Perineal hernias

Re: Perineal hernias

Utlendigur — Sat, 05 Dec 2009 14:13:04 GMT

I would usually recommend surgery aswell. I usually repair by rolling up the internal obturator muscle to patch the ventral bit of the deficit which seems to work well, with very little tenesmus post op. Unfortunately my boss referred one for surgery a decade or so ago and it didn't do well so he tends to advise owners to leave them. We then get these dogs coming in every few weeks to have their diverticulum emptied by some unlucky nurse. If the owner is eventually persuaded to allow surgery or crisis develops it's a nightmare with paper thin muscles, adhesions etc.

Re: Perineal hernias

stuart mcmorrow — Sat, 05 Dec 2009 11:50:43 GMT

I would always recommend a client to get the operation done. And obviously castration as well.

The surgery itself is not much fun for the first few but once you get used to them they are not too bad. Make sure you learn the anatomy well - even though it will look nothing like what is should! If you have the opportunity to watch or scrub in with someone else it would make it much easier for you to visualise everything.

I've seen quite a few that didn't get done and lead to real problems for the dog and a very poor QOL.

Cheers,

Stuart

Re: Perineal hernias

Rob Reid — Thu, 26 Nov 2009 09:34:57 GMT

I would always operate on these, whether they are symptomatic or not. I have seen a case of bladder retroflexion where the owner elected not to have surgery against advice and it is not an experience I would care to repeat. Luckily the dog pulled through in the end.

Otherwise, I have generally found that these cases do well with correct and careful technique.

Re: Perineal hernias

Evelyn Barbour-Hill — Sat, 21 Nov 2009 15:30:27 GMT

[quote user="Jillian Hall"]I've got one at the moment who is being worked up for PUPD and recurrent UTIs seem to be a feature so Im going down the prostate route. But will that take enough pressure off the hernia not to worry about it?[/quote]

Probably not. Once the original "diaphragm" has broken down even normal pressures are likely to shove stuff into the hernia.

I've never that I can recall seen one that was "asymptomatic" lifelong. At any time it may start the faecal impaction or get a bladder retroversion.

Re: Perineal hernias

Hannah Wynne Richards — Sat, 21 Nov 2009 10:09:51 GMT

Wouldn't life be simple if only owners just said "Yes vitnary "? Bring back the days of James Herriot !!!!

Wynne

Re: Perineal hernias

Niall Taylor — Sat, 21 Nov 2009 10:02:03 GMT

[quote user="Hannah Wynne Richards"]I'm always scared of a strangulation, so as long as cardiovascular system and kidneys are OK, I'm inclined to operate[/quote]

Totally agree - if you're certain of your diagnosis they should always be operated on + castration carried out to reduce the risk of recurrence. The best time to operate is early on, before too much rectal dilatation has taken place and while you've still got some muscle tissue to reappose. And there's always the risk of bladder eversion into the hernia - never good news.

The last one I did had been 'sat on' by the owners for 12 months following diagnosis and the dog was in a dreadful state - continual straining, the muscles of the pelvic canal were like tissue paper and we spent the first 3 days post-operatively dealing with his rectal hernia before things settled down. Did ok eventually though.

Cheers,

Niall

Re: Perineal hernias

Hannah Wynne Richards — Sat, 21 Nov 2009 09:38:17 GMT

I'm always scared of a strangulation, so as long as cardiovascular system and kidneys are OK, I'm inclined to operate

Wynne