Mia’s designer vagina gives her something to smile about…
You might be thinking that I’ve cracked, I’ve finally lost it. Why on earth would I do a procedure that involved a designer vagina in a dog? Well poor Mia had a hooded vulva, which means that she had excess skin folding down over the top of her vulva. This resulted in chronic vaginitis (inflammation and infection of her vulva). After months of unsuccessful medical treatment it was time to change our approach. That meant going back to basics and removing the underlying cause rather than treating the symptoms that were presenting.
WARNING: If you scroll down you will see two close up pictures of a dog's vulva! If you're not keen on this, then I would stop now.
Mia is booked in for her designer vagina
So, we booked Mia in for surgery. She was fasted overnight and came into the hospital bright and early in the morning. Her pre-anaesthetic blood test and physical examination were normal so she was able to proceed with her surgery.
Now as you can imagine I was operating on a rather sensitive area so as I do with all surgical procedures I premedicated her with a mild sedative and a nice strong pain killer. It is called pre-emptive pain relief when we provide our patients with pain relief before the painful procedure even begins. By providing pre-emptive pain relief we find that the pain can be better controlled after the procedure and with lower doses of medication that if I was done without pre-emptive pain relief.
She was anaesthetised and attached to an inhalational anaesthetic (the type that she breathes in to keep her asleep). I also attached intravenous fluids and monitoring equipment for the entirety of the surgery. When our patients are anaesthetised we monitor their heart rate, respiration rate (breathing), mucous membrane colour (gum colour), oxygen saturation (SpO2), blood pressure and temperature. Mia’s nurse Liz monitored her anaesthetic whilst I was operating.
Once she was anaesthetised the area was clipped (shaved) and then cleaned so that it was as clean as possible prior to surgery. This means that we clean/prep the area using three different solutions. The first solution is chlorhexidine wash, the second methylated spirits and third is iodine. We do multiple cleans of the area with each solution, always wiping from the middle out so not to introduce dirt onto the area that we are operating on. We avoided getting methylated spirits and iodine in her vulva. I also gave her an antibiotic injection.
Mia was positioned on her tummy (sternal recumbancy) with her bottom elevated and tail held up and out of the way. To ensure that she didn’t defecate (poo) on the surgical site I placed a “stay suture” around her bottom to stop her from being able to poo. This was removed after the procedure.
I made an incision above her vulva and removed a crescent shaped piece of skin. By doing this I was able to lift the skin and stop the fold from obstructing her vulva. I have included before and after photos – apologises if they are a little graphic. You can see from how red and inflamed her vulva is just how irritated it was.
Now, Miss Mia had a real tendency to lick. Lick, lick, lick. That was part of why she kept getting infections in her vulva. I made the decision to bury my stitches because she was a licker, but mostly because it had been impossible to examine her vulva in the clinic. Her vulva had become so sore that she refused to let us look at it. If I put nylon stitches in, I thought the chances of getting them out without anaesthetising her were slim to none. By burying my stitches I wouldn’t have to remove any stitches, they would simply dissolve over time.
I gave Mia, more pain relief before she woke up and went home. Then dispensed a course of antibiotics and pain relief to continue at home. She returned 10 days later so that I could check her wound.
Everyone was thrilled with how well Mia had been progressing at home. She had stopped licking her vulva altogether. She even let me look at her vulva without any help from my nurses (normally it would take 3 nurses and her owner to get a passing glimpse). It was decided that the worst part of the operation was the hair cut – think doggy Brazilian. Apart from the family being to embarrassed to walk her during the day she was fantastic.
I am pleased to report that a month later she is still doing fabulously well. She no longer has the extreme haircut and she’s happier than she has been in months. Has your pet had a life changing procedure?