Perineal hernia results from weakening or complete failure of the muscular diaphragm of the pelvis. Normally, the pelvic diaphragm allows for rectal support and keeps the abdominal contents from encroaching on the rectum. Pets with perineal hernias will demonstrate a swelling adjacent to the rectum on one or both sides. The underlying cause for weakening or failure of the pelvic diaphragm is unclear at this time, although hormones are thought to play a significant role. The disease primarily affects older pets, usually between the ages of 7 to 9 years. Non-castrated male dogs and cats are also over-represented.
The swelling may contain herniated abdominal and pelvic canal contents, such as a dilated rectum, prostate, urinary bladder, fat and small intestine. Clinical signs seen in pets with perineal hernias are related to the organs entrapped in the hernia. Typically, these signs include constipation, straining to defecate and / or urinate, inability to urinate, abdominal pain, anorexia and altered tail carriage.
Diagnosis of perineal hernia involves a thorough examination of the patient, including rectal examination. Ultrasound and abdominal X-rays are helpful to determine hernia contents, bladder position and size, colon position and size, prostate disease, or the presence of cancer. A routine blood screen is also indicated.
Treatment of non-emergency cases may consist of either medical or surgical management. Medical therapy is indicated for preparing a patient for surgery, but is generally unsuccessful at permanently controlling the disease process. Medical management will consist of a combination of enemas, stool softeners, intravenous fluid therapy, dietary management, and pain relief. Important: If a patient is showing signs of abdominal pain, inability to urinate, or where there is suspicion of a strangulated loop of intestine, then emergency surgery is indicated to rectify the underlying pathology. This surgery is sometimes done as a separate procedure prior to the repair of the perineal hernia.
Perineal hernia surgery is aimed at repairing the pelvic diaphragm and placing the hernial contents back in their correct position. It is recommended that all patients be castrated (if not already) during the surgical procedure to help decrease the risk of reoccurrence. All patients will receive pain medications to reduce their post-operative discomfort. Dietary modification with a high fibre diet, coupled with stool softeners are used to help with reducing the pain and straining associated with defecation. In addition, they help to reduce the potential for breakdown of the repaired tissue. Your pet should be kept calm and quiet for the first two weeks after surgery to allow for tissue healing. A collar is necessary to prevent the patient interfering with the surgical site. Cold compresses applied to the surgical site help diminish swelling and perineal irritation.
For more information or to discuss this surgery in more detail with one of our veterinary surgeons please contact us on 015394 88555 or visit the referrals section of our website at www.oakhillvetgroup.co.uk
What is included?
At Oakhill Vets we strive to ensure our surgeries are ‘all inclusive’ and so this surgery INCLUDES the following:
- Pre-anaesthetic blood screen (as required)
- Hospitalisation (up to 24 hours)
- Intravenous fluids during the anaesthetic and surgery
- General Anaesthesia
- Post-operative medication (for up to two weeks)
- 24-hour post-operative laser / cold-pack treatment
What is not included?
Perineal hernia surgery typically involves placing sutures to restore the pelvic diaphragm and the incorporation of an internal obturator muscle flap to bolster the repair. The internal obturator is a muscle that is elevated from the floor of the pelvis. Our fees do not include the placement of surgical mesh or muscle grafting techniques sometimes indicated in severe cases or cases that have failed initial repair. Post-operative complications are not common, but are possible. While we endeavour to give you an upfront, all-inclusive estimate, when it comes to pets recovering from surgery there is unfortunately an element of unpredictability! Complications, which may incur additional costs include (but are not limited to):
- Reherniation; In 10-15% of the cases, recurrence of the hernia may occur within a year.
- Perineal hernias may cause constipation, which in turn, may permanently damage the motility function of the colon.
- Perineal hernias may also disrupt your pet’s ability to urinate. Occasionally excessive straining may cause the urinary bladder to retroflex (flip over backwards into the pelvic canal) leading to urinary obstruction and potentially permanent loss of blood supply to the bladder.
- Entrapment of a loop of intestine into the hernia may cause permanent loss of the blood supply.
- Self-trauma by pet to surgical site
- Post-operative wound infection
Payment is expected in full at the time of consultation or upon discharge from Oakhill Vets. If your pet is insured we would request that you pay for your their treatment and claim the funds back from your insurance company. Once you have settled the cost of any treatment we can help you complete your insurance claim form(s) at no additional charge. Direct claims may be arranged with some insurance companies and are subject to a check with our referral coordinators prior to your appointment. An administration fee is chargeable each time a direct claim is carried out by our referral coordinators. If you have any concerns about payment then please contact us prior to your consultation.
Why choose Oakhill Veterinary Referrals?
Oakhill Vets is based in Windermere in the beautiful Lake District. We are happy to take referrals from clients further afield. Let our friendly, highly skilled and experienced team of Veterinary Surgeons and Registered Veterinary Nurses look after your pet while you relax and enjoy a short break in The Lakes. For more details please phone the practice and speak to one of our helpful referral coordinators on 015394 88555.