Ups and Downs with Yogi

I'm so happy you may finally have a diagnosis and will be able to fix Yogi's bowel distress. Fingers crossed for you and Yogi!
 
Firstly, thank you for your continuing support :smile2: It really does help to be able to talk through your worries with friends at times like this.

I was able to pick Yogi up at 4.15 this afternoon. I had another consultation with the vet beforehand and the good news is that all of the tests have come back clear. The only one not back yet is the hormone test for Addison's but that is unlikely to be an issue. The specialist soft tissue vet had also examined Yogi and even without the case history had arrived at the same diagnosis, so it would seem a certainty this is the issue.

The treatement will be surgery to move muscle from somewhere else to repair the muscle on the right side, which is wasted. It's a well practiced proceedure, although somewhat complicated. Sadly it also means Yogi will have to be castrated, as this will greatly reduce the risk of a reoccurance of the problem. As Yogi is not going to be shown again, or used for breeding, and is not a really 'male' sort of dog (unlike Revel!) it's just really going to be me coming to terms with it.. however, really there's no choice if it is going to help. Poor boy is also going to look like :eek2: with hair shaved off from all sorts of places. He's come back today with a patch missing on each foot. I presume this was something to do with the ECG they have done.

The specialist soft tissue surgeon will be carrying out the operation and I will hear from the vets tomorrow so that this can be arranged. It's going to be fairly soon, maybe even on friday.

I asked what causes this condition and no one knows. Much more common in dogs (more so in certain breeds including corgis, boxers and collies) and only ever seen in (I think) entire males - never bitches. Just seems to be one of those things.

The prognosis following surgery is very good and Yogi should be able to eat a normal diet (perhaps just needing 'stool softning additives) and will be able to lead a normal life with a normal life span.

I'm dreading the operation as I'm sure it is going to be quite horrid (certainly sounds it) but am SO relieved that finally this wonderful vet has been able to correctly diagnose what has been causing this and it is correctable by surgery with very good prospects. There is light at the end of the tunnel and it's slowly coming closer.
 
I'm glad to hear that Yogi's troubles are going to come to an end very soon. It sounds like you're both in wonderful hands at a very knowledgeable vet office. (I wish I could take Miko there!!)

Also, I know that you're feeling badly about what Yogi is going to "lose"... but I'm sure he'd gladly give them up in order to feel better... so if he's not feeling bad, neither should you. :sadsmile:
 
I am so happy to hear you finally have a diagnosis for Yogi. Although we never like to see our babies go through surgery this will be a great outcome for Yogi in the future. Please let us know when you schedule his surgery and I will be praying for You and for Yogi to have an easy recovery.
 
seashel said:
I took Yogi in for admission for his colonoscopy this afternoon..
It was with a vet who has a very high reputation in this area:smile2:

Our consultation lasted very nearly an hour and he asked me to recap on the case history, then did a physical exam. He mentioned Yogi had a lowish heart rate (nothing serious) and explained about the colonocopy, but said he did not think it was the next stage, as he suspected the problems are being caused by a perinela hernia. He drew a very helpful diagram to explain it. Basically there is some muscle wastage on both (more pronounced on one) sides of the rectum and this has caused a pouch to develop into which fecal matter accumulates. When there is sufficient accumulation, Yogi tries to pass it but because it's not normal shape and very impacted, this causes difficulties and straining and sometimes blockage. He has admitted Yogi for further tests overnight and is going to have the soft tissue specialist take a look and is also testing for Addison's, just in case. Apparently perineal hernia is not uncommon in middle agd intact males, especially collies (often associated with prostate enlargement, which I don't think is the case with Yogi). As soon as he explained it, I immediatly felt he was right as it all seemed to fit with the symptoms. It can be surgically corrected so that is a relief. I will have to wait until about 3pm tomorrow to hear what is going to happen next, but for the first time this began, I acatually think we are getting somewhere.
It was horrible having to leave Yogi behined and I am thinking about him all the time, but he's quite laid back about this kind of thing so hopefully will take it in his stride. I had thought that the colonoscopy was the only diagnostic option left but now I am hopeful he will not have to endure this.
I'm feeling optimistic and worrying at the same time, which is odd and can't wait for tomorrow afternoon to come!
Click to expand...

I just catching up on posts and I read your post before this one and thought "man,that sounds alot like a perineal hernia" but dismissed it as you can usually feel it on rectal exam. I glad that they were able to get a diagnosis and that it can be fixed. Sending good thoughts for surgery.

I myself have since 4 cases and 2 where in shelties, 1 GSD, 1 Boykin spaniel. One poor guy had herniated his bladder into the hernia.

Here is some info:
Perineal Hernia Repair
Atlantic Coast Veterinary Conference 2001
Howard B. Seim III, DVM, Dipl. ACVS
Fort Collins, CO
18288573
Key Points
• knowledge of anatomy of pelvic diaphragm is essential

• clearly identify anatomic structures to be sutured

• examine hernia closure carefully for defects

• after surgery remove pursestring, palpate rectum, watch patient walk back to cage

Perineal hernia is defined as a defect in the anatomic structures making up the pelvic diaphragm. The pelvic diaphragm is made up of levator ani muscle, coccygeus muscle, external anal sphincter muscle, and perineal fascia. Other important anatomic structures that aid in surgical repair of perineal hernia include the sacrotuberous ligament and internal obturator muscle.

Perineal hernia occurs when protrusion of pelvic viscera (i.e., prostate, rectum) or abdominal viscera (i.e., bladder, small intestine) occurs through supporting structures making up the pelvic diaphragm.

The cause of perineal hernia is unknown. Many factors have been incriminated in its etiopathogenesis including:

1) hormonal imbalance

2) congenital predisposition

3) structural weakness of the pelvic diaphragm

4) prostatic disease

5) chronic constipation

It was shown in one study of 771 dogs that 93% of the affected dogs were intact males. It has also been shown that females have a larger, heavier, stronger levator ani muscle with a longer rectal attachment than the male, and that the sacrotuberous ligament in the female is larger. These findings may help support a hormonal influence to the etiology.

Certain breeds such as Boston terrier, Pekinese, and boxers have a predisposition for perineal hernia, suggesting a familial risk. However, many mixed breed dogs also are commonly affected.

Structural weakness of the pelvic diaphragm, especially in breeds with rudimentary tails (e.g., Boston terrier, Old English sheepdog, boxer) may imply a conformational predisposition. However, breeds with normal tails (e.g., German shepherd dog, collie, mixed breeds) have an equally high incidence.

Prostatic disease is commonly seen in older (> 6 yrs of age) intact males. This may cause severe straining and predispose the patient to hernia formation. However, many dogs that present with perineal hernia do not have significant prostatic disease.

Any disorder resulting in chronic straining to defecate may have an influence on the incidence of perineal hernia in the dog.

A diagnosis of perineal hernia can be made on history, clinical signs, and visual and digital rectal examination. Dogs often present with a history of constipation and tenesmus. Visual perineal examination reveals perineal swelling that may be reducible. Digital rectal examination reveals loss of the normal pelvic diaphragm and either abdominal viscera or pelvic viscera within the hernial sac.

Occasionally patients present with urinary obstruction due to retroflexion of the urinary bladder into the hernial sac. A presumptive diagnosis is based on a history of urinary obstruction, perineal swelling that is firm and turgid on palpation, and the presence of a fluctuant mass in the perineum on rectal palpation. Definitive diagnosis is accomplished by either urethral catheterization resulting in reduction of the size of the mass or centesis of urine from the perineal mass. These patients may be quite sick depending on the duration of urinary obstruction. An indwelling urinary catheter and sterile collection device should be placed while the patient's renal function is stabilized.

Rarely, a patient will present with incarcerated small intestine. Emergency reduction via abdominal exploratory is indicated. Resection and anastomosis is performed based on bowel viability after reduction and enteropexy considered. Repair of the perineal hernia should be staged depending upon patient status.

Treatment of perineal hernia by surgical correction is generally accepted by most clinicians as the most successful means of management. Medical management with stool softeners and periodic digital evacuation may be attempted but may only temporarily control the problem.
 
Thank you for the info Dr Shelli, reading it, it does sound exactly right:yes: the only thing is Yogi does not apparently have any external swelling but everything else fits.

Yogi is booked to have the surgery on Friday. He will be starved from 7pm Thursday and I will take him in the morning. The proceedure is going to be carried out by a 'soft tissue specialist' vet who comes in every 10 days or so to perform the trickier surgeries, so Yogi couldn't be in better hands. That said, I'm still in rather a state about it. He's had surgery before but it was simple so I've never experienced the worry major operations bring:( The Vet Hospital will keep me updated how he is doing and all being well, I should have him home in the evening. Fortunatly Yogi seems to handle anasthetic better than Revel (who takes a day to recover from mild sedation) so I'm hopefull. Then just a case of recovering.

I'm wondering why the referral vet who did the ultrasound did not make the diagnosis, as he also performed an internal examination, as did all three of the other vets Yogi has seen along the way... However, the main thing is that I at last have a concrete diagnosis of what has been causing all the trouble and once Yogi has recovered from the surgery, he ought to be fine.
The vet sees no reason why he should not stay on the raw food diet, so I am happy that he can remain on this as it did seem to suit.
 
Mikos_Mom said:
I'm glad to hear that Yogi's troubles are going to come to an end very soon. It sounds like you're both in wonderful hands at a very knowledgeable vet office. (I wish I could take Miko there!!)
Click to expand...

This vet is really amazing! Many years ago my auntie (Merlin's mum) had a Golden Retriever who was diagnosed with heart failure and the vet said she had not long to go. My auntie asked to be referred to a heart specialist, and this same vet that Yogi has seen was able to correctly diagnose that Dusty in fact had thyroid troubles. On medication she was instantly a better dog. So we are all round here in total awe of him, as many of our dogs owe him big time!

Not only this, but more importantly in many ways, he has such a reassuring manner that simply installs total confidence in people (and animals).
The surgery is a Hospital as well as a normal clinic so they are able to take the complicated referrals. I acatually used to go there when Revel was a puppy and Yogi has had his eyes examined there by another specialist, it's just further away now I've moved.
We are indeed very lucky.
 
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