Veterinary Medicine - January 2008 - (Page 23)

1. A large, ﬂuctuant swelling of the prepuce was noted on physical examination. Fine-needle aspiration revealed suppurative ﬂuid and urine pooling in the prepuce. 3. Fibrous connective tissue (arrow) was present dorsally and caudally between the parietal preputial mucosa and the visceral penile mucosa. 2. The tip of the dog’s penis was hyperemic and slightly swollen; the penis could not be extruded from the stenotic preputial oriﬁce. Additionally, the mucosae of the penis and prepuce were adhered. 4. A No. 15 blade and Metzenbaum scissors were used to separate the ﬁbrotic tissue attachments from normal tissue. ori ce. A 5-F red rubber catheter was placed in the urethra, and an incision was made with a No. 10 blade on the ventral prepuce starting 2 cm caudal to the preputial ori ce and extending 9 cm caudally. On entry into the prepuce, brous connective tissue between the parietal preputial mucosa and the visceral penile mucosa was present dorsally and caudally (Figure 3). The brotic tissue attachments were separated from normal tissue by using a No. 15 blade and Metzenbaum scissors (Figure 4). Hemostasis was maintained by using unipolar electrocautery. To avoid formation of new adhesions postoperatively, the exposed free edges of the visceral penile mucosa were carefully apposed by using 4-0 poliglecaprone 25 (Monocryl—Ethicon) in a simple continuous pattern (Figure 5). The same procedure was repeated for the free edges of the parietal preputial mucosa. The visceral penile mucosa and the ipsilateral skin edges were apposed with 4-0 polydioxanone (PDS II—Ethicon) in a simple interrupted pattern. The preputial ori ce was reconstructed by removing a triangular wedge of tissue from the dorsal aspect of the ori ce. The triangular wedge resection was oriented with the base at the mucocutaneous junction to create a larger preputial opening. Care was taken to not excise too much tissue, which may result in paraphimosis (an inability to retract the penis into the prepuce).1 The subcutaneous tissue along the ventral aspect of the prepuce was closed by using 3-0 polydioxanone (PDS II— Ethicon) in a simple continuous pattern. The skin was closed by using 3-0 monolament nylon in a cruciate pattern. The red rubber catheter was removed. Immediately after closure, the patient received morphine (0.05 mg/kg) and bupivacaine (0.02 mg/kg) epidurally. An indwelling urinary catheter was placed, and the catheter passed freely. The patient recovered from anesthesia without complications. POSTOPERATIVE CARE The dog recovered in the intermediate nursing-care unit, and a fentanyl patch VETERINARY MEDICINE January 2008 23

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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