Page 2555 - Cote clinical veterinary advisor dogs and cats 4th

Tenesmus Testicular Size Abnormalities 1285

Tenesmus
VetBooks.ir Differential Diagnosis Characteristic Feature

Anal sac impaction/sacculitis/abscess Distention of perianal area laterally and ventrally if severely impacted; rectal palpation strongly
supportive
Perianal gland tumors Location and appearance are suggestive; histopathologic confirmation (or regression after castration
for adenoma)
Perineal hernia Intact males predisposed. Visible perianal swelling less common in cats. Surgical repair and castration
to decrease serum testosterone concentration.
Perianal fistula German shepherds predisposed. May be present externally and/or internally.
Colonic or rectal polyp Mucosal mass. Excision, histopathologic confirmation.
Rectal stricture Small, flattened, ribbonlike stools, ± diarrhea
Anal sac adenocarcinoma Always repalpate after draining anal sacs to rule out a mass/nodule. Fibrotic tissue may mimic a
mass; palpate dorsally for sublumbar lymphadenopathy. Ultrasound of perineal region/anal sacs
(experienced radiologist). Hypercalcemia in 25%-50% of cases in dogs.
Pseudocoprostasis Anal obstruction due to severe matting of fur with feces. Evaluate haircoat, animal’s environment (high
stress, number of pets in household), etc., for deterrent to normal defecation.
Large bowel diarrhea Mucoid feces, hematochezia, increased urgency
Genitourinary tract In general, genitourinary abnormalities other than those causing prostatomegaly produce disorders of
• Prostatic disorders urination rather than tenesmus. Careful history and examination for accurate diagnosis.
• Idiopathic cystitis (cats)
• UTI
• Urethritis Differentials, Lists,
• Vaginitis and Mnemonics
• Urethral or urinary calculi
• Neoplasia (TCC adenocarcinoma, leiomyo[sarco]ma, TVT)
Caudal abdominal cavity disorders Abdominal palpation, rectal palpation, abdominal radiographs and/or ultrasound
Mass (organ compression) Abdominal palpation, rectal palpation, abdominal radiographs and/or ultrasound
Pelvic fractures (misaligned healing of old pelvic fractures) Orthopedic examination, rectal palpation, pelvic radiographs
Pelvic neoplasia Rectal palpation, pelvic radiographs, biopsy with histopathologic diagnosis, rarely nuclear scintigraphy
Lumbosacral disease Painful posturing to urinate and/or defecate, pollakiuria, inconsistent urine stream, incomplete voiding
of bladder. Rectal palpation, neurologic exam, rule out UTI.

TCC, Transitional cell carcinoma; TVT, transmissible venereal tumor; UTI, urinary tract infection.
Modified from the third edition.
THIRD EDITION AUTHOR: Lisa Carioto, DVM, DVSc, DACVIM

Testicular Size Abnormalities

Large Testes Small Testes
Neoplasia Hypoplasia
Acute infection Chronic inflammation
Testicular torsion Cryptorchidism
Inguinoscrotal hernia Degeneration
Sperm granuloma Intersex
From Bonagura J: Kirk’s Current veterinary therapy XIII, St. Louis, 2000, Saunders.

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