Anal (or rectal) bleeding can be a big worry to the cat owner and naturally so. You may notice bright red blood on the anus, especially after a bowel movement, but more commonly it is seen on or in the feces.
There are a number of possible causes of rectal bleeding, including:
- Polyps
- Infection
Blood can originate internally, from the stomach and intestines (colon, rectum, anal canal) or externally, from the anus.
Impacted 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 impactation 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.
Constipation:
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.
Rectoanal polyps:
Thankfully anal polyps are fairly uncommon in cats. They are caused by benign (non cancerous) growths in the rectum.
Symptoms may include straining to defecate, blood in the stool and occasionally you may see a polyp protruding from the anus.
Hookworm infection:
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.
Inflammatory bowel disease:
This condition is due to the infiltration of inflammatory cells into the gastrointestinal tract, resulting in inflammation. The exact cause isn't understood.
The most common symptoms of IBD include chronic vomiting and diarrhea, sometimes with blood in it.
Cancer:
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 may include weight loss, vomiting, bloody diarrhea, anorexia, lethargy and abdominal mass.
Colitis:
Inflammation of the lining of the colon (large intestine) which may 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.
Infection:
Other infections which cause inflammation of the intestines, such as salmonella, cryptosporidium and e-coli.
Diagnosing the cause of anal bleeding in cats:
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 cause. Tests may include:
- Complete blood count, biochemical profile and urinalysis to evaluate organ function, check for signs of inflammation.
- X-Ray or ultrasound to look at the internal organs for signs of cancer.
- Colonscopy which involves insertion of a fine tube with a camera on the end to evaluate the colon for signs of inflammation, polyps and/or cancer. Biopsies may be taken at this time.
- Cancer is treated by surgical removal of the tumour and chemotherapy.
Treatment of anal bleeding:
Treatment depends on the underlying cause.
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 recommend 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. Stool softeners may also be given.
Rectoanal polyps will be surgically removed. Polyps may return at a later date.
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.
Infections such as salmonella and ecoli treated with antibiotics.
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