A hernia is a bulge in the abdominal wall through which the peritoneum and intestines can protrude. Perianal hernia, also known as perineal hernia, is a condition that occurs in 90% of older, unneutered male dogs, in which fat and abdominal organs protrude under the skin in the perineal area (the area between the anus and the external genitalia).
The exact causes of perianal hernias are still unknown. However, it is likely that they are hormone-related, as they almost exclusively affect unneutered male dogs. From around the age of five, the muscles in the perineal area weaken, which ultimately causes loops of intestine, fatty tissue, or an enlarged prostate to protrude under the skin.
As a result of the lack of muscular stability in the pelvis, lateral pouches form in the rectum, in which feces accumulate, gradually thickening and becoming almost impossible for the dog to pass. The pressure in the pelvis increases, leading to increased straining, which further exacerbates the condition.
The first signs noticeable to the owner are usually difficulty passing stool and frequent straining. Upon closer inspection, the owner may also notice a bulge on one or both sides of the anus.
In cases of very large hernias, the bladder may also bend backward and protrude into the hernia sac. This situation is an absolute emergency, as the dog is no longer able to urinate and is at risk of internal poisoning. If you notice that your dog has problems passing urine as well as defecating, please take them to a veterinarian immediately.
Even if your dog suddenly takes a turn for the worse, pants more, seems weak, and has a tense, painful belly, you should definitely take them to a vet immediately. In such a case, it is possible that loops of intestine have become trapped in the hernia. Only timely surgical intervention can prevent parts of the intestine from dying due to lack of blood supply.
The condition is relatively easy for a veterinarian to diagnose based on visible and palpable findings in conjunction with a detailed preliminary report. An additional ultrasound examination is often performed to check for damage to any organs that have prolapsed. Depending on the general condition of the animal, blood and urine tests may also be useful.
In most cases, a perianal hernia must be treated surgically, as even various conservative measures such as a change in diet, enemas, and removal of accumulated feces cannot repair the hernia and the symptoms will return. Only very old dogs with only mild symptoms are occasionally treated in this way if surgery is no longer an option.
The veterinarian has various surgical methods at their disposal and, depending on the severity of the hernia, the operation is performed in one or two sessions. The weakened muscles are partially sutured back together and covered with parts of other muscles to achieve greater stability. In the case of very large or complicated hernias, it may be necessary to reposition the prolapsed organs and attach them to the abdominal wall in a first operation before closing the actual hernia. This prevents the organs from prolapsing again.
In unneutered male dogs, castration should always be performed at the same time to prevent the hernia from recurring. Castration will also cause any enlarged prostate to shrink, which will reduce the need to strain when defecating.
Appropriate aftercare is very important to ensure the success of the operation. In the initial period after the operation, the operated dog will be given painkillers and food supplements to keep the stool soft so that it does not have to strain too much. Furthermore, the dog should be kept on a leash for two to three weeks to prevent uncontrolled movements from hindering the healing process.
If the disease is detected and treated in time, the prognosis is favorable. However, relapses are possible even after surgery. Thanks to modern surgical procedures and the two-stage surgical technique described above, which involves simultaneous castration, the risk of relapse can now be significantly reduced. In general, the larger the hernia and the longer it has been present, the worse the prognosis and the more frequent the relapses.
Complications such as wound healing disorders or fecal incontinence can also worsen the prognosis.
Since mainly unneutered male dogs are affected, neutering is an effective measure to prevent perianal hernias. However, whether a healthy male dog should be neutered should always be considered on a case-by-case basis and discussed with your veterinarian.
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