Zoey was a 4 month old Frenchie mix presented initially for diarrhea and straining to have a bowel movement. A fecal test showed no parasites, so she was started on medications to treat the diarrhea and probiotics. 10 days later, Zoey’s mom came home and found her with colon tissue protruding from her rear (image 1). A rectal prolapseis an emergency situation because the colon tissue is under extreme pressure and, without healthy blood flow, can quickly die. Zoey was immediately placed under general anesthesia and the prolapse was slowly massaged back inside. A purse-string suture was placed around the anus to prevent the prolapse from recurring while all the swelling went down over the next few days (image 2). Zoey recovered well and was instructed to eat a bland diet for then next week, until the suture could be safely removed. 8 days later, Zoey was seen by an emergency clinic for another rectal prolapse, with her purse-string suture still intact. This suture was cut, the prolapse was again corrected and another purse-string suture was placed. 2 days later, Zoey prolapsed her rectum again through the intact purse-string suture. Another prolapse correction procedure was performed, but 2 “X” sutures were placed over the anus, instead of the typical purse-string procedure. Zoey was doing well at home, but returned 3 days later for a colopexy. This procedure permanently tacks the colon to the inside of the body wall, so it’s unable to prolapse out the rectum (image 3 – from Small Animal Surgery 2ndEdition by Fossum). 7 days later, the anal sutures were removed and Zoey has been doing great on a grain free diet.