Posted By: Gudi - Vet

Yorkie needs some help

Very often, when pets are ill, it is immediately apparent. Their worried owners know straightaway that something isn’t right and bring them to see us at the surgery. Sometimes, however, issues can develop so gradually that it is difficult to be sure there is a problem until it is quite advanced, even for the most diligent owners. This was the case for Yorkie, the tiny Maltese-Yorkshire Terrier cross.

We saw Yorkie in January this year for his annual health check and booster vaccination. During his thorough examination Yorkie appeared very fit and well for an eleven-year-old dog – he was bright and lively and in good condition, with no problems apparent. His owners were generally happy with him at home but they did mention that he had occasionally had episodes of appearing constipated over the previous year.

Yorkie had his booster and we advised his owners that the problem with his toileting might be a concern if it persisted. We made a plan to trial a stool softener to see if this would ‘help things along’ but we recommended that we see Yorkie again if the issue continued.

Over the following few weeks Yorkie’s owners felt that the trial treatment hadn’t really helped. They also noticed that he seemed a bit swollen around his bottom, and as the days went on they definitely felt that the swelling was starting to increase in size dramatically, so they brought him back to see us.

This time, when we examined Yorkie, his problem was clear – he had a large swelling on the left side of his bottom and he seemed quite sorry for himself. His owners were very worried about him as he was straining to poo and was only able to pass small amounts at a time. They were understandably concerned that the swelling might be something sinister. Indeed, there are a number of possible causes of a swelling like the one Yorkie had, including certain types of tumour. However, we felt the most likely cause of Yorkie’s issues was a perineal hernia, where the muscles of the pelvic floor become weakened, stretch and eventually split.

Perineal hernias are most likely to occur in older, unneutered male dogs, as it is thought that the muscle weakness is caused by the long-term effects of the male reproductive hormones, so Yorkie was definitely a candidate for the condition. In many cases, we would be able to confirm our suspicions straightaway with a brief internal examination, but with Yorkie weighing in at just over 3kg, smaller than most cats, this would be too uncomfortable for him without sedation.

So Yorkie returned the next day and we were able to more thoroughly examine him while he was deeply sedated. As suspected we found that the muscles of his pelvic floor and rectal wall on the left side were completely ruptured. This meant that there was no strength to constrict his rectum on that side, and it had dilated to form a large pouch. This had occurred over many months as the pouch had gradually stretched and filled with faeces. This must have been very uncomfortable for Yorkie. With him still sedated, we were able to provide some temporary relief by evacuating all the accumulated faeces and giving him an enema to help over the following few days.

Yorkie needed urgent surgery to repair his hernia. Not only would it simply get worse if left, but there was a risk that the bladder or other internal organs could become trapped in the hernia, which would be a life-threatening emergency. However, this surgery is not without its risks – there is the possibility of damage to vital nerves in the area and, because the muscles are so weakened, the repair can often breakdown. We discussed the condition and the surgery in detail with Yorkie’s owners and, although they understood the risks, they had no doubt about proceeding with Yorkie’s surgery. His surgery was booked in and he went home with a high dose of laxatives.

On the day of Yorkie’s operation he must have been thoroughly disgruntled, as he had been nil by mouth for 24 hours to reduce the amount of stool in his system – a long time for such a little dog to go without food! Because of his older age, we ran a pre-operative blood test to confirm there were no undetected health problems to affect his anaesthetic risk and, with the all-clear, he then proceeded to surgery.

His operation was pain-staking, as we carefully identified his thin perineal muscles and reconstructed them, but there were no unexpected complications and we were very pleased with the result. During the same surgery we also castrated Yorkie, to prevent any further hormonal influence on the muscles and hopefully reduce the risk of a recurrence.

After such a major operation Yorkie had a lot of recovering to do and was sent home on a combination of painkillers, antibiotics and laxatives to see him through those crucial first few days. His owners monitored him very carefully for any signs of complications and we checked him regularly at the practice. Despite all our concerns however, Yorkie bounced back remarkably – he was a happy dog again almost immediately and both his surgical wounds were healing perfectly.

A few months on, Yorkie has gone from strength to strength since his op. His owners now say he seems to have a new lease of life, which must be a huge relief for them after such a lot of worry. As for Yorkie, he most certainly seems pleased that his problem is now behind him… in the right way!

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