Colonic Resection and Anastomosis in Dogs

A colonic resection followed by anastomosis is a surgical procedure in which a portion of the large bowel or colon is removed and the remaining ends are then connected. This surgery is used in emergency settings when a blockage or a severe perforation is present in the digestive tract. It also can be a scheduled operation to remove growths on the large bowel or colon.

The goal of this procedure is to resume regular function to the bowels. A dog cannot survive if its digestive tract is compromised. This surgery is complicated and should only be performed by an ACVS board-certified veterinary surgeon. Resections of the small bowel are more common, however, the overall surgery is very similar to removing sections of the colon. 

To determine if the dog is stable enough for general anesthesia, blood work will need to be run. This will assess the animal's overall health and its ability to clot. Ultrasounds of the large bowel and colon will be performed to locate the object, tumor, or damage that is compromising the digestive tract. The dog should be of proper weight at the time of the surgery, as underweight animals experience more complications with this specific operation.

To begin the surgery, either one large abdominal incision will be made, or multiple smaller incisions will be used for laparoscopy. The rectum will be thoroughly washed prior to the procedure. Once the abdomen is visualized, the surgeon will identify all deadened tissue by its black appearance. Purple tissue may be salvaged in some cases. The damaged or affected area will then be divided using clamps. It can then be removed from the body. The new ends should be cleaned before they are reconnected. Sutures or staples can be used to attach these pieces. The use of staples is gaining popularity due to their efficiency. The anterior wall should then be reinforced. To ensure that the anastomosis is completely closed, a 25 gauge needle can be used to test if any leaks are present. At this point, the abdominal incision can be closed.

Removing problematic portions of the bowel can be a very effective way to restore function to the digestive system. It is a permanent procedure, as sections of the colon are taken out of the body. Overall survival of the dog will depend on whether an underlying disease is present, or if other life-threatening injuries also exist. 

The dog should be closely monitored as it comes off of anesthesia. Once the dog can walk again, non-vigorous activity can be promoted as it may lessen the chance of a clot developing. It is not uncommon for a dog who has experienced a colon resection to go through a period of vomiting followed by abdominal distention. If this issue does not let up on its own, a nasogastric tube may need to be put in place to ease the problem. If that does not alleviate symptoms, the anastomosis may not have properly taken. The dog must generally wait 12 hours before eating and drinking may resume. If the dog has not begun to regularly eat by the fifth day after surgery, it may need TPN (Total Parenteral Nutrition). 

Pain medication will be prescribed after the procedure is done, lasting through the healing process. Intravenous fluids may need to be administered for some time after the operation. A dextrose supplement may also be given at this time. Upon discharge, the dog will be prescribed a course of antibiotics. An Elizabethan collar can be helpful in preventing the dog from licking or scratching at its wounds. 

The cost of a colonic resection and anastomosis will generally range from $1,000 up to $8,000. Using a specialist may lead to higher costs, but is also associated with more positive outcomes. Blood tests, diagnostic imaging, and medication prescriptions also contribute to the overall price. There are generally not any alternatives to a colonic resection and anastomosis that will save the animal. If other injuries are present, the vet bill may be significantly higher than with surgery alone.

Certain complications may arise with the use of general anesthesia. Risks are also increased if the animal suffers from heart problems. Peritonitis may develop in some dogs after having this procedure. In cases which a foreign body has been removed, the chance of the anastomosis leaking is greater. If the dog has been diagnosed with an aggressive form of cancer, the worth of the surgery should be weighed against the likelihood of survival and quality of life thereafter.

Steps can be taken to prevent a colonic resection and anastomosis from being needed. To prevent foreign objects being lodged inside your dog, do not let the dog play with toys unsupervised. If a toy breaks, take it from the dog and dispose of it. Do not let your dog chew on sticks or stones. To prevent your dog from sustaining severe injuries from trauma, keep it on a leash at all times when outdoors. It may be wise to stay away from busy roads or highways as well. 

Many cancers cannot be prevented, but certain things have been proven to speed up the progression of cancer. To minimize potential risks, feed your dog a high quality diet and provide it with exercise. Do not expose the dog to cigarette smoke or other known cancer-causing toxins. When getting a dog, always inquire about its family health history. This can help you know what issues you need to screen the dog for throughout its life.