Perineal Hernia in Dogs

The pelvic floor supports the rectum and keeps the abdominal contents in their normal positions. When the muscular diaphragm is weakened, it may rupture, allowing organs to become entrapped in the hernia. Perineal hernias exhibit as a swelling adjacent to the rectum and most commonly occurs in older unneutered dogs.

Though a perineal hernia is not life-threatening in itself, it may require an emergency response if the bladder moves through the rupture, as this can obstruct urination If a loop of intestine is trapped in the hernia, this may lead to strangulation of the bowel and loss of blood supply.

A perineal hernia is commonly detectable as a swelling beside or below the anus. Symptoms that arise from the swelling include:

• Straining to urinate
• Difficulty with bowel movements
• Constipation
• Change in tail carriage

Clinical signs of a perineal hernia may vary depending on the organs affected. Typically, these symptoms include:

• Abdominal pain
• Lethargy
• Depression

A perineal hernia occurs when the muscular diaphragm of the pelvis weakens or fails, allowing organs to protrude into the area between the anus and the scrotum. Hernias are potentially caused by a variety of factors, including trauma, tumors, age, and congenitally. Though there is no known underlying cause for perineal hernias, the vast majority of cases occur in unneutered male dogs that are middle-aged or older, leading to the theory that male hormones or prostate enlargement weaken the pelvic floor. No strong correlation exists between breed and likelihood of the condition.

Perineal hernias are easy to identify by digital rectal palpation. If your dog exhibits swelling around the anus, your veterinarian will ask for a history and conduct a thorough examination of the rectal region to differentiate the hernia from a tumor. Blood work and urinalysis may be required to develop a complete health profile, determine your dog’s ability to withstand treatment, and identify any concurrent diseases.

Though unnecessary in diagnosing the hernia itself, an x-ray or ultrasound can help define the hernia and determine its contents. Your veterinarian may recommend a prostate gland biopsy or an inspection of the testicles as part of the examination. If an enlarged prostate is discovered during any of these steps, additional tests may be necessary to locate the underlying cause and identify treatment.

Treatment varies depending on the extent of herniation. Surgical repair and castration are standard, though non-surgical options are available for management.

Medical Management

For minor cases, medical treatment may be an option, though it does not cure the hernia or address the rupture. A combination of stool softeners, enemas, and a high fiber diet help relieve the strain of defecation, while the bladder can be decompressed with a catheter. However, this does not permanently control the disease or its symptoms, and your dog still runs the risk of having its bladder or colon trapped in the hernia.

Surgical Treatment

Surgery is usually the recommend treatment for a perineal hernia. The hernia contents will be moved back into their normal positions, and the pelvic diaphragm will be repaired. The colon and the bladder may be sutured to the abdominal wall during this process, helping stabilize those organs and prevent a reoccurrence. The pelvic diaphragm is typically reinforced with a local muscle flap or surgical mesh, completely closing the rupture. Castration is performed on intact males as part of this procedure to minimize hormones and reduce the size of the prostate, decreasing the chances of a future perineal hernia.

Antibiotics will be prescribed to combat potential contamination that arises due to the location of the surgical site. Your veterinarian will likely prescribe painkillers to ease your dog’s discomfort, though you should also modify your dog’s diet and employ stool softeners to ease defecation during the healing process. This minimizes straining, which reduces pain while preventing too much stress from being applied to the reconstructed muscles.

The surgical area needs to be kept clean and dry, and you will need to limit your dog’s physical activity during this time. An Elizabethan collar may be necessary to keep your dog from licking or biting at the surgical site. The prognosis is good for most non-emergency cases, though your vet may recommend regular follow-up examinations to ensure that the repair is healing properly and that the possibility of recurrence is low.

Stool softeners for dogs are usually $15 for 40 soft chews. Consult your veterinarian before trying human stool softeners on your dog. Enemas ($4 for a 4 pack) are another option. Changing your dog’s food to a high fiber diet will also help your dog’s condition and overall health. These special dog foods sell for $35 to $40 per 30lb bag. These options will not cure your dog’s perineal hernia, but rather relieve the strain and discomfort your dog is feeling. Surgery is usually the only option to cure a perineal hernia. Surgery can be used to move the hernia back into normal position and to repair the pelvic diaphragm. This surgery can cost $1,500 or more. The veterinarian may decide to castrate your dog (intact males only, obviously) which reduces the size of the prostate and decreases the chances of the hernia reoccurring. This can cost an additional $170 to $200.