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-   -   Reconstructive Surgery - genitals...(sigh) (http://www.pets.ca/forum/showthread.php?t=62933)

bendyfoot May 22nd, 2009 12:24 PM

Reconstructive Surgery - genitals...(sigh)
 
Ok, just throwing this out there...has any one ever had their dog undergo, or know of one who has had, reconstructive surgery on their genitals (the vulva, specifically i.e. the "outie" part") in order to correct a congenital defect that is responsible for recurring infections?

:wall:

luckypenny May 22nd, 2009 12:32 PM

Is this for Heidi?

bendyfoot May 22nd, 2009 12:33 PM

No, Jaida (of course).:rolleyes:

hazelrunpack May 22nd, 2009 12:35 PM

I believe mummummum's Ceili had the surgery done, bendyfoot.

bendyfoot May 22nd, 2009 12:39 PM

Haven't seen M3 in a while...

I mean, she's been through worse. I dunno. It's just one more thing.

luckypenny May 22nd, 2009 12:46 PM

Oh, I guess she's been spayed already then :o. Fanny, our previous foster had a recessed vulva so we decided to let her go through a heat and see if it would correct itself...which it did. We had her spayed afterwords when everything was where it was supposed to be.

She did have a quite the persistent UTI that lasted quite some time. It was treated with two rounds of anti-biotics (consecutively) and we added 500mg cranberry supplements with yogurt high in probiotics to each meal (she was fed Orijen though, not raw) which seemed to do the trick in getting rid of the UTI once and for all.

Do you know if it's a recurring [I]or[/I] pesistent UTI that Jaida has?

hazelrunpack May 22nd, 2009 12:50 PM

MMM is still around now and then, bendy--you might be able to get a PM through to her.

I never realized that this problem was so common! Ceili, Fanny, Jaida... Bummer :frustrated:

bendyfoot May 22nd, 2009 12:52 PM

Knowing what we know now we're kicking ourselves for getting Jaida spayed pre-puberty. I suspect it would have been beneficial for her in many ways to delay the spay. What's done is done, though, sigh. :sad:

It's not UTIs she gets, it's vaginal tract infections. And right now a galloping case of dermatitis. It's more due to extra folds of skin around the vulva, which is already slightly recessed/small.

Egads, i just saw a dog vulvoplasty on youtube. Erk. I guess it's a quick/easy procedure. But oooooowwwwwww.......

hazelrunpack May 22nd, 2009 01:04 PM

Ya, I hear ya. :eek:

Thank dawg for pain meds!

Poor Jaida has really been through the wringer, hasn't she? :grouphug:

Mat&Murph May 22nd, 2009 01:10 PM

wow.I never knew that could happen. your poor girl!! :grouphug: Hang in there

luckypenny May 22nd, 2009 01:11 PM

I just did a quick look-up and it looks like a vulvoplasty is the treatment most vets recommend. However, it would appear that it's not effective if a dog also has vestibulovaginal stenosis :shrug:.

http://www.ncbi.nlm.nih.gov/pubmed/11804321?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed

[url]http://www.uoguelph.ca/~rfoster/repropath/surgicalpath/female/dog/female_dog_vulva.htm[/url]

bendyfoot May 22nd, 2009 01:21 PM

I'm thinking even if she has a mild case of the stenosis, it would at least help with the dermatitis, which is just blech. Poor girl is bald down there right now. The Brazillian look is just not doing a thing for her.

luckypenny May 22nd, 2009 01:27 PM

[QUOTE=bendyfoot;782111]I'm thinking even if she has a mild case of the stenosis, it would at least help with the dermatitis, which is just blech. Poor girl is bald down there right now. The Brazillian look is just not doing a thing for her.[/QUOTE]

:laughing: Sorry, that was hilarious :o.

Do you give her any probiotics and/or cranberry supplements? They're supposed to be good for ph levels of skin as well as well as help in combatting fungal infections :shrug:.

You have to give Jaida a great big smoochie from me please :lovestruck:.

bendyfoot May 22nd, 2009 01:29 PM

No i haven't tried any of those, but the probiotics would probably be best, she can get yeasty...:rolleyes:

I will give Jaida one smoochy-smooch in your name this evening :lovestruck:

chico2 May 22nd, 2009 04:12 PM

Bendyfoot,I was hoping that it would not be Jaida,not that I want it for any dog,but Jaida has had enough problems.
I hope this is an easy procedure:fingerscr

bendyfoot July 28th, 2009 01:06 PM

shameless bump in hopes that [B]Dr. Lee [/B]will visit with insight since he's hanging around here today...

Dr Lee July 28th, 2009 01:23 PM

[QUOTE=bendyfoot;782086]Ok, just throwing this out there...has any one ever had their dog undergo, or know of one who has had, reconstructive surgery on their genitals (the vulva, specifically i.e. the "outie" part") in order to correct a congenital defect that is responsible for recurring infections?

:wall:[/QUOTE]

I assume we are talking about an episioplasty? ...to remove excess perivulvar tissue which can hold in urine and bacteria. This is actually a common procedure and typically works well. It is like a 'face lift'... just in the opposite end of the pet. It usually involves removing a crescent shaped piece of skin and underlying fat. On occasion a second surgery might be needed if not enough tissue was taken on the first surgery. Here is a link from the AVMA which shows a retrospective study that is very encouraging: [URL="http://avmajournals.avma.org/doi/abs/10.2460/javma.2001.219.1577?cookieSet=1&journalCode=javma"]AVMA Abstract[/URL]. Also here is another link: [URL="http://www.veterinarypracticenews.com/vet-practice-news-columns/surgical-insights/common-cause-of-chronic-uti-has-a-surgical-solution.aspx"]Veterinary Practice News[/URL]

Many veterinarians can perform this surgery (with or without laser;))

bendyfoot July 28th, 2009 01:24 PM

Yes, an episioplasty...at least that's what I'm assuming the vet meant when she mentioned it last time we were in. Have you seen this used to treat dermatitis and what was the outcome?

Dr Lee July 28th, 2009 01:25 PM

...and bendyfoot - thanks for bumping it up!:D

also feel free to PM me if you ever want me to look at a thread. Personal life has been a little strained lately, so I have not spent as much time on pets.ca as I would like to. :dog:

bendyfoot July 28th, 2009 01:28 PM

I understand personal life stuff getting in the way these days, and I appreciate you having a look...

another question...we're looking at getting this done probably in the fall...is there anything we should be doing in the meantime to mitigate it? We try to keep her from licking/chewing as best as we're able, I often will wipe with Malacetic wipes that I was given, sometimes I'll put a little antibiotic ointment on there if I'm going to be around long enough to monitor that she's not going to lick it off... I feel bad for her, I'm always hearing "nibblenibblenibble" if I step out of the room. :frustrated:

Dr Lee July 28th, 2009 01:28 PM

Yes. It works well as long as the problem is localized to the perivulvar region. If the problem is from a small amount of urine sitting perivuvlarly and leading to secondary dermatitis, then this should work well.

If there are other problems (food allergy, atopy, etc...) then it will not be as successful. Also a swab cytology might be helpful at the time of surgery - make sure that we know if the local dermatitis is secondary to yeast or bacteria - as antibiotics can make fungal infections worse and visa versa. Usually antibiotics alone post op will work though.

Dr Lee July 28th, 2009 01:31 PM

The wipes are good. How is her weight? If there is any extra pounds, it will make this condition worse.

Also most topical medications are designed to have the majority of the medication absorbed within 10-15 minutes and what is left over is just a carrying agent - often similar to vaseline. Neosporin works well. If there is extra inflammation, Neosporin Plus (which has cortisone) can be helpful as well.

bendyfoot July 28th, 2009 01:31 PM

The area extends about 1-1.5" away from the vulva in all directions. There is some hair loss and irritation further up her belly, and around her anus, but I'm pretty sure that's from the chewing she's doing. She's had several bacterial vaginal infections (staph). No UTIs that we've been able to detect. Very minor presence of fungus showed up on a swab.

If it was an allergy would we expect to see irritation elsewhere? She occasionally gets some dermatitis between her toes but is otherwise fine apparently...

bendyfoot July 28th, 2009 01:32 PM

ok I've used an OTC cortisone a few times too when things looked really red.

She's definitely NOT overweight, we have to stuff her with a ton of food to keep any weight on her, she's usually on the bony side.

Good to know about the absorption rate of the topicals, I didn't know that before...I can mellow out about watching her for licking after 15 minutes then, yay!

bendyfoot January 14th, 2010 08:08 PM

So I'm reviving this thread because there's very little information and fewer personal accounts available on the web, or on this site, and if someone wanders to pets.ca looking for information about an [B]episioplasty[/B], at least there will be this (Yes, I document things. It's what I do, I'm a geek and can't help it)

Jaida, our three year old GSD, had an episioplasty today, to treat the dermatitis she's been suffering around her genital area for quite some time. Medications, wipes, creams etc. had not helped to this point so this was really our last option if we wanted to treat it.

As Dr. Lee described in a earlier post, Jaida now has a horseshoe or crescent-shaped incision between her vulva and her anus. I'm guessing the incision is about 7" long in total; it has been closed with sutures. She has been sent home with antibiotics, and two pain medications (Tramadol and Metacam).

The incision bleeds only a little bit, as long as she's leaving it alone. I've been assured that this is normal for such a highly vascularized area of the body. She is, however, wanting to scoot her bum on the floor; this is definitely something I'm going to be preventing her from doing, as it worsens the bleeding considerably. I'm having a bit of an issue with her cone, too...it's long enough to keep her from licking, but the edge of the cone itself it banging the incision. I'm now considering spending the night here with her on the floor to keep her from damaging the wound...overkill? Maybe, but what's a worried dog-mom to do?

I've also been instructed to apply warm compresses to the area 2-3 times a day. I managed to do this successfully once tonight, although it seemed to be sore for her when I did it.

She has peed once tonight, and it didn't seem to hurt at all, so that's a positive thing.

I may post a picture, or a link to one, later this week so interested parties can get an idea of what we're working with here. There is [URL="http://www.youtube.com/watch?v=54WMHU67xuo"]one video[/URL], of the surgery itself, available on YouTube, for those who aren't squeamish.

rainbow January 14th, 2010 11:02 PM

[B]Bendy,[/B] I hope Jaida has a speedy recovery. :fingerscr :goodvibes:

Since there is so little info here about an episioplasty/vulvoplasty I think you should post your information in the Pet Encyclopedia forum [url]http://www.pets.ca/forum/forumdisplay.php?f=65[/url] with a link to this thread. :thumbs up

TeriM January 15th, 2010 02:11 AM

Speedy recovery for Jaida :goodvibes: :fingerscr :goodvibes:.

bendyfoot January 15th, 2010 08:04 AM

[QUOTE=rainbow;874005][B]Bendy,[/B] I hope Jaida has a speedy recovery. :fingerscr :goodvibes:

Since there is so little info here about an episioplasty/vulvoplasty I think you should post your information in the Pet Encyclopedia forum [url]http://www.pets.ca/forum/forumdisplay.php?f=65[/url] with a link to this thread. :thumbs up[/QUOTE]

Hm, maybe not a bad idea. I can post the few links I found too. Alright lemme see what I can come up with.

Ok, new entry here: [URL="http://www.pets.ca/forum/showthread.php?goto=newpost&t=67934"]Episioplasty-canine[/URL]

And an update for this thread today:

She slept well overall last night, from 11-4 a.m. without a peep. She got another Tramadol at 4:30, and I napped with her until about 6 a.m.; she needed some supervision because she was trying to scoot/lick again.

She had a pee this morning, no problem, and enjoyed a good roll in the snow. She started her antibiotics this morning.

One thing that surprises me is that it doesn't seem to hurt when she wags her tail...I would have thought that would be sore, but her tail hasn't stopped!!!

She is napping now, with her cone on, and is being a good girl. :D

rainbow January 15th, 2010 01:11 PM

Glad to hear that Jaida is recovering well. :thumbs up

And, thanks for posting the info in the Encyclopedia forum :grouphug: .....it was very well written. :highfive:

bendyfoot January 16th, 2010 04:12 PM

Little update:

one end of the incision is still weeping a bit (clear bloody fluid)...I spoke to the vet today about it, and she said it's ok/normal...but I wasn't too worried about it really.

I'm still giving Tremadol three times a day and Metacam once...but we seem to be able to go longer between Tremadol doses before she gets fidgety, so I'm hoping to reduce her to 2x/day tomorrow. Her pain seems to be managed really well.

I have to say I'm really impressed with her recovery so far...she's really full of beans, I have to keep her penned inside mostly, and definitely have to keep her on-leash when outside, otherwise she'd be doing zoomies around the yard I'm pretty sure.

I'll post a photo update later tonight.

On a side note, the lumpectomy incision on her side, which is also pretty big (about 7" long, 10 stitches) seems to be non-existant in her opinion...she's not bothered by it in the slightest and is sleeping on that side as I type this. It's looking lovely and healthy; I'm very pleased.


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