I am not a vet and have no medical background. I do not have a fraction of the experience with cats that BendyMom and critters do.
I agree with critters' suggestion that you might be dealing with a fistula. I agree with your comment about finding a vet with more expertise. I agree with BendyMom's suggestion of a veterinary college, or perhaps ask the veterinary college if they can recommend a veterinarian within a reasonable distance who has done successful
RVF surgery to close a fistula. You could probably call them. If you are near a large city, you could also call the regional veterinary specialty hospital and see if they have experience with this.
If you want to research the condition, here are some search terms to get started.
Rectovaginal fistula is an abnormal connection between the rectum and the vagina.
The abbreviation in veterinary literature is
RVF. You are talking about
RVF surgery.
Most of the veterinary reports of RVF I found online are about cats or dogs with a deformity of the anus (like BendyMom said) as well as an RVF opening between the rectum and vagina.
The term for the deformity of the anus is
anal atresia, also called
atresia ani. There are different kinds. One is an imperforate anus (like BendyMom mentioned, no b*tthole, so waste exits the body through another opening). Three other kinds of atresia ani are described
here. One is anal stenosis where the anus is present but the anal canal is narrow. Since your cat is eliminating through her anus but apparently has a fistula, I think they would want to check whether her anus is normal.
Like BendyMom, at the moment I do not remember a kitten here with this exact situation. But I will look some more today. The case I do remember very well was a puppy with an imperforate anus (no b*tthole).
https://handicappedpet.net/helppets/viewtopic.php?f=29&t=13347
A rescue was lining up surgery for her, which involved fundraising and then scheduling. She became septic (massive infection) before surgery. They managed to get it under control and did the surgery to give her an anus, but she did not survive. I have always saved her photo on my computer. Her name was Juniper. I don't think they ever said what caused the sepsis, but retaining feces for too long is unhealthy, or having fecal contamination of the urinary system (as BendyMom said) can cause infection and sepsis. It seems like they just didn't quite get to her in time, though they were trying.
Here was another story of an imperforate anus with a happier outcome. You may want to read it.
This article from the Canadian Veterinary Journal is about surgical repair in 5 dogs. 4 did well and 1 died.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1914316/
It shows 2 other interesting things. It shows the weight of the dogs was from less than a pound to up to 16 lbs. And it shows they did 2 separate surgeries during the surgical procedure. One to fix the wall of the rectum and one to fix the vagina. If the dog had no anus, that is a third part of the procedure. (And notice 3 of the dogs had no tail, like a Manx.)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1914316/ wrote:
Rectovaginal fistula with anal atresia in 5 dogs
Abstract
Five dogs with rectovaginal fistula and atresia ani that had been treated by surgical correction of the malformations were studied retrospectively. Ages at presentation varied from 1 to 3 months and weight from 350 g to 7.5 kg. The histories included voiding of feces through the vulva, with or without tenesmus, usually observed after weaning. Atresia ani, presence of feces in the vaginal canal, abdominal distention, and discomfort on abdominal palpation were observed during clinical examination. Also, 3 dogs had partial tail agenesis. In all dogs, the rectovaginal fistula was isolated and transected, the vulvar and rectal defects were closed separately, and the atresia ani was repaired. Normal defecation was restored, but 1 dog had fecal incontinence that subsequently resolved. One dog died 2.5 months postoperatively, and follow-up was done on the others for periods ranging from 1.6 year to 7.7 years. Surgical correction in dogs with rectovaginal fistula and atresia ani may result in a favorable outcome, if it is done early.
This facebook post about a rescue kitten may interest you. They did surgery to correct a rectovaginal fistula in Ottawa, had a complication, had to have it repaired 3 hours away in Michigan, but in the end the kitten did well.
https://www.facebook.com/donate/496618970909518/