse, fecal incontinence, and infection.

Recurrence of Rectal Prolapse

If your cat experiences another rectal prolapse, it will look very similar to the first occurrence, with rectal tissue protruding from the anus.

If the tissue is infected, it will be red and swollen, and you may see discharge around your cat's anus.

Fecal incontinence, or the inability to control pooping, is uncommon but possible if part of the rectum had to be surgically removed.