Sciatic perineal hernia in two dogs

A sexually intact, male Chihuahua and a spayed female poodle were presented with left perineal masses. The masses were identified as perineal hernias by rectal palpation. Surgical exploration of the perineal region in each dog revealed retroperitoneal fat protruding between the sacrotuberous ligament and the coccygeus muscle (sciatic perineal hernia). The hernias were repaired using modifications of the standard or internal obturator flap herniorrhaphies. The levator ani muscle was grossly and histologically normal in the Chihuahua and grossly normal in the poodle. No short- or long-term complications were reported in either case. The management of sciatic perineal hernia is similar to the more common caudal perineal hernia.     

Serum testosterone and estradiol 17-beta concentrations in 15 dogs with perineal hernia

Serum testosterone and estradiol 17-beta concentrations, and serum testosterone-to-estradiol ratio were evaluated in 15 dogs (greater than or equal to 5 years old) with perineal hernia (9 sexually intact males and 6 castrated males) and in 9 clinically normal sexually intact male dogs greater than or equal to 5 years old. There was no significant difference in serum testosterone-to-estradiol ratio between sexually intact male dogs with perineal hernia and clinically normal sexually intact male dogs. In castrated dogs with perineal hernia, serum testosterone concentration and testosterone-to-estradiol ratio were significantly (P less than 0.05) lower, compared with those values in sexually intact dogs with perineal hernia and in clinically normal sexually intact male dogs. There was no significant difference in serum estradiol 17-beta concentration among sexually intact male dogs with perineal hernia, castrated dogs with perineal hernia, and clinically normal sexually intact male dogs. Serum testosterone and estradiol 17-beta concentrations in dogs with perineal hernia did not differ from those values in clinically normal male dogs of the same age. Castration cannot be recommended for the treatment of perineal hernia unless a castration-responsive contributing factor such as prostatomegaly is identified, unless the pelvic diaphragm of dogs with perineal hernia has high sensitivity to normal or low serum testosterone and estradiol 17-beta concentrations, or unless there is documentation that other androgens and/or estrogens are involved.     

A percutaneous perineal approach for cystoscopy in male dogs

A percutaneous perineal approach is presented as a further technique for rigid cystoscopy in male dogs. The anatomy of the urethra in the male dog prevents rigid cystoscopy by non-surgical means but a fine flexible fibrescope may be used. Perineal urethrotomy and prepubic percutaneous puncture techniques using rigid endoscopes have been described; however, both have possible serious complications. This new procedure allows access for visual examination, biopsy and resection as necessary and appears to have few adverse sequelae.     

Use of canine small intestinal submucosa allograft for treating perineal hernias in two dogs

Here, we describe two dogs in which canine small intestinal submucosa (SIS) was implanted as a biomaterial scaffold during perineal herniorrhaphy. Both dogs had developed severe muscle weakness, unilaterally herniated rectal protrusions, and heart problems with potential anesthetic risks. Areas affected by the perineal hernia (PH) located between the internal obturator and external anal sphincter muscles were reconstructed with naïve canine SIS sheets. In 12 months, post-operative complications such as wound infections, sciatic paralysis, rectal prolapse, or recurrence of the hernia were not observed. Symptoms of defecatory tenesmus also improved. Neither case showed any signs of rejection or specific immune responses as determined by complete and differential cell counts. Our findings demonstrate that canine SIS can be used as a biomaterial scaffold for PH repair in dogs.     

Small-intestinal volvulus as a complication of acquired inguinal hernia in two horses

Volvulus of the small intestine was diagnosed as a complication of acquired inguinal herniation in 2 horses. One of the horses continued to have signs of pain after reduction of the hernia. The volvulus was diagnosed at a second surgery, but the intestine was devitalized, and the horse was euthanatized. Ventral midline exploratory surgery was performed on the second horse, in conjunction with an inguinal approach. The small-intestinal volvulus was diagnosed and corrected at this time. It is suggested that ventral midline abdominal exploration be performed when acquired inguinal herniation causes acute small-intestinal obstruction in horses.     

Evaluation of estrous activity in bitches treated with mibolerone and exposed to adult male dogs

Over approximately a 16-month period, adult male dogs had no influence on estrous activity in bitches treated with an estrus prevention agent (mibolerone). In addition, there was no obvious effect on interestrous interval in untreated bitches.     

Skull typology of adult male Kangal dogs

In this study, a total of 16 skulls of the adult male Kangal dog were used. Craniometric measurements for 44 different parts of the skull were made. All investigated features were expressed as mean +/- SD. Cephalic indices and ratios were calculated. These indices and ratios have been compared with the average values of indices calculated for other breeds. A skull index of 50.29 +/- 1.033, a cranial index of 46.05 +/- 2.213, a facial index of 99.62 +/- 3.891, a facial index-1 of 81.67 +/- 3.667, a basal index of 28.71 +/- 1.425, a basal index-1 of 57.91 +/- 1.365, a length-length index-2 of 1.08 +/- 0.045, a length-width index-2 of 1.99 +/- 0.041, a length-width index-4 of 2.18 +/- 0.108, a palatal index-1 of 62.24 +/- 2.528, a palatal index-2 of 65.37 +/- 2.208, a palato-basal ratio of 55.44 +/- 1.975, a palato-basal ratio-1 of 54.47 +/- 1.716, a palato-palatine ratio of 33.71 +/- 0.860, a palato-palatine ratio-1 of 34.30 +/- 0.733, a cranio-facial ratio of 107.87 +/- 4.819 and a cranio-facial ratio-1 of 144.17 +/- 8.099 were obtained. When the skull, cranial and facial indices were considered together with the other calculated indices and ratios, it was clear that the skulls of the Kangal dogs have to be regarded as of dolichocephalic type. Kangal dogs, with their mastiff-like appearance and massive head, are shown in this study to be typical of a dolichocephalic breed.     

Effects of milbemycin oxime on adult hookworms in dogs with naturally acquired infections

Previous work indicated that adult Ancylostoma caninum can be removed from experimentally infected dogs, using a formulation of milbemycin oxime at dosage of 0.5 mg/kg of body weight. To determine the efficacy of this treatment in dogs naturally infected with adult hookworms, 24 mixed-breed dogs with patent hookworm infections were purchased from an out-of-state vendor, and 6 male and 6 female dogs were assigned to either a control group or a group that would be treated. Dogs were treated 10 days after their arrival and were euthanatized 1 week after treatment. Beginning 3 days before treatment, fecal samples were collected daily from all dogs, and the number of Ancylostoma eggs per gram of dry weight of feces was determined from each sample. By 1 week after treatment, the mean number of eggs being passed by the treated dogs had dropped from 12,700 to 10 eggs/g of dried feces; there was no apparent change in fecal egg counts for dogs of the control group. At necropsy, the mean number of adult A caninum in dogs of the treated and control groups was 1.3 and 56, respectively; in these naturally infected dogs, efficacy of treatment was calculated to be 97.8%. The mean number of adult Trichuris vulpis recovered in dogs of the control and treated groups at necropsy was 24 and 0, respectively, which yielded treatment efficacy of 100%. Although Uncinaria stenocephala and Toxocara canis appeared also to be removed by use of this dosage, too few dogs were in the study to calculate meaningful efficacies.(ABSTRACT TRUNCATED AT 250 WORDS)     

Diaphragmatic and perineal hernias associated with cutaneous asthenia in a cat

An 11-year-old cat was evaluated because of dyspnea. Since 11 months of age, the cat had hyperextensibility of the skin consistent with cutaneous asthenia. Radiographic examination revealed a diaphragmatic hernia with intestinal loops in the thorax. Electron microscopic examination of skin specimens revealed collagen fibers of highly variable diameter, consistent with cutaneous asthenia. The diaphragmatic hernia was surgically repaired and healed well. Four weeks later, a left-sided perineal hernia was repaired surgically, and 4 months later, a right-sided perineal hernia was repaired surgically and colopexy and cystopexy were performed. All surgical procedures were successful and tissues healed well. Dermatosparaxis is a rare hereditary disorder that commonly results in cutaneous fragility and hyperextensibility in affected animals. The diagnosis depends on clinical findings and light and electron microscopic changes in affected tissues. Surgical repair can be performed successfully in an affected cat, and healing of incisions can occur without complications.     

Surgical treatment of acquired inguinal hernia in the horse: a review of 51 cases

During a seven year period, 51 cases of acquired inguinal herniation in 50 stallions were treated surgically. In 25 cases the herniated loop was ileal, in the other 26 it was jejunal. In cases of strangulation, the vaginal ring was enlarged by incising the peritoneum and transverse fascia. Closure of the superficial inguinal ring was advisable to prevent the hernia recurring. In all cases unilateral castration was performed. Laparotomy was carried out in 33 cases; 22 required intestinal resection and in four cases a bypass was made. Follow-up at least six months postoperatively indicated that surgery had been successful in 76 per cent of the cases treated.     

Massive hematuria of nontraumatic renal origin in dogs

Massive hematuria of renal origin was diagnosed in 4 dogs. In all dogs, blood and blood clots were clearly visible in the urine. Serum urea nitrogen and urine concentrating ability were normal. All dogs were anemic, and results of coagulation and platelet function tests were within normal limits. Excretory urography indicated hydroureter and hydronephrosis in all dogs, with filling defects in the bladder attributable to large blood clots in 2 dogs. Cystotomy and catheterization of the ureters enabled identification of one kidney as the source of bleeding in 3 dogs. Unilateral nephrectomy and ureterectomy resolved their hematuria. The results of histologic examination were normal in 2 dogs. The 3rd dog had evidence of pyelitis. Cystoscopy of the 4th dog did not reveal hematuria from either ureter. The dog was not operated on and it continued to have intermittent hematuria.     

Expression of relaxin receptor LRG7, canine relaxin, and relaxin-like factor in the pelvic diaphragm musculature of dogs with and without perineal hernia

OBJECTIVES: To compare the expression of canine relaxin, relaxin-like factor (RLF), and relaxin receptors within the muscles of the pelvic diaphragm of dogs with perineal hernia (PH) and clinically normal dogs. STUDY DESIGN: In vivo comparative study. ANIMALS: Fifteen client-owned intact male dogs with PH were studied. Four mature intact male dogs with no evidence of perineal pathology served as controls. METHODS: Biopsy samples from the levator ani, coccygeus, and internal obturator muscles were obtained. RNA samples were reverse transcribed and analyzed by real-time PCR for the expression of canine relaxin receptor LRG7, relaxin, and RLF. RESULTS: Significantly higher expression levels of canine relaxin receptors occurred in the musculature of the pelvic diaphragm and internal obturator muscle in dogs with PH compared with normal dogs. Expression of canine RLF revealed no significant difference between dogs with PH and controls. The difference in the expression of canine relaxin between groups was not statistically significant. CONCLUSIONS: Relaxin receptor up-regulation occurs in the coccygeus, levator ani, and internal obturator muscles of dogs with PH. CLINICAL RELEVANCE: The higher expression of relaxin receptors within the muscles of the pelvic diaphragm in dogs with PH suggests that relaxin might play a role in the pathogenesis of PH. Atrophy of these muscles, which predisposes to PH, may be attributable to increased relaxin activity.     

Congenital pleuroperitoneal hernia presenting as gastrothorax in five cavalier King Charles spaniel dogs

Five cavalier King Charles spaniels were examined for acute onset of respiratory distress. Thoracic radiographs demonstrated diaphragmatic hernia and tension gastrothorax, visible as a distended stomach occupying the left caudal thoracic cavity. Exploratory midline coeliotomy confirmed congenital pleuroperitoneal diaphragmatic hernia with herniation and dilatation of the stomach. The hernia configuration was consistent in all cases, with a defect affecting the left diaphragmatic crus. Congenital pleuroperitoneal diaphragmatic hernia is a rare condition caused by a defect in the dorsolateral diaphragm. Defects of the left crus of the diaphragm could result in the herniation of the stomach into the thoracic cavity with possible subsequent tension gastrothorax. Cavalier King Charles spaniels may have a predisposition to this condition. Tension gastrothorax is an acute life‐threatening consequence of gastric herniation through a diaphragmatic defect that must be promptly recognised and surgically treated.     

Epidermal growth factor and active caspase-3 expression in the levator ani muscle of dogs with and without perineal hernia

Objectives : To perform a histological and immunohistochemical study of epidermal growth factor, transforming growth factor‐alpha and their receptor, as well as the apoptotic signal active caspase‐3 in the levator ani muscle of dogs with and without perineal hernia. Methods : Biopsy specimens of the levator ani muscle were obtained from 25 dogs with perineal hernia and 4 non‐affected dogs and were processed for Masson and immunohistochemical staining. Results : The affected dogs exhibited myopathological features, internalised nuclei, destruction and abnormal size of muscle fibres, which were replaced by collagen. The immunohistochemical study revealed active caspase‐3, epidermal growth factor, transforming growth factor‐alpha and epidermal growth factor receptor in the levator ani. Compared to the healthy muscle, transforming growth factor‐alpha staining intensity was lower in the affected muscle, whereas epidermal growth factor receptor and active caspase‐3 staining were higher. Clinical Significance : Pelvic diaphragm muscle weakening is the leading cause of perineal hernia in the dog. Survival and death signals expressed in these muscles may contribute to the pathogenesis of this disease. This study reports epidermal growth factor, transforming growth factor‐alpha and epidermal growth factor receptor immunohistochemical expression in the skeletal muscle and suggests that perineal hernia in the dog is accompanied by levator ani muscle atrophy, increased expression of epidermal growth factor receptor, caspase‐3 activation, and decreased expression of transforming growth factor‐alpha.     

Use of laparotomy in a staged approach for resolution of bilateral or complicated perineal hernia in 41 dogs

OBJECTIVE: To evaluate the value of laparotomy as the initial step in the treatment of bilateral or complicated perineal hernia (PH) in dogs. STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: Forty-one dogs with PH. METHODS: Dogs with bilateral or complicated PH treated by a 2-step approach between November 1997 and December 2001 were studied. Inclusion criteria for complicated PH were: recurrence of PH, unilateral PH with a major rectal dilatation, PH with a concurrent surgical prostatic disease, and PH with retroflexed bladder. Colopexy, vas deferens pexy, cystopexy, and prostatic omentalization were performed during laparotomy as needed. Later, PH was performed by internal obturator muscle flap (IOMF) or if there was a perineal rent or weakness on the contralateral side, appositional herniorrhaphy was performed. Outcome was followed for >/=6 months. RESULTS: PH were bilateral (20 dogs) or unilateral (21). Twenty-one (51%) dogs had prostatic disease (clinical or ultrasonography diagnosis; 17 confirmed histologically) and 12 (29%) had urinary bladder retroflexion. Forty-one colopexies, 32 vas deferens pexies, 6 cystopexies, and 9 prostatic surgeries (omentalization or perineal cyst resection) were performed. PH was performed 2-20 days (median, 6 days) later: 61 IOMF transpositions, 13 appositional. Mean follow-up time was 26.6 months (range, 6-54 months, median, 27 months). PH was resolved in 37 (90%) dogs; 4 dogs had recurrence, and all occurred within 6 months. Thirty-eight (92%) dogs had an improved quality of life (good in 34 dogs, fair in 4 dogs). Wound complications occurred in 7 dogs (17%). Postoperative urine dribbling occurred in 15 dogs (37%) and was irreversible in 7 dogs (17%). Postoperative fecal straining persisted in 18 dogs (44%), and was permanent in 4 dogs (10%). Fecal incontinence did not occur. CONCLUSIONS: In bilateral or complicated PH, fixation of the urinary bladder and colon, and treatment of prostatic disease increase the chances of resolution. Emptying of the perineal space by organ pexy allows improved observation during herniorrhaphy. Despite a 90% clinical resolution, dogs with complicated PH treated by a 2-step protocol may have persistent urinary and fecal disorders. CLINICAL RELEVANCE: To improve the prognosis of bilateral or complicated PH, investigation and treatment of concomitant lesions (rectal, prostatic, bladder) should be part of a rational surgical strategy using a 2-step protocol.