Perineal Hernia in a Bitch
Background: Perineal hernia is characterized by the displacement of abdominal organs to the perineal region after rupture or weakening of the pelvic diaphragm muscles. This condition is common among middle-aged and elderly unneutered male dogs. Considering the severity of the condition and its rarity among bitches, this paper reports on a case of perineal hernia caused by hydrometra in a 12-year-old pinscher bitch.
Case: The patient was a 12-year-old Pinscher bitch, weighing 3 kg, suffering from anuria and constipation in the 36 h prior to treatment, without reported trauma. She was unspayed, and her last estrus had occurred approximately thirty days previously. The physical examination revealed an increase in volume in the right perineal region, increased volume in the left inguinal region, increased body temperature (39.8ºC), pale mucous membranes, tachycardia, tachypnea, abdominal pain and increased popliteal lymph nodes. The diagnosis was determined based on her medical history, clinical signs and an ultrasound scan, which revealed dilated uterine horns displaced unilaterally in the left inguinal region, with evidence of hydrometra, full urinary bladder inside the hernia sac in the right dorsolateral perineal region and right kidney pyelectasis. After evaluating the animal’s physical condition, surgery was recommended, involving ovariohysterectomy associated with inguinal and perineal herniorrhaphy.
Discussion: Perineal hernia, a common condition in male dogs, is characterized by the displacement of organs towards the perineal region. However, in this case, this condition occurred in female dog. Unlike males, the main causes of perineal hernia in females are trauma, chronic coughing related to heart disease, bronchitis, and tracheal collapse. Increased intra-abdominal pressure associated with a weak pelvic diaphragm predisposes for herniation of abdominal contents, such as occurred through hydrometra. In this case, other factors that could pertain to the etiology of perineal hernia were excluded, given the absence of trauma or secondary diseases. The diagnosis was made based on a physical examination and ultrasound scan. Pre-surgical biochemical blood tests were also performed. The chosen treatment was ovariohysterectomy followed by inguinal and perineal herniorrhaphy. The traditional surgical procedure to reduce the perineal hernia was employed, using approximation sutures due to the easy apposition of wound edges. The structures and soft tissues involved showed no changes in color or texture, thus obviating the need for more elaborate techniques, which are employed in the case of relapse or muscle atrophy. The patient showed clinical evolution after surgical correction, with decreased perineal volume and recovery of urinary function (normuria). The patient was discharged after 72 h, and six months after the surgical procedure, she presented no clinical alteration, according to information provided in a telephone call by her owner. It is believed that the increase in volume caused by the presence of hydrometra was the determining factor for the development of inguinal and perineal hernias. It is suggested that alterations causing uterine enlargement be investigated in order to include perineal hernia in female dogs as a differential diagnostic tool.
Aronson L.R. 2017. Rectum, anus, and perineum. In: Tobias K.M. & Johnston S.A. (Eds). Veterinary Surgery: Small Animal. 2nd edn. St. Louis: Elsevier Saunders, pp.4821-4947.
Barreau P. 2008. Perineal hernia: three steps in one surgery: pexy, sterilisation, repair. In: The 33rd World Congress in Small Animal Veterinary Medicine - WSAVA (Dublin, Ireland). 1 CD ROM.
Bellenger C.R. & Canfield R.B. 1998. Hérnia perineal. In: Slatter D. (Ed). Manual de Cirurgia de Pequenos Animais. São Paulo: Manole, pp.578-590.
Bellenger C.R. & Canfield R.B. 2003. Perineal hernia. In: Slatter D. (Ed). Textbook of Small Animal Surgery. 3rd edn. Philadelphia: Saunders, pp.487-498.
Bongartz A., Carofiglio F., Balligand M., Heimann M. & Hamaide A. 2005. Use of autogenous fascia lata graft for perineal herniorrhaphy in dogs. Veterinary Surgery. 34(4): 405-413.
Chambers N.J. & Rawlings A.C. 1991. Applications of a semitendinosus muscle flap in two dogs. Journal of the American Veterinary Medical Association. 199(1): 84-86.
Daleck C.R., Daleck C.L.M., Padilha Filho J.G. & Costa Neto J.M. 1992. Reparação de hérnia perineal em cães com peritônio de bovino conservado em glicerina. Ciência Rural. 22(2): 179-183.
D'Assis M.J.M.H., Costa Neto J.M., Lima A.E.D.S., Martins Filho E., Toríbio J.M.D. & Teixeira R.G. 2010. Colopexia e deferentopexia associadas à omentopexia no tratamento da hérnia perineal em cães: um estudo de trinta casos. Ciência Rural. 40(2): 341-347.
Desai R. 1982. An anatomical study of the canine male and female pelvic diaphragm and the effect of testosterone on the statues of levator of male dogs. Journal of the American Animal Hospital Association. 18(1): 195-202.
Faria B.G.O., Silva V.M., Muramoto C., Quessada A.M., Barbosa V.F., Martins Filho E.F. & Costa Neto J.M. 2016. Autoenxerto de túnica vaginal como reforço na herniorrafia perineal em cão-Relato de caso. Brazilian Journal of Veterinary Medicine. 38(1): 1-8.
Feldman E.C. & Nelson R.W. 1996. Cystic endometrial hyperplasia/pyometra complex. In: Canine and Feline Endocrinology and Reproduction. 2nd edn. Philadelphia: W.B. Saunders, pp.605-618.
Fossum T.W. 2013. Surgery of the abdominal cavity. In: Small Animal Surgery. 4th edn. St. Louis: Elsevier, 1175p.
Hayashi A.M., Rosner S.A., Assumpção T.C.A., Stopiglia A.J. & Matera J.M. 2016. Retrospective Study (2009-2014): Perineal Hernias and Related Comorbidities in Bitches. Topics in Companion Animal Medicine. 31(4): 130-133.
Hedlund C.S. 2002. Perineal hernia. In: Fossum T.W. (Ed). Small Animal Surgery. 2nd edn. St. Louis: Mosby, pp.433-437.
Johnson C.A. 1995. Cystic Endometrial Hyperplasia, Pyometra, and Infertility. In: Ettinger S.J. & Feldman E.C. (Eds). Textbook of Veterinary Internal Medicine. 4th edn. Philadelphia: W.B. Saunders, pp.1636-1642.
Merchav R., Feuermann Y., Shamay A., Ranen E., Stein U., Johnston D.E. & Shahar R. 2005. Expression of relaxin receptor LRG7, canine relaxin, and relaxin‐like factor in the pelvic diaphragm musculature of dogs with and without perineal hernia. Veterinary Surgery. 34(5): 476-481.
Mortari A.C. & Rahal S.C. 2005. Perineal hernia in dogs. Ciência Rural. 35(5): 1220-1228.
Pretzer S.D. 2008. Clinical presentation of canine pyometra and mucometra: a review. Theriogenology. 70(3): 359-363.
Radlinsky G.A. 2013. Surgery of the Perineum, Rectum Anus. In: Fossum T.W. (Ed). Small Animal Surgery. 4th. edn. St. Louis: Elsevier, 1175p.
Rochat M.C. & Mann F.A. 1998. Sciatic perineal hernia in two dogs. Journal of Small Animal Practice. 39(5): 240-243.
Sjollema B.E. & Sluijs F.J.V. 1989. Perineal hernia repair in the dog by transposition of the internal obturator muscle: II. Complications and results in 100 patients. Veterinary Quarterly. 11(1): 18-23.
Weaver A.D. & Omamegbe J.O. 1981. Surgical treatment of perineal hernia in the dog. Journal of Small Animal Practice. 22(12): 749-758.
Winders C.L.B. & Tobias K.M. 2016. Perineal Protrusion Secondary to Imperforate Hymen and Hydrocolpos in an 8-Year-Old Spayed Female Dog. Case Reports in Veterinary Medicine. 3p. Article ID 8067967. https://doi.org/10.1155/2016/8067967
Zerwes M.B.C., Stopiglia A.J., Matera J.M., Fantoni D.T., Sterman F.A. & Lacerda P.M.O. 2011. Avaliação do tratamento cirúrgico da hérnia perineal em cães com o reforço de membrana de pericárdio equino preservado em glicerina a 98%. Brazilian Journal of Veterinary Research and Animal Science. 48(3): 220-227.
How to Cite
This journal provides open access to all of its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. Such access is associated with increased readership and increased citation of an author's work. For more information on this approach, see the Public Knowledge Project and Directory of Open Access Journals.
We define open access journals as journals that use a funding model that does not charge readers or their institutions for access. From the BOAI definition of "open access" we take the right of users to "read, download, copy, distribute, print, search, or link to the full texts of these articles" as mandatory for a journal to be included in the directory.
La Red y Portal Iberoamericano de Revistas Científicas de Veterinaria de Libre Acceso reúne a las principales publicaciones científicas editadas en España, Portugal, Latino América y otros países del ámbito latino