Kamalakar et al. 2015/J. Livestock Sci.

6: 80-84

Congenital atresia ani associated with recto-vaginal

fistula in Ongole calf

G. Kamalakar1*, J. Devaratnam1, R. Brahmaji2 and B. Jyothsna3

1
College of Veterinary Science, Sri Venkateswara Veterinary University, Proddatur-516360 (A.P.), 2Veterinary
Dispensary, Kuchinapdi-522256 (A.P.), 3Veterinary Dispensary, Bhattiprolu—22256 (A.P.) India
*
Corresponding author; E-mail: drkamal_vet@yahoo.co.in; drkamal1vet@gmail.com
Ph. +91.9866158600

Journal of Livestock Science (ISSN online 2277-6214) 6:80-84

Received on 03/07/2015; Accepted on 21/07/2015

Abstract

A female cow calf aged about 5 months was presented with congenital atresia ani and

recto vaginal fistula along with the signs of cystitis. Under epidural anaesthesia, the anal orifice

was reconstructed and the fistulous tract was closed successfully. The animal had uneventful

recovery.

Key words: Ongole; calf; atresia-ani; recto-vaginal fistula

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Introduction
Congenital abnormalities of gastro intestinal tract in animals are not uncommon with an incidence of about
4.3% (Leipold et al., 1972). Atresia ani is one such developmental anomaly due to autosomal recessive gene
(Bademkiran et al., 2009) characterized by absence of anus and may be associated with recto-vaginal fistula, recto-
cystic fistula, vagino urethral agenesis, taillessness, hypospadias (Singh et al., 1993) and diphallus (Loynachan et al.,
2006). Recto – vaginal fistula or anus vaginalis is an inherited lethal abnormality in which, there is an abnormal
passage between rectum and vagina, and faeces are voided through the latter due to imperforate anus (Oehme and
Prier, 1974). Atresia ani associated with recto-vaginal fistula was reported in many species, viz. calves (Shakoor et
al., 2012, Mahesh et al., 2014), lambs (Kamalakar et al., 2014), dogs (Rahal et al., 2007), Pigs (Monsanget al., 2014)
etc. This condition needs early correction to avoid infections of urogenital system like pneumovagina, cystitis,
vaginitis, cervicitis, endometritis, etc. (Farhoodi et al., 1987). In the present case, congenital atresia ani associated
with recto – vaginal fistula in an Ongole calf and its successful surgical management is reported.

Case history and clinical examination

A 5 month old Ongole cow calf was presented to the Department of Veterinary Surgery and Radiology,
College of Veterinary Science, Sri Venkateswara Veterinary University, Proddatur (A.P.) with a history of absence
of anal opening and abnormal defecation through vagina (Fig 1) since birth. As the condition progressed, the calf
showed symptoms of colic, tenesmus and turbidity in urine.

Fig 1. Atresia ani and recto-vaginal fistula in Ongole Calf with passage of dung through urogenital route

On clinical examination, the calf appeared dull, with arched back showing symptoms of oliguria and dysuria
indicative of cystitis. Exploration through vagina revealed presence of abnormal opening between rectum and
vagina. On applying pressure on abdomen bulging was noticed at the sub ischial region. Based on these observations
the condition was diagnosed as congenital atresia ani associated with recto – vaginal fistula and reconstructive
surgery was opted to correct the condition.

Treatment
Pre operatively, the owner was advised to give laxatives to the animal for 2 days and to keep the animal
under fasting for 8 hrs prior to Surgery. Fluid therapy was initiated with 500 ml DNS and pre emptive analgesia was

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achieved by Ketoprofen @ 3mg/ kg BW. The rectum and vagina were evacuated and area was prepared aseptically.
The surgery was carried out under caudal epidural block using 2% lignocaine hydrochloride and the animal was
controlled in right lateral recumbency. A circular incision was made on the skin at the bulging area at the sub ischial
region and the rectal cul de sac was identified by exploration (Fig 2). The rectum was opened and the contents were
cleared. The fistulous orifice, which was about 4cm in diameter and 2” away from anus, was reached through anal
route and was closed in simple interrupted patternwith chromic catgut no.1. The area was irrigated with Normal
Saline and rectal mucosa was sutured to the skin in simple interrupted pattern usingblack braided silk. A sterile 20ml
syringe barrel was cut at non winged end and two holes were made at the centre of each wing. The non winged end
was lubricated with liquid paraffin and inserted into rectum to maintain patency. The wings of barrel were secured to
the perineal skin by passing nylon suture material from skin through hole in that side wing and tied to outside using
simple interrupted sutures (Fig 3).

Fig 2: Surgical procedure with finger guided rectal cul de sac identification.

Fig 3 showing placing of cut barrel of 20 ml syringe in rectum, whose wings were sutured to perineal skin.

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Post operatively 500 ml Ringer Lactate, 500mg ceftriaxone I/V, 3ml B complex and 3ml chlorpheniramine
maleate I/M were administered to the calf for next 4 days. The owner was advised to continue laxatives for one
week and offer 100g Raagi malt for a period of one month. Sutures, along with the cut barrel inserted in rectum were
removed on 10th post operative day and no complications were reported.

Discussion
Cattle embryos are more susceptible for chromosomal aberrations between 14 – 42 days age leading to
mutations (Bademkiran et al., 2009). Atresia ani is one of such congenital and hereditaryanomaly at embryonic
period resultant of autosomal recessive gene (Loynachan et al., 2006). Though other reasons like environmental
teratogens, plant toxins (Bademkiran, 2009) and viral infections (Loynachan et al., 2006) were stated as causative
factor of atresia ani in calves, in the present case the reason could not be ascertained and unspecific as reported by
Johnson et al. (1980). The increased faecal pressure causes an abnormal opening between rectal wall and vagina in
females forming recto-vaginal fistula and thus permitting defecation via vulva (Norrish and Rennie, 1968). Atresia
ani is frequently associated with recto-vaginal fistula between dorsal wall of vagina and ventral wall of terminal
rectum.Though this condition was persisting in calf since birth, ano rectal fistula was not formed, as the farmer was
clearing dung in the cul de sac of rectum regularly. The cystitic signs might be attributed to the ascending infection
from the faeces in vagina. This calf was suffering from type II atresia ani in which rectal cul de sac formed cranial to
imperforate anus (Kilic and Sarierler, 2004). Passing of dung through unnatural route was not apparently causing
much discomfort to the animal as was reported by Purohit et al., (2006) which may be due to larger fistulous orifice
which could accommodate 3 fingers against size of one finger as reported by Ali and Youssef (2007).
Epidural anaesthesia could achieve sufficient desensitization to complete Surgery as followed by Badawy
(2011). However, reports indicated use of ketamine + diazepam (Monsanget al., 2014), local infiltration of
lignocaine + adrenaline (Shakooret al., 2012), lignocaine only (Sutharet al., 2010). For correction of recto – vaginal
fistula, Fossel’s operation was also indicated (Venugopalan, 2009) which was not followed here because the
fistulous orifice was in reach. Surgical correction was in a manner similar to that of Shakoor et al. (2012). Fistulous
opening was closed in simple interrupted pattern with chromic catgut, but Rahal et al. (2007) reported use of plastic
adhesives. Closure of this orifice required including much of wall of rectum and vagina that led to mild stenosis of
both lumens, which may not pose serious implication as the calf grows older. Cut barrel of 20ml syringe placed
inside the rectum prevented soiling of sutures, reduced pressure on sutures at fistulous orifice and at anal sphincter
thus augmented healing. Continuation of laxatives post operatively for one week aided for free defecation that
avoided pressure on sutures of fistula. Offering Raagi malt which is rich in calcium and iron had improved the
general body condition of the calf that indirectly aided in rapid wound healing.
It could be concluded that reconstructive surgery is the only treatment for correcting atresia ani and recto-
vaginal fistula. Moreover breeding of such surgically treated animals should be discouraged.

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