Helping a rat with unusual rectal injury (basically has a second butthole) - stitching it up isn't working

[rhapsody]

Backstory: Several months ago at the rescue, Westley's then cage mates literally tore him a new butthole, practically a centimeter from his actual one. Whenever he pooped, it would come out of this new opening. The rescue was able to get him in to surgery, but he tore the stiches out. Covid wrecked havoc on the rescue being able to schedule surgeries, so they weren't able to get him in again before I came by and adopted him in February.

In the beginning of March, Westley underwent surgery to repair the rectal tear. He has since been back to the vet FIVE times to repair the stitches because they would somehow break 3-4 days after each surgery and he would start pooping out the wrong hole again. Up til this point, both the vet and I thought that he was somehow chewing/scratching the stitches open, but after his last restitching last Monday, I'm beginning to think there is a more serious issue. I made darn sure between an e-collar and a special vest I concocted with a toilet paper tube that he couldn't bend over and reach the wound site with either his mouth or front paws. Then I noticed that there seems to be something wrong with his pooping. He pooped normally the first day after the restitching, but then I wasn't seeing him poop the next couple days after - and he has been on laxatives since the initial surgery. He was super grumpy and did not want me touching him. Then on Thursday, I caught him passing the largest poop I've ever seen through stitches - there's no way it could have passed through a normal healthy colon. The diameter was huge and it was rock hard.

I'm starting to think that Westley has lost the ability to poop normally after not having to use his colon for over three months since the poop was just leaking out the wound site before getting to his real butthole. I think that after each restitching, he's been holding on to his poop until he backed up enough that it went through the path of less resistance - straight through the stitches. And after the stitches broke last Thursday, Westley is back to his usual happy self and has been begging for treats and scritches.

I'm meeting with the vet later this week to figure out how best to move forward since it seems impossible to close this "second butthole" up. Should we just leave the wound site be? Prior to the initial surgery at the beginning of this month, there wasn't any sign of infection despite all the fecal matter passing through this open wound. Should he just be on antibiotics for the rest of his life to ensure that it stays infection free? To be honest, I'm starting to regret putting Westley through all this since he seemed to be functioning fine before we started trying to fix this.

 

[Dena]

Poor guy! Hopefully you get answers, and he can start enjoying a more nornal-ish life!

 

[rhapsody]

Been chatting with the vet, and we've both come to the conclusion that Westley's plumbing got screwed up - either there was nerve damage in the colon when the initial injury happened, or that too much time has passed and the colon has forgotten how to function. The second butthole might be a blessing in disguise. By trying to close up the hole, we're essentially turning him into a megacolon rat.

Right now the biggest issue is infection around the hole since its now irritated because the stitches kept ripping apart. So we're going to let things be over the next couple weeks, and keep him on antibiotics.

There is a highly acclaimed research veterinary school in the vicinity that could attempt to fix him, but it would be experimental and extremely invasive. If we're able to get Westley back into his pre-surgery state, theoretically he should be able to live normally although I would need to keep an eagle eye out for infection flare-ups.

As an aside, I'm wondering if replicating Westley's injury on an actual megacolon rat could save them from having to be euthanized. It would be super tricky though since its a miracle that Westley didn't end up septic when the initial injury happened.