Nithida Boonwittaya 1, Wutti Bunjerdsuwan 1, Piyathip Choochalermporn 2
Background
Atresia ani is a rare congenital anomaly, particularly in male cats, involving improper development of the anal opening. This condition can be life-threatening without prompt surgical correction. A urethrorectal fistula, where the rectum abnormally connects to the urethra, is an exceptionally rare concurrent condition. This case report describes what is believed to be the first successful surgical correction of this combination in a male kitten.
Methods
A 2-month-old male British Shorthair kitten with no anal opening and faecal discharge from the penile urethra underwent diagnostic imaging, which confirmed type II atresia ani and a urethrorectal fistula. A staged surgical approach was employed. An initial anoplasty was performed under general anesthesia to establish a functional anus. Six months later, a fistulectomy was carried out via a perineal approach, also including castration through the same incision. Both procedures aimed to preserve the external anal sphincter and minimize surgical and anesthetic risks.
Results
The initial surgery resulted in restored defecation with temporary faecal impactions and mild incontinence, which resolved within a month. No urinary tract infections occurred. By six months postoperatively, despite regained continence, faecal discharge from the urethra persisted, prompting the second surgery. The fistulectomy successfully resolved the urethrorectal connection, confirmed by postoperative imaging. The kitten recovered uneventfully and exhibited normal urination and defecation. A one-year follow-up reported no complications or abnormalities.
Limitations
The authors noted challenges due to the patient’s small size and the limited surgical access associated with a perineal approach in young animals. The absence of preoperative CT for the second surgery, due to anesthetic risk concerns, limited detailed anatomical visualization. The staged approach, while beneficial for safety, delayed complete correction and could potentially increase infection risk.
Conclusions
This case demonstrates the feasibility and success of a staged surgical approach for correcting type II atresia ani with a urethrorectal fistula in a male kitten. The techniques used, particularly the perineal approach, preserved anatomical structures and achieved excellent long-term outcomes, offering a model for managing similar congenital anomalies in veterinary practice.
Preoperative photograph and radiographs: (a) preoperative view showing an anal dimple with the absence of an anal opening, with faecal discharge visible at the tip of the penile urethra; (b) plain radiograph showing a distended colon filled with faeces and gas, with the rectum terminating as a blind pouch cranial to the anal region; and (c) positive-contrast urethrogram revealing a diverticulum-shaped fistula connecting the urethra and rectum
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