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What is Perineal Hernia?

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 a rupture in the pelvic floor, through which an organ may protrude into the region between the anus and the scrotum. This affects a dog’s ability to urinate and defecate and may be life-threatening if the bladder or intestine is involved.

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Average Cost

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Symptoms of Perineal Hernia in Dogs

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
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Causes of Perineal Hernia in Dogs

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.

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Diagnosis of Perineal Hernia in Dogs

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.

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Treatment of Perineal Hernia in Dogs

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.

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Recovery of Perineal Hernia in Dogs

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.

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Cost of Perineal Hernia in Dogs

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.

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Perineal Hernia Average Cost

From 173 quotes ranging from $1,500 - $5,000

Average Cost

$2,100

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Perineal Hernia Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Ask a Vet

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Chicho

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Chihuahua

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14 Years

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Serious severity

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1 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Constipation
Green Diarrhea

Early this year my senior chihuahua developed a perineal hernia. When I took him to the vet to get it removed they told me he could not have surgery. Apparently his hernia is attached to the bone and he can't have surgery. He often cries and spends so much time trying to poop. He currently eats dog chow beef but I noticed its to harsh for me. What are some rich fiber foods he could consume?

Aug. 30, 2017

Chicho's Owner


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1 Recommendations

In severe cases like Chico’s it would be best to supplement his diet with plain canned pumpkin or to give him a stool softener to help loosen the stool and to reduce the amount of straining whilst defecating; high fibre food diets on their own probably wouldn’t be sufficient on their own so stool softeners would be the way to go. Regards Dr Callum Turner DVM

Aug. 30, 2017

I wish I would of known this :( I gave pumpkin and it matters so much worse!

April 21, 2018

Michelle O.


High fiber is bad for perineal herina. You need low fiber which has a similar effect but prevents build up of hard stool. Miralax and a prescription low fiber canned food is great. As things get better you can possibly add a low fiber puppy food with a little water to soften it up in to the mix. I went through this for 5 years and low fiber is the way to go on this type of issue.

Oct. 22, 2017

Tasio C.

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Otis

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Boxer

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8

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Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Blood In Urine
Swelling

My 8 year old boxer was dx'd with such condition, Vet recommends castration and repair, my question is, if he is just neutered will that stop any further herniation (dx'd with enlarged prostate also) ? The procedure is costing $6000, and whether or not how much benefit this will provide and 8 year old boxer ? and why 8 years of vet visits NONE recommended neutering (as it seems this, statistically, is the underlying cause of the enlarged prostate and herniation. Dog has NO issue with defecation.

July 26, 2017

Otis' Owner

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0 Recommendations

Whilst it would be nice if neutering was a fix, the hernia would still need to be repaired as the severity of the hernia may increase due to straining whilst defecating; once the hernia is formed due to a defect in the pelvic floor, any additional straining or movement may cause strangulation which then becomes a more expensive medical emergency. Medical management and dietary changes may help in the short term, it is still in Otis’s interest to have the surgery done sooner rather than later. As for neutering recommendation, I cannot speak for other Veterinarian’s but I always suggest neutering if an animal isn’t intended to be bred. Regards Dr Callum Turner DVM

July 26, 2017

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Bobby

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Chihuahua

dog-age-icon

12 Years

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Serious severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Fecal Spotting
Swollen Anal

My 12-year-old male chihuahua has had 2 perineal hernia repair surgeries, each surgery correcting the left and right side. The first surgery was done 2 years ago and the second surgery was just 3 months ago. Yesterday he was constipated and straining and passed feces which was very hard, large and round. Now I'm concerned that he may have ruptured the hernia again because he's leaking small drops of feces and he is very uncomfortable. I want to find another Doctor who's experienced with this type of surgery to take him to as I've already spent over $3000 for the surgeries and I'm worried about the occurrence of this happening when it's only been 3 months since the last surgery. I'm also very worried if he does have another hernia (again) how much more of this can he endure with him being older and will it just keep continuing. I'm at a loss and could really need some guidance.

July 26, 2017

Bobby's Owner

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0 Recommendations

Recurrence of perineal hernias are not uncommon and may not be able to be repaired a second time in some cases; each case is different, but your Veterinarian would be able to tell you if there has been a recurrence. It would be best to give Bobby stool softeners to reduce the need for straining whilst defecating. If you are looking for an experienced Veterinarian, try your nearest Veterinary School as you would find a specialist there. Regards Dr Callum Turner DVM

July 26, 2017

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Homer

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Pittbull mix

dog-age-icon

11

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Fair severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Fair severity

Has Symptoms

None

We just adopted a 10 year old pit bull from a shelter. He has a perineal hernia on the left side. At the time of the adoption he was intact but we had him neutered. He has no urinary or defecation symptoms and pees and poops normally. His enlarged prostate has been cultured negative, and ultrasound shows it has visibly shrunk since the neuter one month ago. The shelter vet recommended surgery for the hernia. However our regular vet seems to think that--since there are no symptoms--that the hernia can be medically managed. He even mentioned that as the testosterone leaves the bloodstream the hernia could improve (though not go away). Is this true? I'm struggling with whether to just do the surgery preemptively. He's eleven, but in good health.

July 26, 2017

Homer's Owner

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0 Recommendations

Intact males are more prone to perineal hernias than neutered males; I would recommend having the hernia corrected so that the risk of complications are reduced, however many cases of perineal hernia are managed medically and the response to management is usually positive. Whilst surgical correction is treatment of choice, recurrence is common and may require further surgeries; this decision is ultimately down to you, if you choose the medical management route you just need to ensure that there is no straining whilst defecating. Regards Dr Callum Turner DVM

July 26, 2017

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Mickey Cosme

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chihuahua mix

dog-age-icon

7 yrs 9 months

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Shaking
Bloody Mucus

My dog Mickey was diagnosed with Perineal Hernia on his right side. It is trying to push through his colon. He was scheduled for surgery yesterday. Unfortunately other emergency surgeries took priority and they rescheduled him for Thursday. So he came home very sedated and out of it, he keeps trying to poop but nothing is coming out. Now he tried to poop again and I noticed he is constipated again however he did manage to poop. I just found a bloody mucus with a little loose poop in the house right after he just got done pooping outside. He has been shacking a lot since he came home from the Vets. Is it normal for him to have a bloody mucus/stool? If not should I call the Vet?

July 26, 2017

Mickey Cosme's Owner

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0 Recommendations

Bloody stool isn’t a normal occurrence in cases of perineal hernia; some small amounts of blood may occur during straining to defecate, however if there is a large quantity of blood I would visit your Veterinarian or Emergency Clinic to be on the safe side. Regards Dr Callum Turner DVM

July 26, 2017

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Perineal Hernia Average Cost

From 173 quotes ranging from $1,500 - $5,000

Average Cost

$2,100

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