Vaginal rupture and evisceration in a dog

Successful medical management of a vaginal wall tear in feline dystocia

Case summary

A 2-year-old domestic shorthair queen sustained a tear in the vaginal wall through which the queen herniated a fetus during parturition. An exploratory laparotomy was performed, the patient had an ovariohysterectomy and the fetus was removed vaginally. The tear was managed medically with antibiotics, analgesics and careful monitoring. Assessment of the injury site 2 weeks later confirmed successful healing without the need for surgical intervention in the vaginal wall.

Relevance and novel information

This is the first report in veterinary medicine describing the successful medical management of a dystocia-related vaginal wall tear in a feline patient without surgical repair.

Management of Vaginal Hyperplasia in Bitches by Bühner Suture

Vaginal hyperplasia in bitch is an exaggerated response of the vaginal mucosa to estrogens during the proestral-estral phase of the cycle that can protrude through the vulvar lips. The present study refers to the management of vaginal hyperplasia in bitches by Bühner vulvar suture. Fourteen private-owners animals were refereed for spontaneous vaginal hyperplasia and complete protrusion of the mucosa, without ischemic or necrotic areas, which occurred during the proestral-estral phase. Under general anesthesia, prolapsed mass was cleaned with 50% glucose solution to reduce oedema and gently repositioned; the Bühner suture was applied using a Gerlach needle and a sterile vaginal suture tape, maintaining a minimal opening to allow urination in order to avoid possible recurrence in the same estrus. None of the bitches showed recurrence during the current cycle, proving the effectiveness of the Bühner suture. To prevent the possible recurrence of vaginal hyperplasia at the subsequent estrus, all the bitches underwent an ovariectomy 2 months later, when the Bühner suture was removed. In conclusion, the Bühner suture proved to be useful for the conservative treatment of vaginal hyperplasia in medium- or large-sized bitches. However, this approach should be considered only for cases in which the prolapsed mass does not show trauma, ulceration, ischemic or necrotic areas.

Perineal hernia repair in dorsal recumbency in 23 dogs: Description of technique, complications, and outcome

OBJECTIVE

To describe repair of perineal hernias in dogs positioned in dorsal recumbency.

STUDY DESIGN

Retrospective case series.

SAMPLE POPULATION

Twenty-three dogs with perineal hernias treated by herniorrhaphy, with or without adjunctive procedures.

METHODS

Medical records from 2016 to 2020 were reviewed for technique description and animal outcomes, and owners and referring veterinarians were contacted for follow-up information.

RESULTS

Internal obturator muscle transposition (IOMT) was performed in 22 dogs, and polypropylene mesh repair was performed in one dog. Transection of the internal obturator tendon was feasible in all dogs undergoing IOMT. Eighteen dogs underwent abdominal pexy procedures, castration, or both during the same anesthetic period. No intraoperative complications were noted. Postoperative complications were noted in the hospital in 14 dogs and after release in 11. Incisional infection/drainage and persistent urinary incontinence were reported in four and two dogs, respectively. Hernias reoccurred in four dogs and tended to be more common in dogs that had undergone previous herniorrhaphies (p = .053). Recurrence rates were lowest in dogs that had no prior hernia repair or organ pexy (p = .035).

CONCLUSION

Perineal hernia repair was feasible in dorsal recumbency. Complication and recurrence rates of perineal herniorrhaphy in dorsal recumbency were similar to those reported for dogs undergoing the procedure in sternal recumbency.

CLINICAL SIGNIFICANCE

Positioning of patients for perineal hernia repair can be dictated by surgeon preference. Perineal hernia repair in dorsal recumbency allows a single-stage abdominal and perineal approach without repositioning.

Transvaginal uterine evisceration during labor in a Bengal queen

Case summary

A 2.5-year-old Bengal queen was admitted with a 12-h history of a mass protruding from the vulva during labor. At that time, three healthy kittens had already been delivered. Physical examination identified the mass as a portion of the uterus that was eviscerated without eversion of the mucosa. Exploratory laparotomy revealed a vaginal vault rupture with a large portion of the uterus herniated through the tear and eviscerated through the vulva. Ovariohysterectomy was performed, and a dead fetus was removed with the uterus. Reconstruction of the vaginal rupture required careful dissection and urethral catheterization. The queen recovered without complications.

Relevance and novel information

Uterine evisceration through a vaginal tear is a very rare condition that sometimes is erroneously referred to as ‘prolapse’. Uterine prolapse and uterine evisceration may have similar presenting signs; however, proper identification and surgical correction is key when the uterus is eviscerated. This case highlights the importance of differentiating these two conditions and of rapid identification and surgical intervention for successful patient survival.

Transrectal bladder prolapse secondary to pelvic fracture in two dogs

This report describes the exteriorisation of the urinary bladder in two dogs as a result of a laceration of the rectum from a traumatic pelvic fracture. Clinical examination and contrast radiography of the bladder were used as diagnostic tools. Both patients were treated with exploratory laparotomy, where traction of the bladder was utilised to pull the bladder through the traumatic rectal laceration allowing the organ to return to its normal anatomical position. This procedure was followed by surgical reconstruction of the rectum, resulting in effective resolution of each case.

Uterine prolapse with associated rupture in a Podengo bitch

A case of uterine prolapse coexisting with uterine horn rupture in a 3-year-old Portuguese Podengo bitch, which is an uncommon occurrence, is described. The female was presented with a history of recent parturition, with delivery of four healthy puppies that were normally tended and nursed. The situation developed after an uneventfully pregnancy, and no direct causative factor was identified. The duration of the prolapse was unknown, but considered to be recent because of the swollen reddish appearance of the tubular everted mass. No foetus was found in the uterus or the abdominal cavity. The female was presented in good physical condition, without signs of shock or haemorrhage. During surgical treatment, the uterus was replaced to its normal position followed by ovary-hysterectomy at 12 h from admittance.