Prior to performing a perineal herniorrhaphy, a veterinarian will want to examine the dog. In most cases, a perineal hernia is very visible. Unfortunately, seeing how severe the hernia is may be difficult without further testing. This is why some veterinarians recommend radiographs prior to surgery.
Veterinarians will also recommend blood work prior to a perineal herniorrhaphy. Blood work is to ensure that all organs are functioning correctly. It also ensures that the dog’s organs are healthy enough to undergo anesthesia.
In most cases, the severity of the perineal hernia depends on how fast the perineal herniorrhaphy is done. If it is found that the bladder is trapped in the perineal hernia, emergency perineal herniorrhaphy surgery is usually performed right away.
If the veterinarian does not believe emergency surgery is necessary, the procedure usually is scheduled within one to two days. If surgery is not scheduled right away, the dog may have to take stool softeners up until the day of surgery.
Prior to a perineal herniorrhaphy, it’s important that the dog’s intestinal tract is empty. Veterinarians may use laxatives, enemas, and even manual extraction to ensure this. If the veterinarian discovers the bladder is in the weakened pelvic wall, a catheter will be placed in the bladder to help drain any urine present.
Anesthesia is administered prior to making any incisions. Most dogs will also require antibiotics through an IV during a perineal herniorrhaphy. After all anesthesia and antibiotics are administered, the veterinarian will began preparing the dog for surgery.
The dog is laid on his or her back with the neck slightly extended. The paws and front legs are brought forward. The back legs are slightly spread, with knees slightly bent. Once in position, the surgical area will be prepared for the perineal herniorrhaphy.
All hair in the area is removed and the area is cleansed aseptically. As soon as the area is clipped and clean, the veterinarian can begin making their incisions.
A curved incision is made above the rectal muscles known as the coccygeus muscles. The incision then continues over the perineal hernia until it reaches about 3 cm under the pelvic floor. A cut is then made under the skin, into the hernia. This cut is made to remove or repair any abdominal material or organs present in the perineal hernia.
Once all foreign materials are removed and repaired, the veterinarian will suture the inner muscles of the rectal area. Once the inner cut is sutured, the outer incision is sutured. If the dog is not castrated, castration will be performed after the outer incision is sutured.
After a perineal herniorrhaphy, dogs usually stay in the veterinary hospital for at least 24 hours. Some dogs may need to stay up to 48 hours after surgery. Dogs are usually required to return to the veterinary hospital around five days after they are released and again in another five days to check the surgical site and remove the outer sutures.