My Dog's Experience With Perineal Hernia
I cannot discuss in detail how the surgery was done, neither will I try to explain the medical procedures done to Peso. Only veterinarians can explain it. This article 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), and the food I gave him to make his diet well-balanced.
I decided to start an article about perineal hernia so that fellow dog owners with the same experience can find a place where they can ask an existing human who has taken care of a dog with the same ailment.
When Peso was diagnosed in 2008, the Internet and Peso's veterinarians were my source of information. Although they provided good information, my heart was still yearning for something else that even I couldn't tell at that time.
Then I realized that 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 on the internet. Someone shared her story, but there was no follow-up, and she did not respond when I commented on 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. I will give my best to answer to help you understand your 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 at his worst, he couldn't release even 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.
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 SurgeryClick thumbnail to view full-size
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: https://www.acvs.org/small-animal/perineal-hernias
First Surgery Photos
Castration after Perineal Hernia Surgery
After his 1st Surgery, Peso was castrated to avoid further complications, like enlarge prostate and testicle.
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.
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.
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 SurgeryClick thumbnail to view full-size
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 PhotosClick thumbnail to view full-size
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
A few days after the surgery, Peso was returned to the clinic Because of difficulty urinating again...His veterinarians and other Senior Vets were already planning for another surgery just in case there was no other options left. That surgery would be about repair of muscles at his behind using a Silicon mesh, to support the thinning pelvis muscles, but while planning for it ( because mesh was not available yet in the Philippines in 2009), procedures were tried so Peso can urinate. Catheter was not effective to him so bladder topper device was used instead. This device has a sharp needle like object attached to the tube in which the other end was connected to a container. The veterinarian tried to find Peso's bladder by touching his stomach. He then slowly pierced the sharp object to where the bladder was, then he pushed one button and the device automatically collected the urine from the bladder and went to the Jar like container. It went on for days and After a few series of Bladder tapper procedure, Thank God! Peso was able to urinate naturally on his own, and his vet said, "At least there is no need for us to put Peso to another immediate surgery", and I was so happy we did not return to his vet for surgery since then.
I mentioned that probably Peso's case was the worst case of Perineal Hernia, why because he experienced all the possible complications of Perineal hernia. Repaired muscle suddenly showed wounds with surgical thread, and his veterinarian prescribe an ointment for wound which was quite expensive but very effective. It can dry up even the open weeping wounds.
What you see in the picture was an open wound, and yes that was where he was opened in his last surgery the called bladder transifixation. That wound came out years after his 6th surgeries. The veterinarian did not find it serious, but he recommend another remedy for wound which is very natural but expensive, I looked for Manuka honey, and I used it like ointment to Peso's wound. It was effective but when the wound dried up, the bulge at his behind became noticeable again, quite big if he had not urinated yet, but in spite of Peso was just okay. Urine straining never happened again, but when it comes to putting his poop out, he really needed my help.
How to Help Your Dog
Helping your dog to poop is not clean so it is recommended to have a stock of surgical gloves at home.
The Lamp Shade Collar or E Collar
This is very important for this will prevent your dog from licking his wound or stitches. Without this the dog has the tendency to remove the stitches by himself causing the reopening of wound and possible exposure to infection.
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.
I remember when Peso got used to it, he ran around our subdivision while wearing it, and it was a funny sight to my neighbors.
Laxative as prescribed by Veterinarian
Ointment for wounds
Once your dogs were diagnosed with Perineal hernia don't hesitate to bring them to surgery, my fears and doubts made me delay Peso's surgery, and in this type of ailment prolonging it means worsening it.If in case it reaches the case of Peso, don't deny them the chance to life, believe me once you see them surviving the feeling is very magical.
Indeed my dog had experienced so much, but I can't just give up on him because I know he wanted to live, and I will never deny that chance to him.
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. After his sixth surgery, in case the hernia recurred, There was another option for surgery, which will need the use of "Surgical Mesh". In 2009, the mesh was 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, that would be enough to consider him in a very good condition.
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. there was a time that I sent Peso to Vet. clinic for stool removal, and after more than 3 months, there was the impacted stool again but this time, I successfully managed to help him bring it out using my hands wearing the surgical glove. You can use your imagination for what I did to help him..
and I know Peso was just so grateful
Picture Years After His Last Surgery
Peso Died on June 7, 2016
Peso's last surgery was in 2009, and since then he lived actively for seven long years. He died a month before his 16th birthday, and the cause of death was old age complications. Meaning, if properly treated combined with tender loving care of the owner, Dogs with perineal hernia can live longer. I think dog that died due to this ailment is rare.
Mario Peso will always stay in my heart... and for me this is his Legacy.
© 2010 Maria Cecilia