Rectal Prolapse

A rectal prolapse is not a disease so much as a dramatic symptom: the rectum, the last stretch of the bowel, turns inside-out and pushes through the anus, appearing as a red, tube-shaped mass. It happens because something has made the cat strain long and hard — and it is that underlying cause, not the prolapse itself, that ultimately matters.

The usual culprits are severe diarrhoea, stubborn constipation, a heavy load of intestinal worms, inflammation of the colon, or straining to pass urine because of a blockage. Late pregnancy and the effort of giving birth can do it too. Kittens are over-represented, because a bad bout of worms or diarrhoea sets them straining while their pelvic tissues are still lax and easily everted.

Time matters. Healthy prolapsed tissue is moist and glistening and can often simply be cleaned, lubricated and eased back into place, then held with a temporary purse-string stitch that leaves just enough room for the cat to pass stool while everything settles. Left out for hours, though, the tissue dries, swells and can lose its blood supply, turning dark and dying — and then it has to be surgically removed instead. A prolapse that keeps coming back can be tacked down internally with a colopexy.

But replacing the tissue is only half the job. If the diarrhoea, constipation, parasites or urinary problem that caused the straining is not found and fixed, the cat will strain again and the prolapse will return. So the vet's real work is as much detective as surgeon: sorting out why the cat was straining in the first place. Caught early and with the cause treated, most cats recover well.