Semitendinosus muscle transfer flap for external anal sphincter incompetence in a dog

Abstract

A 5-year-old sexually intact female Yorkshire Terrier was referred with a history of fecal incontinence of at least 2 years and chronic intermittent colitis. The external anal sphincter to the left of the anus was intact; the external anal sphincter was not detectable to the right of the anus. To repair the defect, the semitendinosus muscle was isolated and severe 2 cm proximal to its insertion on the tibia. Care was taken to preserve the integrity of the vasculature and nerve supply in the proximal third of the muscle body. The body of the muscle was passed around the ventral and right aspects of the rectum; the cut end was secured with simple interrupted sutures dorsal to the levator ani and coccygeus muscles to simulate the external anal sphincter. After surgery, the dog could defecate normally. Absence of a portion of the external anal sphincter may be congenital or the result of anorectal trauma, rectal prolapse, severe perineal disease, or surgical resection. The use of a semitendinosus muscle flap for treatment of fecal incontinence secondary to sphincter incompetence in dogs may be a viable alternative to euthanasia.