Episiotomy in Dogs

An episiotomy is a surgical cut made from the vaginal opening up the perineum. While this is often used to ease childbirth in humans, for dogs this is not the case. Episiotomies in dogs are used to begin various surgical procedures on the vulva. For dogs who are experiencing problems breeding due to a small vaginal opening, an episiotomy may be used on its own.

For dogs experiencing chronic urinary tract infections (UTI), surgery may be the recommended course of action if antibiotics have failed to cure the issue. An episiotomy is sometimes used to begin an episioplasty (a common surgery to help alleviate UTIs). An ACVS board-certified veterinary surgeon should be used for this operation.

To assess whether an episiotomy in surgery will be advantageous, a full physical examination of the dog will be needed. Blood work will be run to determine if the dog is healthy enough to undergo the use of general anesthesia. X-rays or ultrasounds will be used to plan out the procedure, especially if tumors are present. The dog will need to fast for several hours before surgery.

A sedative is often given to the animal prior to IV insertion. The general anesthesia is administered through the IV tube. The surgical area will be clipped and disinfected before an incision is made. The episiotomy is often the first cut to be made. It is generally performed with a scalpel. The incision is made from the vagina along the perineum muscle. If another procedure is being done, it can now take place. To finish the surgery, the opening is closed using sutures. Sometimes the mucosal flap is rotated into the closure to assist with healing.

In cases of vulval stenosis, an episiotomy may successfully address the small opening and allow for regular breeding once fully healed. For other issues, studies are now showing that episiotomies can lengthen healing times and increase possible complications. With newer surgical tools, episiotomies may no longer be needed in many vaginal procedures. 

The dog should be closely monitored as the anesthesia wears off to ensure all vital functions resume properly. Pain medication may be administered as soon as the dog regains consciousness, and can continue for several days post-surgery. A prescription of antibiotics will also likely be given to reduce the chance of infection in the urinary tract or surgical wound. 

All activity will need to be lowered while the dog heals. To prevent the dog from licking or biting at the incision site, an Elizabethan collar can be used. A follow-up appointment will be needed to remove any sutures and assess how the dog is healing. If any infection is present, blood work will be needed at this time. If the dog has been diagnosed with cancer, a treatment regime may be started at this time. The dog should not be bred until the surgical wound has completely healed.

The cost for an episiotomy varies depending on if it is being paired with another operation. In general, prices for this procedure range from $100-$1,000. If diagnostic imaging is needed, the overall cost will increase. If the dog is an intact female suffering from vulval stenosis, artificial insemination may be an alternative to this surgery and does not require the use of general anesthesia.

As with all surgeries using general anesthesia, certain serious risks exist. Although it is rare, some dogs have very negative reactions from the use of this sedative. In many procedures, the use of an episiotomy actually increases the chance of death during the operation. This is due to the heightened risk of hemorrhage and longer surgery time that episiotomies bring. If a dog's vaginal opening has been enlarged, it will be prone to more urinary tract infections. 

Some breeds of dog are more prone to vulval stenosis than others. Both Collies and Shelties suffer from this condition. It is also known as dyspareunia. Predisposition for chronic urinary tract infections of often caused by the passing down of genes that lead to shorter urethras and improperly placed ureters.