Veterinary Medicine - January 2008 - (Page 22)

PEER-REVIEWED A challenging case: Phimosis in a young adult dog This homeless dog’s phimosis had not improved with conservative medical management. Surgery and diligent postoperative care gave this patient a second chance for adoption. Kelly Saporito, DVM A Vital Stats Signalment A 2-year-old 32.1-lb (14.6-kg) intact male mixed-breed dog 2-year-old 32.1-lb (14.6-kg) intact male mixed-breed dog from a local animal shelter was presented to the Cornell University Hospital for Animals soft tissue surgery service for castration and surgical treatment of phimosis due to a congenitally stenotic preputial ori ce. HISTORY The shelter of cials had noted the stenotic preputial ori ce and preputial swelling when the dog was initially presented to them. Fine-needle aspiration of the swelling had revealed suppurative uid and urine pooling in the prepuce. Repeatedly aspirating uid from the prepuce had not resolved the problem. History and presenting complaints • Phimosis due to a stenotic preputial oriﬁce • Preputial swelling • Unsuccessful treatment with ﬂuid aspiration PHYSICAL EXAMINATION On presentation to the hospital at Cornell, the dog was bright and alert and had a body condition score of 4/9. A large, uctuant swelling of the prepuce (Figure 1) and a retained right testicle were noted. Additionally, the visible tip of the penis was hyperemic and slightly swollen and could not be extruded from the stenotic preputial ori ce (Figure 2). The penile mucosa was adhered to the preputial mucosa at the preputial ori ce. Urination was observed, and the dog urinated a normal amount in a constant stream and had no stranguria. The urine was normal color. Physical examination results were normal except for ea infestation. Physical examination ﬁndings • Preputial swelling • A retained right testicle • Flea infestation by refractometry), and rapid estimation of blood urea nitrogen concentration (by using a dipstick) were normal. Oral nitenpyram (Capstar—Novartis Animal Health) was administered to treat the ea infestation. The patient was premedicated with subcutaneous acepromazine and hydromorphone. The preputial swelling was aspirated, and 78 ml of purulent uid was obtained. Since previous analysis showed a nonseptic suppurative uid, the shelter of cials declined uid analysis, cytologic examination, and bacterial culture and antimicrobial sensitivity testing. Anesthesia was induced with intravenous propofol, an endotracheal tube was placed, and anesthesia was maintained with iso urane. Carprofen (4 mg/kg) was also administered subcutaneously. The dog was placed in dorsal recumbency. Its ventral abdomen and prepuce were clipped, aseptically prepared, and draped in the standard fashion. Perioperative antibiotic therapy consisted of intravenous cefazolin (22 mg/kg every two hours). Plasmalyte A (Baxter Healthcare) was administered intravenously at 10 ml/kg/hr for the rst hour and at 5 ml/ kg/hr every hour thereafter throughout the procedures. Kelly Saporito, DVM* Hospital for Animals College of Veterinary Medicine Cornell University Ithaca, NY 14853 *Dr. Saporito’s current address is Coral Springs Animal Hospital, 1730 N. University Road, Coral Springs, FL 33071. SURGICAL PROCEDURE The right testicle was palpable in the subcutaneous tissues of the inguinal region. A right inguinal castration was performed, and a routine closed castration was performed to remove the left testicle. The right testicle was submitted for histologic examination. Further examination of the preputial ori ce revealed that the penile mucosa was adhered circumferentially to the preputial ©iStockphoto.com/Tamara Murray PRESURGICAL TESTING AND PREPARATION Before surgery, the results of the dog’s packed cell volume, blood glucose concentration (measured by using a glucometer), total solids concentration (measured 22 January 2008 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - January 2008

Veterinary Medicine - January 2008 Contents Digital Extra Letters Toxicology Brief Idea Exchange A Challenging Case: Phimosis in a Young Adult Dog The Indications and Technique for Continuous Ambulatory Electrocardiographic Recording in Dogs A Review of Selected Systemic Antifungal Drugs for Use in Dogs and Cats CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - January 2008

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