A Retrospective Study of Inguinal Hernia in 35 Dogs

Inguinal hernia was associated with trauma in five dogs and was considered nontraumatic in 30 dogs. There were 11 males, 13 intact females, and six spayed females with nontraumatic inguinal hernia. Six dogs had bilateral hernias. Five dogs were younger than 4 months at the time of diagnosis. In 11 older dogs with nontraumatic inguinal hernia, the hernias were identified less than 7 days before surgical repair; in 14 older dogs, the hernias had been recognized for 1 to 60 months. Clinical signs in dogs without small intestinal incarceration were usually limited to a visible or palpable mass without pain or systemic illness. Hemiorrhaphy approaches included inguinal, midline with contralateral ring evaluation, and celiotomy with or without inguinal exposure. Fat and omentum were the most common hernial contents. Small intestine was within the hernias of 12 dogs. Six dogs had nonviable small intestine. Postoperative complications included two incisional infections, one incisional dehiscence, two cases of peritonitis and sepsis associated with bowel leakage after intestinal resection and anastomosis, and one hernia recurrence. The overall prevalence of postoperative complications was 17%, and the mortality rate was 3%. Vomiting for 2 to 6 days was predictive of nonviable small intestine. Dogs younger than 2 years were at 11 times greater risk for nonviable small intestine than dogs older than 2 years. Four of five dogs with nontraumatic inguinal hernia and nonviable small intestine were intact males, whereas none of 13 intact females were affected. Only one of 14 dogs with longstanding hernias had nonviable small intestine.     

Mineralized paraprostatic cyst as a potential contributing factor in the development of perineal hernias in a dog

Perineal hernias almost exclusively affect male dogs (sexually intact or castrated). Factors that may contribute or predispose a dog to perineal hernias include tenesmus, pelvic musculature variations (male vs female), and gonadal hormone influence. In dogs with perineal hernias and tenesmus it is important to include rectal and prostatic diseases, including paraprostatic cysts, in the differential list of potential underlying causes. Surgical correction of the perineal hernia with a perineal herniorrhaphy is indicated. Successful treatment depends on the degree of preexisting neurologic alterations, meticulous surgical technique, and identification and correction of underlying contributing factors. Paraprostatic cysts develop predominantly in sexually intact medium to large breed dogs. These cysts are thin-walled structures often attached to the prostatic dorsal midline. Osseous metaplasia of paraprostatic cysts may occur. Clinical signs of tenesmus often result from compression on adjacent structures (urinary bladder and colon), and tenesmus may contribute to the development of perineal hernias. Preferred treatment of a paraprostatic cyst is surgical removal and castration. This report describes a dog with bilateral perineal hernias and a large mineralized paraprostatic cyst that was identified as a possible contributing factor to the hernias.     

Inguinal-Scrotal Urinary Bladder Hernia in an Intact Male Domestic Rabbit (Oryctolagus cuniculus)

An 8-year-old intact male dwarf rabbit (Oryctolagus cuniculus) was presented with a 2-month history of unilateral scrotal swelling. The external physical examination of the rabbit patient confirmed the severe, unilateral, fluid-filled scrotal distention. Radiographic images of the effected scrotum revealed a soft tissue swelling in the area of the left testicle, and the absence of the urinary bladder in the caudal abdomen. Ultrasonography verified the presence of a fluid-filled mass in the scrotum, enveloping the left testicle. A fine-needle aspiration of the scrotal mass yielded urine, thus a diagnosis of a nonreducible herniation of the urinary bladder into the scrotum was made. An inguinal herniorrhaphy was performed, and the bladder was successfully reduced into the abdominal cavity. A bilateral routine castration and left scrotal ablation were also performed. Two months after surgery no recurrence was noted, and the patient had normal urinary function. Inguino-scrotal bladder herniation is rare in both humans and animals. Male rabbits are predisposed to inguinal and scrotal hernias because their inguinal rings remain open throughout life. Herniation of the urinary bladder should be considered as a differential diagnosis when intact male rabbits are presented with unilateral scrotal swelling.     

Use of an inguinal approach adapted from equine surgery for cryptorchidectomy in dogs and cats: 26 cases (1999-2010)

OBJECTIVE-To determine whether a surgical technique used in cryptorchid horses can be used successfully to remove testicles retained in the inguinal region or abdominal cavity in dogs and cats. DESIGN-Retrospective case series. ANIMALS-22 dogs and 4 cats with cryptorchidism. PROCEDURES-In 1999 through 2010, 26 cryptorchid patients underwent surgery during which an incision was made over the inguinal ring and the undescended testicle was located for removal via identification of the vaginal process and the embryonic gubernaculum. Castration was performed once a testicle was located in the inguinal region or via removal of an intra-abdominally located testicle through the inguinal canal. RESULTS-4 dogs and 1 cat were bilaterally cryptorchid. Testicles were retained in the abdominal cavity in 18 dogs and in the inguinal region in 4 dogs; in all 4 cats, undescended testicles were located in the inguinal region. Twenty-one dogs and 4 cats were castrated without breaching the abdominal cavity; in one of those dogs, the inguinal ring was enlarged to permit extraction of a tumorous testicle. In 1 dog, the inguinal ring was enlarged into a paramedian laparotomy and viscera were manipulated to exteriorize an intra-abdominally located testicle because the gubernaculum had ruptured. Major intraoperative or long-term complications did not occur. CONCLUSIONS AND CLINICAL RELEVANCE-Results suggested that as in horses, the surgical approach over the inguinal ring, wherein the vaginal process and the remnant of the gubernaculum are identified and used to locate an undescended testicle for removal, can be used successfully in dogs and cats.     

Laparoscopic esophagopexy,fundopexy, and hiatal herniorrhaphy for refractory regurgitation in a racing Alaskan husky sled dog

A 2-year-old intact female Alaskan husky sled dog was presented with a history of chronic exercise-induced regurgitation refractory to medical management. Previous diagnostics were unremarkable except for an endoscopic examination and histopathologic evaluation of the upper gastrointestinal tract that revealed the presence of Helicobacter spp. and mild non-specific inflammation of the proximal duodenum. A laparoscopic hiatal herniorrhaphy, esophagopexy, fundopexy, and ovariectomy were performed without complications in anesthesia or surgery and clinical improvement was observed with continued follow-up for 8 months after surgery.Key clinical message:Surgical treatment for hiatal hernia may be considered in racing Alaskan sled dogs with regurgitation refractory to gastric protectant therapy.     

Laparoscopic Repair of Scrotal Hernia in Two Foals

Nonstrangulating indirect scrotal hernias were corrected in two 4-week-old Percheron foals by a laparoscopic technique. After laparoscopic reduction of herniated nonstrangulated small intestine each testes was retracted through the vaginal ring. The ligament of the tail of the epididymis was transected by electrocautery. The testicular vessels and nerves were isolated by cautery of the mesenteric portion of the mesorchium and then ligated. Staples were used to close the opening of the inguinal canal by apposing the peritoneal edges of the vaginal ring. Resection of umbilical stalk remnants via celiotomy performed in one foal after laparoscopic observation of enlargement of the right umbilical artery and urachus. No complications or recurrence of herniation had occurred 16 weeks after surgery.     

Ovarian remnant removal using minimally invasive laparoscopic techniques in four dogs

Four partially intact, female dogs with a median age of 6 · 5 years were presented to Angell Animal Medical Center for laparoscopic treatment of ovarian remnant syndrome. Dogs were positioned in dorsal recumbency and a three‐port laparoscopic technique was used to identify and remove en bloc any abnormal tissue in the area of the ovarian pedicles. None of the dogs required conversion to open coeliotomy and there were no major complications. Abnormal tissue, including granulosa thecal cell tumour (n = 1), was identified bilaterally in three dogs and unilaterally in one dog. Clinical signs associated with ovarian remnant syndrome resolved in all dogs following surgery.     

Laparoscopic adrenalectomy for treatment of unilateral adrenocortical carcinomas: technique, complications, and results in seven dogs

Objective— To investigate the feasibility of, and outcome after, laparoscopic adrenalectomy in dogs with unilateral adrenocortical carcinoma.
Study Design— Case series.
Animals— Dogs (n=7) with Cushing's syndrome caused by unilateral adrenocortical carcinoma.
Methods— Laparoscopic adrenalectomy with the dog in lateral recumbency on the unaffected side. Three 5-mm portals (1 laparoscopic portal, 2 instrument portals) were placed in the paralumbar fossa. A fourth instrumental portal (5–12 mm) was placed above the kidney. After dissection and hemostatic control of the phrenicoabdominal vein, the adrenal gland was carefully dissected or when there was capsule fragility, necrotic content was partially aspirated. The remaining glandular tissue was removed through the 12-mm trocar site.
Results— Dogs with unilateral adrenocortical carcinoma (3 right-sided, 4 left-sided) without invasion of the caudal vena cava were successfully operated by laparoscopic approach. There were no significant intraoperative complications; 2 dogs died within 48 hours of surgery because of respiratory complications. Five dogs were discharged 72 hours after surgery, and signs of hyperadrenocorticism disappeared thereafter (survival time ranged from 7 to 25 months).
Conclusions— Laparoscopic adrenalectomy is feasible in dogs with either right- or left-sided adrenocortical carcinoma not involving the caudal vena cava.
Clinical Relevance— When performed by experienced surgeons, laparoscopic adrenalectomy offers a minimally invasive alternative to open laparotomy or retroperitoneal surgery for the treatment of unilateral adrenocortical carcinoma in dogs.     

Unilateral and Bilateral Stifle Arthrodesis in Eight Dogs

Nine stifle arthrodeses in eight dogs were reviewed retrospectively to evaluate use of the limb, each dog's comfort, complications, and factors that may have influenced the final outcome. Ability to use the limb after unilateral fusion was good (limb used at all times) in three dogs, fair (limb used at all gaits except a gallop) in three dogs, and poor (limb used only when running) in one dog. Factors that appeared to affect the outcome included angle at which the stifle was fused and lesions in the ipsilateral coxofemoral joint. One dog with bilateral arthrodesis had a good outcome with minor limitations. The only potentially devastating complications occurred in one dog in which infection and premature implant loosening jeopardized the fusion. None of the dogs exhibited signs of pain and all owners were satisfied with the results.     

Surgical treatment for different forms of hernias in sheep and goats

Sheep and goats are frequently presented with different forms of hernias to veterinary clinics. The aim of this study is to investigate the outcome of the surgical treatment of abdominal, umbilical, inguinal and scrotal hernias in sheep and goats. Fifty-eight clinical cases (sheep = 44, goat = 14) were presented to the Veterinary Teaching Hospital, College of Agriculture and Veterinary Medicine, Qassim University, Saudi Arabia from September, 2003 to September, 2006. These animals had abdominal (sheep = 30, goat = 10), umbilical (sheep = 6, goat = 4), inguinal (sheep = 7) and scrotal (sheep = 1) hernias. All the cases of hernias in sheep and goats were subjected to full study including the history of the case, classification of hernias, the size of the hernial ring, surgical repair of the hernias, adhesions between the hernial sacs in each case, the postoperative care and follow up of the cases. The results revealed that gender had an effect on the incidence of hernia. The incidence of abdominal hernias was higher in females and the incidence of inguinal hernia was higher in males. There was a positive correlation between the history of hernia and the degree of adhesion. For the sheep, 26 out of 30 cases of abdominal hernia had good outcomes and the healing was excellent. There were postoperative complications in 4 ewes. For the goats, there were slight swellings at the site of operation in 2 out of 10 cases of abdominal hernia, while the remaining 8 cases had good outcomes. There was one case of umbilical hernia with an umbilical abscess that had broken down with sepsis formation at the surgical site. In conclusion, the success rates of surgical treatment for all types of hernias were very high and there were no significant differences in the success rates among the different types of hernias in both sheep and goats. The types of suture materials and the types of hernias had no significant effect on the outcome of the surgical treatment.     

Evaluation of Internal Obturator Muscle Transposition in Treatment of Perineal Hernia in Dogs

A technique that utilizes transposition of the internal obturator muscle for repair of perineal hernias was evaluated. Forty-two male dogs were followed for at least one year after surgery. The repair failed in only one animal, a dog with previously operated bilateral hernias. Microangiography demonstrated an adequate blood supply to the transposed internal obturator muscles of two dogs examined at three weeks and three months after surgery.     

Results of adrenalectomy in 36 dogs with hyperadrenocorticism caused by adrenocortical tumour

Summary

A total of 38 adrenocortical tumours were removed from 36 dogs with hyperadrenocorticism. The surgical approach was by way of a unilateral flank laparotomy (32 dogs; 14 left and 18 right), a bilateral flank laparotomy (3 dogs) or a midline celiotomy (1 dog).

Two dogs were euthanized during surgery because their tumours could not be resected. Eight dogs died from post‐operative complications. Pancreatic necrosis with peritonitis was the most common cause of death. Eight of the 26 dogs that survived had signs of recurrence of hyperadrenocorticism. Unsuppressible hyperadrenocorticism was found in four dogs; one dog had probably pre‐existent pituitary‐dependent hyperadrenocorticism, and adrenocortical function could not be re‐examined in the remaining three dogs.

Among the 37 tumours examined microscopically expansion of neoplastic tissue into blood vessels was found in 22 of them. Four adrenal glands with adrenocortical tumours also contained phaeochromocytomas. Necropsy was performed in eight dogs. Metastases were found in the lungs of two dogs and in the lungs and liver in one dog.

In combination with the data of previous reports, it is suggested that histological findings in surgery specimens are not good predictors for the clinical outcome.     

The use of porcine small intestinal submucosa as a biomaterial for perineal herniorrhaphy in the dog

OBJECTIVES: To develop an in vivo perineal hernia model, to develop a technique for using small intestinal submucosa (SIS) in perineal hernia repair, to further elucidate the biological behavior of SIS, and to compare SIS herniorrhaphy with the internal obturator muscle transposition (IOT) technique. STUDY DESIGN: Prospective evaluation comparing SIS herniorrhaphy with IOT. ANIMALS: Twelve adult castrated male, large-breed dogs. METHODS: All dogs had bilateral pelvic diaphragm defects created by complete excision of the levator ani muscle. Each dog had one side repaired using SIS and the other by IOT. Pain and inflammation were subjectively scored. Dogs were killed 2 weeks (n = 4), 12 weeks (n = 4), or 16 weeks (n = 4) after surgery. Each pelvic diaphragm was biomechanically tested to failure. The pelvic diaphragms from 2 normal dogs (n = 4 sides) were also biomechanically tested. Failure site, maximum pressure, displacement at failure, and initial linear stiffness values were determined. Histologic assessment was performed. Statistical analysis was performed with significance set at P <.05 RESULTS: No significant postoperative complications were noted. There were no significant differences in maximum pressure to failure, displacement, or stiffness when comparing normal, SIS, and IOT at any time point. The SIS group had significantly less displacement (P =.004) at 2 weeks than at weeks 12 or 16. For all herniorrhaphy techniques, the failure site was central (n = 22) or at the suture line (n = 2). At 2 weeks, histologic evaluation of tissues from the IOT group showed inflammation, mineralization, and necrosis, which were not present in tissues from the SIS group. Histologic examination at 12 and 16 weeks showed no microscopic differences in cell population or tissue characteristics between the IOT and SIS groups. CONCLUSIONS: SIS herniorrhaphy was successfully performed in this in vivo model of perineal hernia in the dog. CLINICAL RELEVANCE: This study suggests that SIS can be used as a primary means of repair, as augmentation when the internal obturator muscle is thin and friable, or as a salvage procedure in cases of recurrence in dogs with perineal hernia.     

Evaluation of concurrent perineal hernia in adult male dogs presenting with nontraumatic,acquired inguinal hernias

A possible association between the development of nontraumatic, acquired inguinal hernias (NAIH) and perineal hernias (PH) has been postulated in adult dogs. The objective of this study was to evaluate the frequency of concurrent diagnosis of PH in dogs presented with NAIH and determine potential risk factors for concurrent PH and NAIH. Medical records of adult male dogs presented for NAIH to 4 hospitals between 2007 and 2017 were retrospectively reviewed. Twenty-one dogs with NAIH were included, 8 of which had concurrent PH. There were no significant differences between dogs with and without PH; however, among dogs with both conditions, intact dogs (8.1 ± 1.4 years) were younger than neutered dogs (11.7 ± 1.0 years; P = 0.007). Thirty-eight percent of male dogs presenting for NAIH had concurrent PH, indicating that these conditions commonly occur together. Dogs presenting for NAIH should be carefully evaluated for concurrent PH before surgical intervention.     

Limited open reduction and stabilization of sacroiliac fracture-luxations using fluoroscopically assisted placement of a trans-iliosacral rod in five dogs

Objective— To describe percutaneous fluoroscopically assisted placement of a trans-iliosacral rod to stabilize sacroiliac fracture-luxations after limited open reduction.
Study Design— Retrospective clinical case series.
Animals— Dogs (n=5) with sacroiliac fracture-luxations.
Methods— Medical records and radiographs were reviewed to evaluate implant placement, fracture reduction, pelvic canal diameter ratio, maintenance of reduction, implant stability, assessment of union, and to identify any complications. Owners were contacted to obtain long-term assessment of limb function.
Results— Dogs weighed between 6 and 31 kg. Trans-iliosacral rods were placed correctly traversing the sacral body. Mean (±SD) percent reduction of the sacroiliac joint was 92.9±6.6%. Pelvic canal diameter ratio did not differ significantly between time periods. With the exception of 1 dog, which died in the early postoperative period, all sacroiliac fracture-luxations healed without appreciable complications. Three dogs were sound and 1 dog had a subtle lameness at final physical and radiographic examination (mean±SD: 217±205 days). Owners assessed their dog's limb function (mean±SD: 355±205 days) as good or excellent.
Conclusions— Trans-iliosacral rods can be accurately placed using intraoperative fluoroscopy after limited open reduction of sacroiliac fracture-luxations. Trans-iliosacral rods provided bilateral secure fixation, allowed early weight-bearing and dogs consistently had good long-term clinical results.
Clinical Relevance— Trans-iliosacral rods are suitable implants for the stabilization of sacroiliac fracture-luxations, particularly in dogs with bilateral fracture-luxations and/or concurrent musculoskeletal injuries.     

Autologous tunica vaginalis communis flap for repairing an abdominal wall hernia in a dog

An 8-year-old, intact male miniature dachshund dog, weighing 8.6 kg, was presented with a soft swelling in the caudal abdominal region, including both sides of the groin area. Laparotomy revealed a severe caudal abdominal wall hernia with atrophy of the rectus abdominal muscle. The defect was repaired using a tunica vaginalis communis flap following a standard open prescrotal castration. There were no complications or recurrence of the hernia at 11 months after surgery. This surgical technique involves autogenous reconstruction, is easy to perform, and requires minimal dissection. The tunica vaginalis communis flap has potential clinical applications for repairing caudal abdominal wall hernias in male dogs.     

Surgical treatment of lumbosacral foraminal stenosis using a lateral approach in twenty dogs with degenerative lumbosacral stenosis

Objectives— To describe clinical signs, magnetic resonance imaging (MRI) and surgical findings using a lateral approach to the lumbosacral intervertebral foramen and to evaluate clinical outcomes in dogs with or without concurrent dorsal decompression and annulectomy.
Study Design— Retrospective study.
Animals— Dogs (n=20) with degenerative lumbosacral stenosis (DLSS).
Methods— Medical records (2002–2006) of dogs that had lumbosacral lateral foraminotomy alone or in combination with dorsal decompression were reviewed. Degree of dysfunction was assessed separately for each pelvic limb; dogs with unilateral signs were included in group A, those with bilateral signs in group B. Retrieved data were: signalment, history, neurologic status on admission, 3 days, 6 weeks, and 6 months postoperatively, duration of clinical signs, results of MRI, surgical site(s), intraoperative findings, and outcome.
Results— Based on the clinical and MRI findings unilateral foraminotomy was performed in 8 dogs, bilateral foraminotomy in 1 dog, unilateral foraminotomy with concurrent dorsal decompression in 7 dogs, and bilateral foraminotomy with concomitant dorsal decompression in 4 dogs. Surgery confirmed the presence of foraminal stenosis in all dogs, with osteophyte formation and soft tissue proliferations being the most common lesions. Outcome was good to excellent in 19 dogs and poor in 1 dog. Mean follow-up was 15.2 months (range, 6–42 months).
Conclusion— Lateral foraminotomy addresses compressive lesions within exit and middle zones of the lumbosacral foramen.
Clinical Relevance— Successful surgical management of DLSS is dependent on recognition and correction of each of the compressive lesions within the lumbosacral junction.     

Standing laparoscopic herniorrhaphy in stallions using cylindrical polypropylene mesh prosthesis

Standing laparoscopic herniorrhaphy was performed in 9 stallions. Appropriate analgesia was achieved by sedation with detomidine and local flank infiltration with mepivacaine. Three portal sites at the paralumbar fossa were used to perform the herniorrhaphy by means of triangulation. A cylindrical polypropylene mesh was inserted and fixated in the inguinal canal. Subsequent adhesion formation resulted in an obliterated inguinal canal within 2 weeks. This minimal invasive technique allowed us to perform a testis sparing herniorrhaphy in the standing horse.     

Comparison of herniorrhaphy versus clamping of umbilical hernias in horses: a retrospective study of 93 cases (1982-1994).

Many uncomplicated umbilical hernias have been managed successfully in foals by the application of a hernia clamp. Isolated reports of complications following clamp application have led some authors to suggest that it is an unsuitable method of treatment. Little information has been published comparing the complication rates associated with the use of hernia clamps and herniorrhaphy in the treatment of umbilical hernias. The purpose of this retrospective study was to report the characteristics of clinical cases of umbilical hernia and to compare the complication rates following these 2 treatment approaches. Information was collected from records or from owners to identify the occurrence of complications and owner satisfaction following treatment. Of 93 cases, 10 complicated and 18 uncomplicated hernias were treated by herniorrhaphy, 40 uncomplicated hernias were treated by clamping, 1 originally uncomplicated hernia was treated by both techniques, and 24 cases were untreated. Nineteen percent of uncomplicated hernias treated by herniorrhaphy, and 19% of those clamped developed minor complications. This study demonstrates that although minor complications may be associated with either technique, they generally do not result in significant morbidity.     

Intracapsular Prostatic Omentalization: A New Technique for Management of Prostatic Abscesses in Dogs

Twenty dogs with abscessation of the prostate gland were treated by celiotomy, drainage, and digital exploration of the gland through bilateral capsulectomy wounds. Omentum was introduced through the capsulectomy wounds and packed into the abscess cavities around the prostatic urethra. Most dogs were discharged from the hospital within 48 hours of the surgery. Long-term resolution of the problem (no recurrence within 12 months) was achieved in 19 dogs. One dog had recurrent abscessation that was managed by the placement of dependant Penrose drains. Temporary tube cystostomy was performed postoperatively in one dog for the management of transient dysuria. One dog with septic peritonitis resulting from preoperative abscess rupture was managed by concurrent open peritoneal drainage. Intracapsular prostatic omentalization was a simple and effective means of managing prostatic abscessation with minimal requirement for postoperative hospitalization of the patient. The frequency of serious complications, including postoperative urinary incontinence, was low.