Recto-Vaginal Wound Repair in Dogs

Wounds between the rectum and vagina are not overly common occurrences in dogs, however they can happen. A difficult delivery may lead to the vaginal canal being ripped internally right through to the rectum. Small openings may heal on their own, but larger wounds have the potential of becoming a serious problem. If fecal matter begins to enter the vaginal canal, urinary tract infections and even sepsis may follow. 

Dogs suffering from this ailment will often present with vaginal irritation, bloody discharge, bloody stools, painful defecation, and feces within the vagina. Once an infection has developed, the dog's abdomen will distend and be painful to the touch. The opening, or fistula as it is called, must be repaired for the dog to survive. This should only be done by an ACVS board-certified veterinary surgeon, as the procedure is complicated and wrought with risks. 

To assess the amount of damage that has been done, the veterinarian will physically examine the dog. Using a probe or finger, the vet will determine where and how large the wound is. If the wound is difficult to palpate, x-rays will be taken using a contrast medium flushed through the opening. Blood work will be run to get an idea of the dog's overall condition, and help determine whether general anesthesia can be used. 

The day of surgery, the dog will be required to fast for several hours prior to the procedure. Once the dog has been sedated, the perineal region will be shaved and cleaned. An incision will be made to this area, allowing the fistula to be accessed. All of the tissue surrounded the wound will then be dissected. Using lembert sutures, the opening will be sewn shut. On the vaginal side, lateral sutures will be placed for extra support. The dead space between the rectum and vagina will need to be closed. Sutures will be used on the perineum to pull the incised skin back together. If at all possible, the sphincter should be kept intact, as this improves the dog's end condition.

The sooner that a recto-vaginal wound is found and repaired, the better the overall outcome can be. It is possible to restore the function of the anus with this surgical repair. If an infection exists in the affected area, the prognosis for the dog may be guarded. Keeping the area clean enough for a proper recovery tends to be difficult. New techniques for repair including the use of plastic adhesives and reconstructive methods may improve the long-term results for this type of wound repair.

The dog should be closely monitored as the general anesthesia wears off. Pain medication can be administered as the dog wakes. A course of antibiotics will be prescribed in attempts to keep the area free from infection, or to eradicate an existing infection. The area will need to be regularly cleaned throughout the healing process. An Elizabethan collar may be used to prevent the dog from licking or biting at the surgical site. The area will be extremely sore after the operation, so a diet of soft foods will be needed, and stool softeners may be recommended. A follow-up appointment will be required within two weeks of the surgery to remove sutures and assess how the dog is healing.

Repairing a recto-vaginal wound can cost from $550 up to $5,000. If the wound is small and discovered early on, the repair may be fairly simple. Emergency situations with large or infected wounds may be quite difficult to treat, and may require multiple vet visits, numerous tests, and many medications to fix. Diagnostic imaging also can add to the overall price of treatment. 

After receiving a recto-vaginal wound repair, many dogs experience fecal or urinary incontinence, and in some instances both. This is not always permanent. If the sphincter has been removed or if there is significant nerve damage, the incontinence may be something that has to be dealt with for the remainder of the dog's life. Foul odors may also leak out of the dog's anal glands after undergoing this surgery. The surgical wound may break open, leading to many more complications and requiring a second surgical repair. The dog may also suffer from severe cramping and constipation after a repair. Despite the risks, the issue can not be left and the only alternative to surgery is euthanization.

Preventing a recto-vaginal wound from occurring in the first place can help lessen the chance of your dog ever needing this complicated surgical repair. If your dog is pregnant, it may be advantageous to bring her to the veterinary clinic for an assisted delivery, or at least bring the mother and puppies in as soon as possible after the birth for a full assessment. To prevent blunt force trauma, keep your dog on leash at all times when on walks. Ensure your yard is secure so that your dog can not escape and access nearby roads.