Preputial damage and lateral penile displacement during castration in a degu

CASE DESCRIPTION: A 2-month-old male degu was treated for preputial damage and lateral penile displacement that occurred during attempted castration. CLINICAL FINDINGS: Bruising and swelling of the prepuce and severe edema to the left of the prepuce were evident. The penis could not be extruded from the prepuce. Radiography revealed a large bladder. Contrast medium injected into the prepuce filled the peripreputial subcutaneous tissues. TREATMENT AND OUTCOME: During surgical exploration through a peripreputial approach, the penis was found to be completely separated from the prepuce and located in the adjacent subcutaneous tissue. The penis was repositioned in the prepuce and anchored with a suture at its base. The following day, the preputial orifice was crusted over, urine was leaking from the incision, and the penis could not be extruded from the prepuce. The anchoring suture was removed, and the tip of the penis was sutured to the preputial orifice so that the penis protruded slightly from the prepuce. Urination was normal after the second surgery. Two years later, the preputial orifice remained adhered to the distal portion of the penis and the exposed penile tissue was healthy. CLINICAL RELEVANCE: Penile displacement from the prepuce is an unusual complication of castration in degus. The surgical technique used in this animal may be an effective means of repair. Permanent exposure of the tip of the penis may be well-tolerated in degus.     

Surgical treatment of paraphimosis in a pony

Circumcision (or reefing operation) was performed on an aged pony stallion to remove excessive granulation tissue involving the preputial integument following an injury and subsequent paraphimosis. Postoperative swelling of the penis and prepuce was reduced daily with gentle massage. Initially, an improvised suspensory was used to support the penis postoperatively. The pony was able to voluntarily retract its penis six months following surgery.     

Surgical repair of urethral transection in a horse

A recently castrated horse was examined because of preputial and ventral abdominal swelling, prolapse of the preputial fold, and serosanguinous fluid dripping from the external urethral orifice. After a poor response to initial medical management, a urethral laceration was found during exploratory surgery. Half of the ventral portion of the corpus cavernosum penis had been transected. Primary closure was followed by healing without complications.     

Preputial hematoma in a stallion

An 8-year-old Quarter Horse stallion was admitted with a swelling involving the prepuce, dorsal part of the scrotum, and root of the penis. The swelling was first noticed 10 days after breeding, with no evidence that it had resulted from a kick by the mare. The penis was retracted into the prepuce, except for a 10- to 15-cm protrusion of the glans penis. Treatment included warm hydrotherapy, massage, stockinette compression, antidiuretics, antibiotics, penile support, and exercise, without success. At necropsy, a massive preputial hematoma was found extending forward from the root of the penis to 12 cm proximal to the glans penis. The exact origin of the hematoma could not be determined. Most likely, bleeding had originated from the vascular plexus lying subfascially on the surface of the penis outside the intact tunica albuginea or from a branch of the external pudendal artery.     

Iliopsoas abscess with iliac and femoral vein thrombosis in an adult Siberian husky

A nine-year-old, male Siberian husky was presented with fever, decreased appetite and activity, non-weightbearing lameness, and oedematous swelling of the right inguinal and preputial area and the right hindlimb. An abscess within the right iliopsoas muscle, with severe thrombosis of the iliac and femoral vein, was diagnosed by haematology and diagnostic imaging. The abscess and adjoining lymph node were removed surgically through a median coellotomy. The isolated pathogen was Staphylococcus intermedius. Clinical signs resolved completely after surgery. Antimicrobial therapy was continued for four weeks. Within the follow-up period of six months, no recurrence of the clinical signs was detected.     

Chronic prostatitis, cystitis, pyelonephritis, and balanoposthitis in a cat

An adult, intact male domestic shorthair presented for preputial swelling and urinary incontinence. A caudal abdominal mass was palpated. A transabdominal ultrasound examination showed severe prostatomegaly with abnormal tissue extending along the urethra. The cat was euthanized due to the owner's financial constraints and the veterinarians' suspicion of a poor long-term prognosis. Biopsies showed chronic active inflammation of the prostate, bladder, kidneys, ureters, penis, and prepuce most consistent with a chronic infectious process. Reports of feline prostatic disease of any kind are rare. Chronic prostatitis may have a more favorable prognosis than feline prostatic adenocarcinoma, currently the most commonly reported disease of the feline prostate.     

Surgical treatment of phimosis due to preputial stenosis in a Thoroughbred colt

A 6-month-old Thoroughbred colt was referred to Rossdales Equine Hospital with a recent history of discomfort and inability to protrude the penis whilst urinating, resulting in accumulation of urine within the prepuce. Careful examination and manual palpation revealed a constrictive ring of fibrous tissue at the level of the preputial orifice. With no evidence of trauma or a persistent penile frenulum, a tentative diagnosis of phimosis due to congenital preputial stenosis was made. Exploratory surgery confirmed the diagnosis and surgical transection and release of the fibromuscular ring at three sites allowed the colt to protrude the penis and urinate normally immediately post-operatively. At follow-up examination 11 months later, the colt continued to be able to extrude the penis and urinate conventionally. A slight excess of skin was present at the end of the prepuce but this was only of minor cosmetic concern.     

Anaerobic orbital abscess/cellulitis in a Yorkshire Terrier dog

A retrobulbar abscess/cellulitis occurred in a Yorkshire Terrier dog. The clinical signs were exophthalmos, prolapsed nictitating membrane and purulent ocular discharge. Ultrasonography showed a marked soft tissue swelling of the retrobulbar tissues as well as echogenic parallel lines between the globe and the medial orbital rim. Surgical exploration of the orbit was performed and no foreign body was found. The pterygopalatine fossa was incised and therapeutic retrobulbar drainage attempted. A drain was placed to encourage ventral drainage of the abscess. Anaerobic cultures revealed heavy growth of gram negative rods (prevotella bivia and prevotella buccae were isolated). Recovery was successful but subsequent treatment for keratoconjunctivitis sicca was necessary. A full recovery of tear production occurred after several weeks.     

Preputial urinary diversion to treat urine soaking during urination in a dog

A young dog was presented with a history of adopting an unusual posture to urinate, resulting in urine soaking of the ventral abdomen and caudal forelimbs. The dog was initially treated surgically with cranial advancement of the prepuce, which did not resolve the problem. Further surgery was then successfully carried out to create a more caudal preputial orifice, which angled the penis ventrally when extruded, directing urine away from the body. At follow-up clinical examination, the dog was clinically normal.     

Ultrasound-guided retrieval of plant awns

In dogs, surgical removal of plant awns causing a foreign body granuloma or abscess may be challenging. The inability to localize the foreign body during surgical removal often leads to abscess recurrence. In this report, we describe ultrasound-guided retrieval as an alternative to standard surgical retrieval in animals where the plant awn can be identified sonographically. This procedure was used in six dogs with a superficial abscess due to a plant awn, and in all dogs the foreign body was successfully retrieved with Hartmann forceps. No complication was observed and no abscess recurred. Minimally invasive ultrasound-guided plant awn retrieval appears to be a safe effective method of retrieving superficially located plant awns in the dog.     

Surgical correction of a congenital preputial and penile deformity in a dog

An 11-month-old, intact male Great Pyrenees was presented for recurrent, nonpainful accumulation of suppurative fluid within the prepuce. Surgical exploration revealed a continuation of the urethral mucosa with the cutaneous epidermis of the prepuce, thus creating a closed preputial cavity surrounding the penis where fluid could accumulate. A persistent frenulum and a previously undescribed tissue remnant connecting the dorsal and distal aspects of the penis to the dorsal wall of the prepuce were also present. Surgical correction of the preputial and penile deformity, along with correction of the resulting paraphimosis and pendulous prepuce that became apparent following the initial surgery, are discussed.     

Surgical treatment of 45 horses affected by squamous cell carcinoma of the penis and prepuce

The medical records of 45 horses treated for suspected squamous cell carcinoma of the penis and/or prepuce were reviewed. The age of 40 horses was known, and these had a mean age of 17.4 years. The duration of neoplasia was known for only 3 of the 45 horses. The results of histological evaluation of lesions, available for 35 horses, confirmed that the diseased tissue was squamous cell carcinoma. The location of gross neoplastic lesions was recorded for 43 horses; the glans penis was involved in 24 horses, the body of the penis or the inner lamina of the preputial fold in 27 horses, and the external fold of the prepuce in 10 horses. Surgical treatments of these horses included phallectomy (penile amputation) in 35 horses, segmental posthectomy in 4 horses, phallectomy plus segmental posthectomy in 2 horses, and en bloc resection of the penis, prepuce and superficial inguinal lymph nodes with penile retroversion in 4 cases. Short-term complications in the immediate postoperative period included preputial oedema and haemorrhage at the end of urination. One horse developed acute urinary retention because of severe urethral oedema. Long-term (>1 year) follow-up information was obtained for 31 horses. Neoplasia of the penis and/or prepuce recurred in 6 of these 31 horses (19%), and in 5 of these the recurrence necessitated euthanasia of the horse.     

A case of hypospadias in a dog

: This clinical case report described a three-month-old mongrel dog that had the urethral orifice opening 3 cm from the tip of the penis and lacked a completely formed preputial sheath. It was presented to the clinic with an exposed penile shaft that was dry. The dog had urinary incontinence that was not of neurological origin. It also had unilateral agenesis of the right testicle. The preputial sheath was successfully reconstructed. Urinary incontinence stopped soon after surgery, suggesting that it had been probably due to an ascending urethritis. A large preputial opening was left because of the location of the urethral opening.     

Penile prolapse and urethral obstruction secondary to lymphosarcoma of the penis in a dog

A 5-year-old Chihuahua presented for clinical signs of dysuria and penile prolapse. Radiographic studies identified a urethral obstruction distal to the junction of the proximal and middle third of the os penis that appeared to be secondary to swelling of the penis. Penile resection combined with a scrotal urethrostomy was performed. Histopathological examinations of tissue samples of the body of the penis revealed lymphosarcoma. Lymphosarcoma of the penis is a rare finding in all species. It can occur as a primary tumor of the penis in dogs. Penile lymphosarcoma should be considered in the differential diagnosis of dogs affected with penile prolapse and dysuria.     

Treatment of a sole abscess in an Asian elephant (Elephas maximus) using regional digital intravenous perfusion.

Regional digital i.v. perfusion was used to treat a severe sole abscess associated with a wire foreign body in a 19-yr-old female Asian elephant (Elephas maximus) housed at the Paris Zoo. The cow presented with acute right forelimb lameness and swelling that persisted despite 4 days of anti-inflammatory therapy. Under anesthesia, a 10- x 0.5- x 0.5-cm wire was extracted from the sole of the right foot. There was a 2-cm-deep, 7-cm-diameter abscess pocket that was subsequently debrided. Regional digital i.v. perfusion was performed and repeated 15 days later, using cefoxitin and gentamicin on both occasions. Between treatments, the cow received trimethoprim-sulfamethoxazole and phenylbutazone orally. Within 2 days of administering anesthesia and the first perfusion treatment, the lameness improved dramatically. When phenylbutazone was discontinued 1 wk after the first treatment, the lameness had completely resolved. At the second treatment, there was no evidence of further soft tissue infection, and the abscess pocket had resolved.     

Combined preputial advancement and phallopexy as a revision technique for treating paraphimosis in a dog

A 7‐year‐old neutered male Jack Russell terrier‐cross was presented for signs of recurrent paraphimosis, despite previous surgical enlargement of the preputial ostium. Revision surgery was performed using a combination of preputial advancement and phallopexy, which resulted in complete and permanent coverage of the glans penis by the prepuce, and at 1 year postoperatively, no recurrence of paraphimosis had been observed. The combined techniques allow preservation of the normal penile anatomy, are relatively simple to perform and provide a cosmetic result. We recommend this combination for the treatment of paraphimosis in the dog, particularly when other techniques have failed.     

Hypospadias in a Himalayan cat

A one-year-old male Himalayan cat was presented with a history of chronic cystitis. Physical examination revealed that the cat had hypospadias. It was postulated that the abnormal urethral opening on the ventral aspect of the penis permitted faecal contamination of the preputial area and gave rise to the ascending infection. The hypospadias was surgically corrected and a complete recovery was achieved.     

Use of Intraoperative Ultrasonography to Identify a Cervical Foreign Body A Case Report

Real-time ultrasound was used to identify a foreign-body abscess causing an extraluminal esophageal obstruction in the neck of a horse. Surgical exploration to remove the foreign body and drain the abscess was performed after 2 months of medical management that had failed to resolve the problem. The abscess could not be visualized because there was no draining tract or other localizing sign of inflammation. Ultrasound was used aseptically to guide surgical dissection to the walled off abscess with minimal damage to adjacent vital structures in the surgical field. The signs of esophageal obstruction abated and have not recurred in 15 months.     

Brain abscess in seven cats due to a bite wound: MRI findings, surgical management and outcome

PRESENTATION AND LESION LOCALISATION: Seven adult domestic shorthair cats were presented with a 1- to 6-day history of progressive neurological signs. A focal skin puncture and subcutaneous swelling over the dorsal part of the head were detected on physical examination. Neurological examination indicated lesion(s) in the right forebrain in four cats, multifocal forebrain in one cat, left forebrain in one cat, and multifocal forebrain and brainstem in the remaining cat. In all cats, magnetic resonance imaging revealed a space-occupying forebrain lesion causing a severe mass effect on adjacent brain parenchyma. CLINICAL APPROACH AND OUTCOME: All cats were managed with a combination of medical and surgical treatment. At surgery a small penetrating calvarial fracture was detected in all cats, and a tooth fragment was found within the content of the abscess in two cats. The combination of surgical intervention, intensive care and intravenous antimicrobials led to a return to normal neurological function in five cats. PRACTICAL RELEVANCE: As this series of cases indicates, successful resolution of a brain abscess due to a bite injury depends on early recognition and combined used of antimicrobials and surgical intervention. A particular aim of surgery is to remove any skull and foreign body (tooth) fragments that may represent a continuing focus of infection.     

Penile self-mutilation as an unusual sign of a separation-related problem in a crossbreed dog

A two-year-old, male, crossbreed dog was presented for evaluation of licking, biting and severe self-mutilation of its penis, which resulted in ulcers and haemorrhagic preputial discharge. History revealed signs of separation anxiety such as active greeting behaviour, excessive vocalisation and intermittent episodes of licking of the penis when the dog was left alone. The owner reported that he had been hospitalised after a car accident, and he had no chance of seeing the dog. During that time, the behaviour progressed to frequent episodes of licking and biting of the penis. Three weeks of treatment with clomipramine in addition to the presence of the dog's brother, who was brought into the dog's living environment, appeared to produce a considerable degree of improvement. The purpose of this report is to contribute to an increased awareness within veterinary practice of unusual signs of separation anxiety such as penile self-mutilation.