Colopexy in Cats

Colopexy is a surgical treatment used in cats to treat rectal prolapse. It is indicated when rectal prolapse is viable but not digitally reducible or if there is a history of repeated prolapse. The goal of colopexy is to treat rectal prolapse and prevent future occurrences of rectal prolapse. Rectal prolapse is a common problem in cats, however, cases that require surgery are more rare. Surgery is often provided after medical management options have been exhausted.  Your veterinarian will assess your cat and determine if surgery is needed to treat rectal prolapse. If so, your vet may refer to a boarded veterinary surgeon to perform the surgery. 

Before surgery, the veterinarian will give your cat a thorough physical exam and ensure that your cat is healthy enough for surgery with basic bloodwork. As with most surgery, you cat will need to be kept off food for 24 hours the day before surgery to ensure that there is not an adverse reaction to the anesthetic medications used. The steps of the surgical procedure are detailed below.

1. Midline incision made
2. The descending colon is gently pulled to reverse the rectal prolapse
3. The colon is tacked to the left abdominal wall (colopexy)  by cutting the outer layer of the colon and sewing it to the peritoneum 
4. Colopexy is done in 3-4 sites along the colon
5. If the prolapsed tissue has died (is devitalized) the the devitalized tissue is removed and the remaining rectal tissue sewn together (resection and anastomosis)

Colopexy typically is very successful in managing rectal prolapse, however, it should be used after medical options have been exhausted to ensure that your cat is not subjected unnecessarily to an invasive and more expensive procedure. Medical treatment of rectal prolapse includes treating the underlying cause (i.e. treating the parasite infection for kittens), manually reducing the prolapse, and using a purse string suture to hold the prolapse in place while inflammation of the associated tissues is being treated. 

Your cat will likely be placed on pain medication and antibiotics for the first few days after surgery to reduce pain and swelling associated with surgery and prevent infection associated with a “dirty” surgery. Your cat will need to stay still for the first 10 days after surgery while the stitches are healing, and the skin incision site will need to be checked daily for signs of infection (swelling, redness, discharge). Your vet will remove the sutures and check the incision after 10 days. Once your cat is fully recovered from surgery there should be no further maintenance needed. 

Colopexy can cost between $800 and $1,800 depending on the severity of your cat’s case and the cost of living in your region. 

Since colopexy is a surgery, there are significant risks associated with it, most notably infection, bleeding, and suture failure (dehiscence). Colopexy should only be used after other treatment options have been exhausted.

Preventing colopexy involves prevention of the causes of rectal prolapse. To prevent rectal prolapse in kittens, it is important to deworm kittens to prevent them from developing intestinal parasites. Deworming kittens also has a positive effect for the humans in the family by reducing their exposure to feline endoparasites which can cause illness in humans. 

For older female cats, rectal prolapse is associated with difficult births (dystocia). To prevent this, the best solution is to always spay your female cats. There are numerous health benefits to spaying your cat--namely the prevention of mammary tumors. If your cat is being used for breeding and therefore cannot be spayed, it is important to understand when your cat becomes pregnant and to get proper veterinary care when she does get pregnant. Proper veterinary care throughout the course of your cat’s pregnancy can alert your veterinarian to potential problems before your cat gives birth. 

For older male cats, it is important to avoid urethral obstruction. Keeping your male cat well hydrated and on a special diet to prevent stones can prevent urethral obstruction. Unfortunately, some urethral obstruction is due to spasming of the urethra. In those cases, it is important to take your cat to the vet immediately if you see signs of straining to urinate as this can be alleviated medically before symptoms become severe. 

If rectal prolapse does occur then acting quickly to have your cat seen by a veterinarian increases the chance of the prolapsed tissue remaining healthy so that medical management can occur.