Perineal Hernia in Dogs
The Author and her dog Peso
I cannot discuss in detail how the surgery was done, neither will I try to explain some medical procedures done to Peso. Only veterinarians can explain it better .
This hub is about my personal experience as Peso's human. I will be sharing my dog's journey and what I did to help him. I will be writing about post surgery care, procedures done to him (again not the surgery in detail) up to the food I gave him to make his diet well balanced.
I decided to start a hub about perineal hernia so that fellow dog owners with the same experience, can find a place where they can ask an existing human who took care of a dog with the same ailment.
When Peso was diagnosed in 2008, internet and Peso's veterinarians were my source of information, although they provided good information, still my heart was yearning for something else that even I can't tell at that time.
Then I realized I wanted to speak to a dog owner who took care of a dog with perineal hernia, but I was not lucky to find one from the internet. Someone shared her story but there was no follow up and they did not respond when I commented at the site where the story was posted.
Now I would like to be that person to those who need enlightenment. I would like to be their emotional support. I wish to give them hope and encouragement.
So I decided to post my dog's journey, and I will give my best to answer them until I can finally pacify their longing to understand their pet's situation.
How I Found Out About My Dog's Ailment
It was in late 2007, I never knew about this ailment until a veterinarian told me about it. Peso was 7 years old when I observed him having difficulty putting his poop out... even if I gave him a soft diet, a stool softener medicine and lots of water, still the poor dog had a hard time and the worst can't bring out a small piece... The next time I brought him to his veterinarian, Enema was performed to remove the impacted stool that stuck up in the space developed by the hernia.
Enema Procedure to remove the Impacted Stool
Sedation is not always an option for Difficult Dogs.
Difficult Dogs are hyper dogs, that react violently during treatments, but depending on the style of the veterinarians, sedation may not be necessary. The second veterinarian from a different clinic was able to perform enema with Peso even though I was the only one controlling my dog. She said dogs are more threatened with too many people trying to stop him. Peso's third veterinarian again, from another clinic too, just remove the stool using his finger.
Muscle started to stretch
Hesitation to Bring Peso to Surgery
Since the ailment was new to me, I hesitated to bring my dog to surgery. The veterinarian said only surgery can correct it and there is a possibility of recurrence. I was not convince or I was in denial that my dog needed to undergo operation, aside from his difficulty putting his poop out, I did not see anything wrong with him, the appetite was good, he was clever and playful.
I also fear for the possible effects of anesthesia, the veterinarians always have this waiver for the owner to sign before surgery, which frightened me more. Peso was already 7 years old then and I was wondering if he was too old to withstand the possible anesthetic complications.
Instead of considering surgery, I decided to manage his ailment by changing his diet. At first I gave him oatmeal as his source of fiber. But later on I converted to red and brown rice because Peso was more of a rice eater. I also boiled squash and made it part of his diet. He was given laxative after each meal to ensure that his poop will be "paste" like in consistency not hard and dry, still he had difficulty and slowly, he was developing something at his behind. There was a discoloration from natural colors to pale pink, and when you look closer, it was like a muscle started to stretch and skin was thinning.
Photos before his First Surgery
Peso just turned 8 years old in 27 July 2008, when I decided to bring him to surgery, but ahead of the set schedule of surgery, one morning my dog just can't urinate, the veterinary clinic where his surgery would be performed was still close and unlike other clinics, it was located in a business area (all pets related) that closes at a particular time and opens late in the morning,
Suddenly, there was noticeable bulk at his behind. It was so large he looked like he developed a head right under his tail. Peso was restless and uncomfortable, walking here and there trying his luck to pea but nothing came out.
So his first surgery was performed well (First week of August 2008), the bladder went out when the Veterinarian made an opening at the bulge. The bladder was bloated and urine went out automatically filling up an ordinary size dipper. The bulge of the stretch muscles was repaired. Peso woke up and urinated without difficulty, the first surgery was a success.
Please see this links for medical terms for further information:
First Surgery Photos
Castrated After his First Surgery
Castration after Perineal Hernia Surgery
After his 1st Surgery, Peso was castrated to avoid further complications, like enlarge prostate and testicle.
Small Bulge Showed Up at the Right Side a Few days after 1st. Surgery
Days after the 1st Surgery, I observed a small bulge at the right side of Peso's behind. It moved or threatened to enlarge whenever Peso Barks. Since the left part was repaired, the hernia was like searching for another space where it can enlarge again. So it transferred to the right. We did not wait for complications like urine straining and constipation that we scheduled the surgery at least three weeks interval from the first.
Picture of Peso's Behind Before 3rd Surgery
Traumatic 3rd Surgery
Less than a week after his second surgery, Peso showed signs of urine straining again. I soaked small towel in hot water and and used it as hot compress to Peso's bulgy behind. I tried available home remedies because it was hard to accept then that Peso might be needing surgery again. All Fears came back, including fear of anesthetic exposure. I walked Peso in spite of the rain, walking may do a miracle and there was that hope he can urinate again, but later in the afternoon, he had difficulty putting his poop out, and in that stormy evening, as a finale, when he attempted to poop again, a red like flesh was showing from his anus instead of a poop, and it completely blocked the hole.
It was the longest night of my life. Peso was crying and whining desperately. It must be really very painful and uncomfortable to have something stuck on his anus plus the volume of urine that he can't release. I felt so disappointed and helpless asking myself over and over again why those things are happening and what have I done wrong? I cried like a child, Peso immediately went to me and hugged me as if telling me to calm down. I realized that when I cried, the more Peso cried too. Manila was already flooded and I was advised to go to the veterinary clinic as soon as the sun is up the following day. I guess it will be more devastating to get stranded with a crying dog if I insists to go to the clinic that night. At this point we (I and his veterinarian) already decided to transfer to the hospital branch of Peso's veterinary clinic, where I can always bring Peso even in the middle of the night or as early as possible.
What gave me hope that night was when Peso took a piece of meat that I offered to him while he was crying, a sign for me that in his agony, he never really lost his appetite, and that means strong fighting spirit. He will live..
After 3rd Surgery Photo
We changed veterinarian during Peso's 3rd surgery simply because as I mentioned earlier we decided to transfer Peso to the hospital branch of the Clinic, and Peso's case was handled by equally competent veterinarian and indeed one of the best Veterinarians in the Philippines.
If my memory serves me right, the side that was repaired during 3rd surgery was the right side again. Because of the space created by the hernia, bladder was displaced so, the red flesh showing on Peso's anus was his bladder. In other perineal hernia case, it was the colon that normally shows up from the anus. Probably because of exposure, his bladder had some discoloration and his veterinarian told me that if Peso can't urinate after the surgery, it could mean his bladder developed a problem. And it meant two things, he will be opened up for surgery again or put him to sleep.
When Peso woke up, he urinated and I knew the bladder did not develop anything at that moment.
Before 4th Surgery Photo
4th Surgery Story
Since his 3rd surgery everything went well, except that there were things that I need to do to help my dog. The surgery did not correct his bowel movements, So Peso has a lifetime maintenance of laxative drug after each meal, to control the consistency of his poop. Although the stool is paste like, still it did not go out naturally and easy. And so we go on with our lives, bringing Peso out and let him poop as regularly as possible. I also observed if he can urinate because if he can't that would mean another problem. His food is always rich in fiber, and I made sure he has boiled squash in his meal. I was happy he seemed normal for months. But I observed something again from his behind.
It begun to protrude again, and it looked like both sides were bulging. Bulges were not scary big but it was noticeable. The bulks are showing when he had not urinate yet, and once he did, his behind became flat like normal again.
December 01, 2008, I brought Peso again to the Hospital for fourth surgery, honestly during those days, I can no longer observe or monitor how he was treated, So I really can't tell which sides was repaired. But the Veterinarian was very positive that he already repaired even the potential one that started to stretch. And we had a Merry Christmas
Photos before 5th Surgery
5th Surgery Story
A few days after New year of 2009, or more than one month after his 4th surgery, the bulk started to appear again, but the one at his right was the most obvious. January 7, 2009 was the exact date of Peso's 5th surgery, the bladder was displaced again resulting for Peso's urine restraining again. Although Peso was okay after the surgery, his veterinarian decided to confine him for a few more days for observation. I was told Peso's newly repaired muscles was already thinning that it can possibly give in when he moves drastically. Hyper dog Peso was discouraged to run and jump. Even excessive barking is bad for him. It was not easy to stop dog in doing things the he normally does, but I tried my best. At least he remains active and strong in spite of his surgeries and for me that is great fighting spirit.
6th Surgery called Bladder Transfixation
The story did not end there, after another month, Peso showed signs of restraining again. The veterinarian said, Peso's muscles is already thinning, that a repair may not be helpful anymore, so he decided to use another option which he called Bladder Transfixation. His brief explanation was like he made opening near the Dog's Penis, and repaired what was needed to be repaired inside like, he attached the bladder to the abdominal wall, to prevent the bladder from roaming the hernia. In Medical terms, Transfixation means piercing of a part of the body (as by a suture, nail, or other device) in order to fix it in position.
After Surgery Photos
Roller Coaster Ride Feeling
Whenever Peso woke up from surgery, the feeling was always magical, Yes we survived another ordeal. But as Human of a dog with perineal hernia, I realized that I can't just relax and believe that my dog is already back to normal. The struggle did not end with the surgery, although you do your best to follow all rules so that hernia will not recur anymore, there were complications that still needs to be addressed.
Although drinking laxative is regular after every meal, there were still time that Peso developed impacted stool. They way I observed it, impacted stools are stool that went to place created by the hernia, meaning when Peso poop, not all were completely released, some went to that space and once that space was full,the behind will protrude again. In other cases, dog in this condition must undergo enema process, But I learned from Peso's veterinarian, He just used his finger doing it, of course he wore surgical gloves. I did the same later on, and Peso got used to that situation during poop time.
Bladder Topper Procedure
Bladder Topper Procedure
A few days after the surgery, Peso was returned to the clinic Because of difficulty urinating again...His veterinarians and other Senior Vets are planning to use Silicon mesh, to support the thinning pelvis muscles, but while planning for it ( because mesh is not available yet in the Philippines), bladder topper procedure was done to Peso to collect urine from his bladder... at that time catheter was not effective to Peso..but thank God, after a few series of Bladder tapper procedure, Peso was able to urinate, and his vet said, "At least there is no need for us to put Peso to another immediate surgery", and we never returned to his vet for surgery since then.
Open wound is another complication.
An Update about my Dog's Ailment
A Dog's perineal hernia, never stop in the success of the surgery. Peso's sixth surgery, the Bladder transfixation was considered a success because it kept the bladder in place, at least at the right side of his behind, which prevented it from blocking his intestine which remained at the left side of his behind. Meaning, for more than a year now, Peso survived, his life is back to normal and he can poop now with my help and with stool softener drugs which will be his lifetime maintenance... After Sixth surgery, we still have another option for another surgery, which may need the use of "Surgical Mesh". Last year this mesh is not yet available in the Philippines, but my dog's veterinarians were determined to get one for Peso, if in case Peso did not respond well to his last surgery. This mesh will be added to the dogs thinning muscles at his behind, making it stronger to hold the organs like bladder in place, this is 95% non recurring.
But since Peso managed without the mesh transplant and considering his age, I believe he is okey as he is now...
but expect more impacted stool, in spite of taking his maintenance stool softener drug, you can still observe your dog's behind getting extra ordinarily bulky. Last March, I sent Peso to Vet. clinic for stool removal, and just today, after more than 3 months, I successfully managed to help him bring out the impacted stool...You can use your imagination for what I did to help him..
and I know Peso was just so grateful
If in case your dog has perineal hernia and had undergone surgeries too, always observe him when he poop. In case he has difficulty putting it out, try to help him by pressing gently the bulky part where the feces may be is...always give him stool softener drug after meal (twice a day) and give him soft diet with high fiber..
Elizabethan Collar, A must have after surgery
the Lamp Shade like collar or E Collar
This is very important for this will prevent your dog from licking his wound or stiches. Without this the dog has the tendency to remove the stiches by himself causing the reopening of wound which will need restiching of the opened wound.
At First the dog will surely resist it, but as his master you must insist and show him you are the boss... The dog will soon get use to it and even sleep with it or play with it. Once the wound is dry, and not that itchy anymore, you can remove this from your dog's neck anytime
Peso's first Perineal Hernia Surgery
© 2010 Maria Cecilia