Sunday, December 28, 2014

Perineal hernia repair surgery - queries

EMAIL TO DR SING DATED DEC 29, 2014

Hi

I brought XXX to your clinic yesterday. He is the 8 year old mini Maltese with a hernia on the right. It was recommended that we send him for surgery.
 
We love him very much and are concerned that he should not go through any suffering.
May we please know the following:

1. What are the risks of surgery and the likelihood of these risks occurring?
2. What will happen if we do not go for the surgery now? Is there an option to go for surgery later?

Thank you for your time.

Kind Regards

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EMAIL REPLY FROM DR SING DATED DEC 29, 2014

I am Dr Sing from Toa Payoh Vets.

1. The risks are mainly anaesthetic deaths on the operating table as the dog is old (more than 7 years in small breeds is considered old).
It is hard to predict the chances of survival as each dog is an individual with different outcomes.  Generally, if the dog has a normal heart and lungs, is active and eating and drinking normally, with normal stools and urine, the blood tests show normal values, then the risks are less than 1%. Such dogs survive anaesthesia and perineal hernia repair. in my experience over the last 30 years.

2. The hernia gets bigger if you wait another year. The intestinal blood vessels may get twisted when the herniated intestines in the hernia turns and twists. This results in death or emergency surgery for painful obstruction of urine flow or intestinal gangrene. In such situations, the risks are much higher.

Presently, the dog has "no problems" passing urine and stools and show "no pain" although the hernia is much larger. Therefore, you have to make an informed decision as to whether you want surgery to repair the hernia.  


Hernia now is the size of an orange. When it was small, a vet had advised that there was no need to operate as the dog could pee and poop. Over time, it mushroomed to the present size. I could feel a full bladder and the intestines could be pushed inwards, reducing the size temporarily. There was only slight pain on reduction of the hernia.
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EMAIL TO DR SING DATED DEC 30, 2014




Dear Dr Sing
 
Thanks for the reply. It is really appreciated. We just have a few follow up questions - What sort of care will Pickles require post surgery? Will he require special attention? Also, will he be able to pass urine and stools immediately after the surgery?
 
Regards



EMAIL REPLY FROM DR SING DATED DEC 30, 2014
Post-op care include wound cleaning and confined to a cage for at least 14 days so that the backside and inner stitches will not break down by jumping. A diet that does not cause hard stools to form. Can pee and poop after surgery in most cases if the intestines and bladder have not suffered inflammation and infection before surgery. Stools may be passed 2-3 days later. Pain-killers will be given for at least 4 days. Antibiotics given for 14 days generally. 

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