Episioplasty - canine
I've been prompted to enter an article about canine episioplasty, based on our experience with Jaida. There's not a ton of info available online, so I'll try to compile the most useful stuff here.
What is an episioplasty?
An episioplasty (also sometimes called a vulvoplasty) is a surgery that removes extraneous perivulvar skin. In English: extra skin growing around the vulva. If you would like to see an example of the surgery, there is a YouTube link available here. Warning: this video contains graphic, uncensored images of an actual surgery.
Where does the extra skin come from?
This problem of excess skin is especially common in obese dogs and those dogs born with prominent perivulvar skin folds that cover the vulva (also called recessed vulva, or vulvar hypoplasia). This means, in some cases (i.e., those involving obesity), the condition can be preventable. Weight management is also very important for the long-term management of the condition after the surgery; research indicates that post-surgical weight gain can lead to a recurrence of the condition.
Why would a vet recommend that a dog undergo an episioplasty?
Excess skin around the vulva traps urine, debris and bacteria. Common ailments of dogs that have these extra folds of skin include chronic urinary tract infection (UTI) and chronic perivulvar dermatitis (also called skin fold pyoderma, perivulvar pyoderma, mucocutaneous pyoderma of the vulva, perivulvar dermatitis, and intertriginous dermatitis), i.e., redness, itching, swelling of the skin around and on the vulva. Some dogs will worsen their condition through self-mutilation (chewing, etc. of the area). Vaginal tract infections and urinary incontience are also common.
These conditions are painful and can be costly for the owner. If other management methods (i.e. antibiotics, weight loss, topical creams, etc.) fail to improve the condition, the vet may recommend a surgery to remove the extra tissue.
What about cats or other animals?
Cats can get this condition as well, and can undergo a corrective episioplasty, but it doesn't seem to be as common. One article from the Journal of Small Animal Practice describes an episioplasty effectively treating perivulvar dermatitis in cat.
There are also several articles that describe the condition and surgery for mares (female horses). See here for an example.
What is the recovery like?
If your dog comes home the same day as the procedure, expect her to be a bit woozy/dopey from the anaesthetic. Anaesthetic can make dogs feel pretty weird for a day or two, so she may be whiny or clingy until it is flushed from her system.
You will see a horseshoe or crescent-shaped incision between your dog's vulva and anus (with the "ends" pointing down towards her feet). Our dog's incision is about 7" long with roughly 20 sutures. Some post-operative swelling for the first little while is normal.
She will very likely want to lick the surgical area, or even scoot her bum on the ground...both of which you must prevent in order to allow the incision to heal. The vet should give her an elizabethan colar (cone) to wear to prevent licking, and she may need to be crated and/or monitored closely to prevent scooting.
Your dog will go home with antibiotics to prevent infection, and pain medication. You may be asked to apply hot compresses to the area several times a day to help with pain and swelling. Your dog's activity level will be reduced for 10-14 days; your vet may recommend a different time frame. Sutures will have to be removed approximately two weeks after the surgery.
Expect your dog to be sore after the surgery. Medication should effectively manage the pain for the post part, but there will still be some discomfort; the mere presence of stitches can also be very agravating for some dogs. Some minor bleeding from the incision would be considered normal for the first few days.
Watch for unusual swelling, redness or discharge, as you would for any surgical incision.
You can read my own pets.ca thread on our experience with Jaida's episioplaty for a personal account of her experience and recovery.
I have also created a photobucket album of pictures taken during her recovery, plus one pre-operative picture. Warning: these are graphic photographs showing a recent post-operative surgical site.
What is the long-term prognosis after the surgery?
Research indicates that, barring weight gain after the surgery, the vast majority of dogs experience complete resolution of the UTIs or dermatitis after healing was complete. Post-surgical complications are extrememly rare. The surgery seems to be a very effective solution for the conditions listed above.
How much will this cost?
A fair question. I have been able to find no references to cost online, and of course the price will vary depending on your own dog's needs and your vet's pricing. Some things that could increase/lower the cost include: preanaesthetic blood work, medication, elizabethan colar (cone), IV fluids, extra surgical time/anaesthesia units, overnight hospitalization, etc. In our case, the surgery was roughly $550 CAN (I'm not sure of the exact cost because she had a lump removed as well, so I'm guestimating the amount of surgical time/anaesthetic that was used only for the episioplasty). We did not do any preanaesthetic blood work for this procedure (but have for others) and we did not need either a cone or one pain medication that was offered, since we have them both at home. I would say that $700-1000 would be a reasonable estimate for the procedure.
This may seem like a lot of money, but if you consider that treating a single UTI can cost several hundred dollars (examination fee, urine collection, urine analysis, urine culture&sensitivity, antibiotics, and recheck exam), this procedure is likely less expensive for the owner in the long run, and means fewer bouts of illness for your pup as well...it's a win-win.
American College of Veterinary Surgeons page on Vulvar Fold Dermatitis Warning: post-operative pictures on the page
University of Guelph web page on Reproductive Pathology
Episioplasty for the treatment of perivulvar dermatitis or recurrent urinary tract infections in dogs with excessive perivulvar skin folds: 31 cases from the Journal of the American Veterinary Medical Association
Results of Vulvoplasty for Treatment of Recessed Vulva in Dogs , from the Journal of the American Association of Animal Hospitals
Solomon - black DSH - king of kitchen raids (11)
Gracie - Mutterooski X - scary smart (9)
Jaida - GSD - tripod trainwreck and gentle soul (4)
Heidi - mugsly Boston Terrier X - she is in BIG trouble!!! (3)
Audrey - torbie - sweet as pie (11 months)
Patrick - blue - a little turd (but we like him anyways) (6 months)
Boo, our Matriarch (August 1 1992 - March 29 2011)
Riley and Molly
Last edited by bendyfoot; January 19th, 2010 at 06:50 PM. Reason: added photobucket album link, other edits