Perineal Hernia

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Perineal Hernias

Herniation of the intestine or bladder through the pelvic diaphragm, seen as a swollen mass adjacent to the rectum and can affect dogs of all breeds and sizes as well as cats.

 

The swelling can be on either one or both sides of the rectum, and incidence is higher in older male animals that have not been castrated. The hernias result from weakening or failure of the intra-pelvic muscles, this failure often results when animals are straining to defecate due to an enlarged prostate gland or constipation. The swollen area at the base of the tail can contain organs that belong in the abdominal and pelvic canals, such as rectum, bladder, prostate, intestines and omentum.

Soft tissue - perineal hernia

Symptoms:

Breeds more prone to perineal hernia: Boston Terrier, Corgi, Boxer, Collie, Kelpie, Old English Sheepdog, Dachshund and Collie

Symptoms include:

- Unilateral or bilateral swelling near the anus

- Constipation or straining to defecate

- Inability/straining to urinate

- Abdominal pain

- Lethargy

- Altered tail carriage

- Anorexia

Certain connective tissue and dermatological conditions can be related to the development of perineal hernias.

The hernia itself can cause constipation, which in severe cases can permanently damage colon function. Severe constipation can also cause urinary outflow obstruction. If an animal cannot defecate or urinate, metabolic wastes are not eliminated from the body and this can affect the function of other internal organs and cause further illness. If the intestines or bladder become entrapped in the hernia a loss of blood supply to these organs can cause tissue death which left untreated can lead to the death of the animal

Procedure:

The surgical procedure to correct perineal hernias re-establishes a pelvic diaphragm utilizing intra-pelvic muscles, suture material and in extreme cases surgical mesh. If the bladder has been contained within the hernia for an extended period of time it may need to be sutured to the colon within the abdomen. Depending on whether the muscle failure has affected only one side or both sides, the surgery can be performed bilaterally if necessary.

The possibility of recurrence following surgery is greatly reduced after the first year and drastically reduced in the cases of uncastrated male dogs being neutered. For this reason, many surgeons will suggest castration at the time of hernia repair if the dog is male and intact.

After Care:

Hospitalization:

- As most hernias occur in older animals, they will benefit from overnight monitoring and fluid administration. Your pet may be discharged the day after surgery.

- When you get your pet home, place your pet in a cool/warm (season dependent), quiet and dark room. If you leave your pet alone, he/she will sleep and be comfortable. You can increase your pet’s anxiety by doting. Your pet will have adequate medication for pain so you do not need to worry about discomfort.

Medication:

- Antibiotics and an anti-inflammatory agent (Previcox) are given for 10 days.

Rechecks:

- Your pet should be rechecked in 14-21 days by Dr. Dew. Please call 479-964-4300 to schedule this appointment.

Exercise Restriction:

- An E-collar is placed immediately after recovery to prevent your pet from licking/traumatizing the surgical site. The collar should be maintained 24/7 until the final recheck examination.

- Limit to short leash walks 3-4 times daily for 3 weeks. During this time your pet should not be allowed to jump on/off furniture or play with other pets.

Physical Therapy:

- None required, however most animals will appreciate a warm compress applied to the surgical site for 2-3 minutes twice daily. This will make your pet comfortable and keep the area clean.

Other Information:

- A small amount of blood tinged discharge from the incision or blood in the stool would not be unusual and should resolve in 1-10 days time.

- When you get your pet home, offer him a small amount of water. If he drinks it and does not vomit, offer twice the original amount. 2 hours later if no vomiting has occurred, offer ¼ of the amount of food in a normal meal.

- If your pet eats and no vomiting occurs in a 2-hour time period, then you may resume normal alimentation.

- Please call Dr. Dew’s office or your regular veterinarian if your pet does not drink within the first 6 hours of being home or if vomiting occurs.

- The transdermal patch used for pain relief can cause constipation. Feeding the recommended amount of tuna in oil daily for 4 days along with his regular food will help prevent constipation.

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