Wednesday, March 13, 2013

1318. Update: Rectum falls out in the red-eared slider


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Date:   14 March, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
Rectal prolapse in terrapins and people
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   14 March, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2013-0131

Blog 1278. Rectal prolapse in terrapins and people 

Recently an 82-year-old man, sound in mind and in good health brought in a terrapin with black and smelly prolapsed rectum. "No hope of repairing as the tissues are rotten and stinking," I usually push back the rectal tissues and suture up the anus for 7-14 days. If the purse-string suture is done early (within 1-2 days of rectal prolapse as for the 2011 case, image, left), the outcome is excellent. I had written that case study some years ago and the images of this 2011 case are shown below.

As for this terrapin with the gangrenous rectum, euthanasia was done.
 
"Holding in the rectum"  - rectal prolapse where the rectum falls out of the anus. New surgical technique is providing relief. - Ventral Mesh Rectopexy. A mesh (plastic or biodegradaable material) is sutured to the pelvic floor muscles on both sides of the rectum. The top end is sutured to the spine to lift up the rectum. In women, the mesh is sutured to the top of the vaginal to prevent vaginal prolapse. At Singapore General Hospital, the fees range from $5,000 - $25,000. Recurrences are said to be low for this type of procedure as compared to other surgeries. Therapy to retrain the pelvic floor muscles in human will not apply to animals!

REFERENCE:  The Straits Times Jan 17, 2013 pg 12-14 "Mind Your Body" has details of various surgeries in people. Reading what the human surgeons do and the latest advances in surgery may be of some use to veterinary surgeons as some techniques can apply to veterinary surgery.

More Singaporeans are kinder towards terrapins, rabbits and hamsters in 2012 and 2013 unlike 10 years ago. The younger generation loves their companion animals much more than the baby boomer generation. There are 51 veterinary practices as at Feb 9, 2013. There were around 5 when I started practice in 1982!

It is good for the pets and the pet lovers and vets should have more time to devote to the practice of veterinary medicine nowadays instead of rushing 40 cases per vet per day as in some busy practices. Successful diagnosis needs time to build up the case scientifically and to reflect and follow up. This can't be done if the vet has to attend to 40 cases per day as in hospitals.

Updates will be on this webpage:
http://www.bekindtopets.com/animals/20130209terrapin_rectal_prolapse_toapayohvets.htm
 
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Clinical Research
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All rights reserved. Revised: March 14, 2013

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