Anal and rectal bleeding refers to blood from the anus, the rectum or is on the inside or outside of the feces.
There are a number of causes including constipation, polyps, cancer, inflammation and internal bleeding.
Diagnosis is based on accompanying symptoms as well as diagnostic tests including colonoscopy, medical imaging, routine blood and fecal studies.
Treatment depends on the underlying cause but may include surgery, stool softeners, anti-worming medications, antibiotics and dietary changes.
Anal and rectal bleeding refers to blood which may be noticed on or around the anus, the opening at the end of the cat’s digestive tract, its function is to pass feces out of the body, or the rectum (which is the final section of the large intestine) inside your cat.
You may notice bright red blood on the anus, especially after a bowel movement, but more commonly blood is seen on or in the feces.
What are the causes of anal bleeding?
Blood can originate internally, from the stomach and intestines (colon, rectum, anal canal) or externally, from the anus or the anal glands.
The anal glands are located at the 5 and 7 o’clock position on the cat’s anus. They contain a thick, foul-smelling substance which is released from the glands when the cat defecates. From time to time, the substance within the glands can become thick, causing impaction and inflammation. Eventually, the glands will abscess and possibly rupture.
Symptoms include pain when defecating and the presence of blood in the feces or around the anus and an unpleasant smell.
From time to time, your cat may experience difficulty emptying his bowels. When this occurs, the feces can become dry and hardened. If they are passed, small tears can occur in the rectum, resulting in bleeding.
Symptoms include crying in the litter tray, passing small amounts of feces, or straining to defecate.
These types of polyps are uncommon in cats. They are caused by benign (noncancerous) nodular growths in the rectum or anus.
Symptoms may include straining to defecate, blood in the stool and occasionally you may see a polyp protruding from the anus.
Hookworms live in the small intestines of cats, they attach to the wall of the intestine, which causes the area to bleed. Symptoms of hookworms may include bloody stools which are often running, pale gums (due to anemia), and stunted growth in kittens.
Cancers can occur anywhere along the intestinal tract and rectum can lead to bleeding. There are several types of cancer which can form depending on the originating cell. These include mast cell cancer, lymphoma, adenocarcinoma, neoplasms.
Common symptoms include weight loss, vomiting, bloody diarrhea, anorexia, lethargy and abdominal mass.
Inflammation of the lining of the colon (large intestine) which have a number of causes including infection, stress, dietary, parasites or cancer.
Symptoms of colitis include diarrhea, which may contain blood, frequent passage of watery stools, reduced appetite.
Swelling around the anus (impacted anal glands or anal gland abscess).
Mucus in the stool (inflammation or infection).
Diarrhea (due to infection, inflammation or hookworms)
Blood in the urine (due to low blood platelets).
Pale gums due to anemia (hookworm infection)
Red spots on the gums (due to low blood platelets).
Diagnosing the cause:
Your veterinarian will perform a complete physical examination of your cat and obtain a medical history from you. Depending on presenting symptoms, he will want to run some diagnostic tests to determine a cause. Tests may include:
Complete blood count, biochemical profile, and urinalysis to evaluate organ function, check for signs of inflammation. Low blood platelets will be found in cats with thrombocytopenia. Anemia may be present in cats who have severe hookworm infection.
X-Ray or ultrasound to look at the GI tract for tumours or polyps.
Colonoscopy which involves insertion of a fine tube with a camera at the end to evaluate the colon for signs of inflammation, polyps, and/or cancer. Biopsies may be taken at this time which will be evaluated.
Blood clotting tests for hemophilia such as coagulation assays.
Bone marrow biopsy to determine the cause of low blood platelets.
Treatment of anal bleeding in cats:
Treatment depends on the underlying cause and may include:
Impacted anal glands will be emptied and packed with antibiotic ointment. Your cat may need to go on a course of antibiotics. Surgical removal of the anal glands will be recommended if this is a problem which returns.
Constipation is treated by putting your cat on a high fibre diet or adding fibre to his diet and encouraging water consumption. Stool softeners may also be given.
Rectoanal polyps will be surgically removed. Polyps may return at a later date.
Cancer: Surgery to remove the growth if possible, chemotherapy or radiotherapy may also be necessary.
Intestinal parasites such as hookworm are treated with a worming medication.
Inflammatory bowel disease and colitis are managed with a highly digestible diet, corticosteroids and on occasion antibiotics.
Salmonella and E-coli treated with antibiotics.
Blood clotting disorders: Find and treat the underlying cause if possible. Whole blood or plasma transfusions may be necessary to maintain normal blood cell counts and administration of vitamin K.
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