Exotis ISSN 2398-2985

Reptiles

Cloacal organ prolapse

Contributor(s): Sonya Miles, Livia Benato

Introduction

  • Cause: secondary to multiple underlying causes depending on what organ has been prolapsed. Common causes include intestinal parasites, uroliths, metabolic bone disease (MBD), egg binding, etc.
  • Signs: tissue protruding from the cloaca that has fallen out from their normal anatomical position.
  • Diagnosis: based on clinical examination. Sometimes if the tissue is engorged or severely damaged it can be difficult to ascertain what type tissue is exactly protruding. The diagnosis of the cause of the prolapse is generally made by further investigations, eg radiographic examination, fecal testing.
  • Treatment: dependent on the tissue protruding from the cloaca.
  • Prognosis: dependent on the tissue that has prolapsed. It also depends on the underlying cause, general health of the patient and the condition of the tissue that has been prolapsed, ie level of necrosis, etc.
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Pathogenesis

Etiology

  • Organs that prolapse are:
    • Hemipenis or penis.
    • Oviduct.
    • Bladder.
    • Colon.
  • There are multiple organs that can prolapse from the cloacal of a reptile, and many reasons why an organ can prolapse from that cloaca:
    • No true prolapse: normal behavior.
    • Parasites.
    • Dystocia.
    • Hypersexual activity/excessive libido.
    • Infection of hemipenis/penis.
    • Trauma during copulation/other cloacal trauma.
    • Cloacal infection.
    • Impaction/foreign body.
    • Constipation.
    • Enteritis.
    • Hypocalcemia (nutritional secondary hyperparathyroidism).
    • Urolithiasis.
    • Neurological dysfunction.
    • Neoplasia.
    • Respiratory disease or trauma.
  • Often these causes involve chronic environmental deficiencies. However, regardless of the underlying cause for the prolapse, it should, in all instances be investigated and addressed.
  • If the underlying cause is not addressed, then the prolapse will reoccur.
  • All prolapses should be treated as an emergency, this initial therapy including the removal of gross debris and the application of a hypertonic glucose solution to the tissue.

Predisposing factors

General

  • Any prolapse should be investigated thoroughly to find the underlying cause.
  • The prolapse should be replaced as soon as possible, if possible.
  • Supportive treatment should be started.

Specific

  • See 'Etiology' above.

Pathophysiology

  • Prolapses of different tissues caused by the specific problems mentioned above.

Epidemiology

  • 1.9% population (retrospective study on 56 reptiles).

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Hoffman E M, Garrett K & Doneley R J T (2017) Pneumocoelom causing cloacal prolapse in a perentie monitor (Varanus giganteus). Aust Vet Pract 47 (4), 117-120 VetMedResource.
  • Girolamo N D & Mans C (2016) Reptile soft tissue surgery. Vet Clin Exot Anim 19 (1), 97-131 PubMed.
  • Hedley J & Eatwell K (2014) Cloacal prolapses in reptiles: a retrospective study of 56 cases. J Small Anim Pract 55 (5), 265-268 PubMed.
  • Sykes J M (2010) Updates and practical approaches to reproductive disorders in reptiles. Vet Clin Exot Anim 13 (3), 349-373 PubMed.
  • Rivera S (2008) Health assessment of the reptilian reproductive tract. J Exotic Pet Med 17 (4), 259-266 VetMedResource.
  • Wellehan J F X & Gunkel C I (2004) Emergent diseases in reptiles. Semin Avian Exotic Pet Med 13 (3), 160-174 VetMedResource.

Other sources of information

  • Barten S L (2006) Penile Prolapse. In: Reptile Medicine and Surgery. 2nd edn. Ed: Mader D R. Saunders/Elsevier, USA. pp 863-864.
  • Bennett R A & Mader D R (2006) Cloacal Prolapse. In: Reptile Medicine and Surgery. 2nd edn. Ed: Mader D R. Saunders/Elsevier, USA. pp 751-755.


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