Case of the month: Samuel’s Perineal Hernia
Reason for visit:
Samuel is a very fit 8.5 year male German Short Haired Pointer. His owner noticed over the previous week that he had developed a lump to the right hand side of his tail which would vary in size depending on what he was up to. He was not licking or biting at the lump and was not having any problems going to the toilet. He was otherwise his usual self.
- Samuel had a 10cm x 8cm fluctuant non painful lump to the right hand side of his tail. The lump would disappear when pushed and would pop out again when pressure was applied to his groin area.
- On rectal examination his prostate was found to be generally enlarged.
These symptoms made us very suspicious of a Perineal Hernia – a condition that occurs almost exclusively (95%) in entire male dogs who are over 5 years of age.
A Perineal Hernia occurs due to weakening and or rupture of the pelvic muscles located next to the tail. This can occur on just one side or both. The muscle damage allows various structures to prolapse including the bowel, bladder, prostate gland and fat. Trapping of the bladder or bowel in the hernia can be very serious and require emergency treatment.
The most likely causes of the Samuel’s hernia was his enlarged prostate gland putting increased pressure on the pelvic muscles combined with sex hormone imbalance causing weakening of the pelvic muscles. Other possible causes include any condition which causes chronic straining (e.g. constipation, bowel problems), and congenital and age related degenerative pelvic muscle weakness.
Pre-anaesthetic bloods, urinalysis and blood pressure testing was performed prior to surgery. All results were normal. Under general anaesthetic with intravenous fluid support Samuel was castrated and his hernia was fixed by replacing the contents of the hernia and reconstructing the damaged pelvic muscles. He went home the same day on pain relief, antibiotics and a laxative to keep his faeces nice and soft during his recovery period.
Samuel made an excellent recovery from his surgery and his stitches were removed 10 days later. The prognosis for Samuel is very good as his hernia was treated early and was relatively small, and his surgery was performed by an experienced surgeon using the technique associated with the lowest post-operative complications and reoccurrence rate.
Take home message:
Early castration (5-6 months of age) significantly reduces the risk of prostatic enlargement, perineal hernia/s, testicular cancer and has behavioral benefits. If you do not plan to breed from your dog we recommend getting him castrated early or as soon as his breeding days are over.