Boston terrier's hernia problem illustrates value of second opinion
Q My dog is a 10-year-old Boston terrier has problem that's been going on for about a year and he is miserable. My vet called it a hernia and said that his colon was trapped in it. He has a huge bulge on his backside and he strains to have a bowel movement. My veterinarian says that we should consider putting him to sleep because the surgery for this is not very successful, and he is too old to go through that anyway. We are devastated. He/we cannot go on like this, but he is otherwise very active and healthy for his age. What do you think?
A: This kind of story drives me (Dr. Henri Bianucci) crazy. I just had a client tell me that they had put their puppy to sleep recently because he had very bad hip dysplasia. He was going to be a big dog and their vet told them that hip replacement surgery was the only option for a dog that size.
There is, however, a much less expensive alternative to a hip replacement called a femoral head ostectomy. This is very effective even for very large dogs.
Everyone, including the veterinarian, was trying to make the right decision for the dog. The owners didn't want to see him living in pain and immobility, and the vet didn't want them to do a procedure that wouldn't work.
The problem is, he was giving them outdated information, which was based upon a study published in the 1970s that said dogs over 45 pounds were not suited for this procedure. This belief persists to this day in the minds of many veterinarians. I was taught the same thing. But my experience and subsequent studies say otherwise. I have performed femoral head ostectomys on huge dogs for 18 years with virtually no complications.
Your case is another example of why you should not hesitate to seek a second opinion, and do some research, when it comes to the health of you or your pet. Innovations in medicine and surgery are happening all the time, and conditions once thought to be poorly responsive to surgical repair are now seen to be highly treatable. So when a condition seems beyond help, digging a little may yield some promising options. Charlie has such a condition.
In addition to being man's best friend, dogs share a condition with us: benign prostatic hypertrophy. This is the testosterone-driven enlargement of the prostate gland. In men, this growth tends to compress the urethra, obstructing the flow of urine. In dogs, the urethra is not usually affected, but the enlarged gland can impede the passage of stool, causing dogs to strain.
The testosterone also seems to weaken the muscles of what is known as the pelvic diaphragm. This is a network of muscles in the pelvis that helps keep the abdominal contents in when abdominal pressure rises. The combination of increased straining against impaired muscle tone results in hernia formation. This condition is almost exclusively seen in intact males, which is just one more reason to neuter your dog.
These hernias cause the colon to make a U-turn at the exit, making it difficult to impossible to pass stool. These can become life-threatening emergencies if the urinary bladder is entrapped. The procedure entails rebuilding the pelvic diaphragm. Most of the time this is done by rearranging muscles. Neutering also is required to reduce straining.
As we have said many times, age is not a disease. Certainly, with advancing age, the odds that an individual has or will develop a health condition increases. But in an otherwise healthy patient, age is not a significant factor in the ability to withstand anesthesia, surgery and recovery.
Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to email@example.com.