Ivan had major surgery at New Perth Animal Hospital earlier this week and is back home with his family, under strict doctor’s orders to rest. We think this picture arrived yesterday so that Ivan could reassure us that he is following Dr. Claudia’s instructions to the letter!
We are so thrilled to have the opportunity to care for Ivan and feel honoured that his family has entrusted his care to us. He is the sweetest little fellow (although he really does NOT like being given pills!) and we hope he continues to do well throughout his recovery. Ivan is a Papillon and an older male of perhaps 12 years. Not uncommonly, senior male dogs can develop hernias alongside their anus. Perineal hernias may be associated with hormones and may be an expression of aging and a deterioration of muscles of the pelvic diaphragm.
Ivan had surgery elsewhere for this condition for the first time almost three years ago. Unfortunately, hernia repair has a high risk of failure (in some studies up to 50%) and Ivan’s hernia recurred shortly afterwards. For the past few years, he had a small bulge beside his behind but it was not painful and did not seem to be slowing him down at all. Sometimes, these hernias can be medically managed through special diet and increased fibre. With increasing age and repeated surgeries, the risk of failure becomes greater.
We first met Ivan after his hernia changed and became larger and he had been diagnosed with a possible very serious complication of a perineal hernia. Ivan had developed retroflexion of his bladder, where his bladder had flipped and come down into the hernia. Statistically, this occurs in 20-25% of dogs with perineal hernias. Bladder retroflexion can require more immediate intervention because it can cause painful urination, with urine being voided drop by drop.
Ivan had two different surgeries in an attempt to correct his condition. Both surgeries were performed consecutively during the same anesthesia so keeping this little guy warm and monitoring his vital signs throughout were critical. Having dedicated technicians to monitor patients in surgery is invaluable in this regard. The first surgery was a cystopexy designed to create a permanent adhesion between his bladder and his abdominal wall. This means we want the bladder to actually stick to the body wall so it cannot flip backwards and put pressure on the area of the hernia repair. His second surgery was directed at closing the hernial opening and required moving muscle bellies into new positions and suturing them together. Ivan received intravenous fluids, antibiotics to guard against infection, and pain medications to keep him comfortable.
At this point, Ivan is doing very well and we are cautiously optimistic. His family recently told us that there is no longer any “bulge” and they “can hear his pee hit the ground for the very first time!” so we know his bladder is in its proper place and he is urinating more normally. We wish him a speedy and uneventful recovery and look forward to his next visit.