Cryptorchid Neuter Canine. What Happens When Your Dog Doesn't Have His Testicles In The Scrotum?

This is Cash. He is an 11 month old German Shepherd.

He was purchased from a private breeder at 8 weeks old. At his first examination I, his veterinarian, found that only one of his testicles was in the scrotal sac where it belonged. He also has a small umbilical hernia.

Umbilical hernia in the center, shaving the scrotal area for the neuter.

An umbilical hernia can be a very dangerous finding in puppies. If the hernia (a hole the communicates with another adjacent body cavity, in this case the abdomen), doesn't close like it is supposed to then the contents of one space can possibly move between them. In Cash's case his intestines could slip out the open umbilical (belly button) hole. If a piece of intestine slips out we worry that it can twist and strangulate, therefore, inhibiting gut function. This can be fatal. All hernias should be checked by a veterinarian frequently to decide if, or when, surgical intervention is needed. Not all need to be closed, or require surgery, but all need to be monitored very closely and if the hole is big enough to let abdominal contents slip through surgery should be planned as quickly as possible.

Correcting the umbilical hernia

My bigger concern for Cash was his undescended, unpalpable testicle.

The testicle in the abdomen.

Abnormally small (the retained, intra-abdmoninal testicle) on the left,
and, the normal testicle (one in the scrotum) on the right.

Cash was seen by me every 3 weeks for his puppy examinations and vaccines. His missing testicle never made an appearance. At his 6 month exam we discussed giving him another few months to let gravity and maturity see if it could coax anatomy into its correct position. At 10 months old he still didn't have two palpable testes so his family elected to neuter him, correct his umbilical hernia, and perform an exploratory surgery to look for the missing goods.

Pre-op bloodwork ($60 for a partial chemistry and CBC) was done and returned normal.

Surgery included; umbilical hernia repair.
pre-scrotal neuter of the left teste.
abdominal exploratory surgery to find and excise the retained left testicle.

Cash did very well under anesthesia and his testicle was quickly and easily found in the caudal part of his abdomen by his urinary bladder.

cost for surgical care was;
anesthesia, $215, approx 90 minutes
medical pet shirt; $28
suture material; $150
NSAID, for analgesia; $20
antibiotic $$30
hernia repair $75
e-collar $15
castration cryptorchid $300
total about $930

Related Blogs;

Retained Testicle In A Dog.

If you are interested in help for your pet and don't know where to go please find us here at Pawbly.com. It is a free online community dedicated to educating and inspiring pet people everywhere. It is free to use and open to everyone.

I can also be found at Jarrettsville Vet in Harford County Maryland. Visit our Facebook page here, or see our online Price Guide at our website jarrettsvillevet.com

The Reason Veterinarians NEVER USE RUBBER BANDS!

There are a few Never, Evers! in veterinary medicine. They are the secrets that every veterinarian knows because one of our clients has learned the lesson the hard way. 

Like grandma used to say, "Never, Ever.. do this!" 

Here is my list of things that no sensible veterinarian would ever do. I hope they help you and your pet avoid a potential trip to the vet. 

This is Samantha. She is like many pets in that she licks her feet. 

She licks her feet for two reasons;

1. She has allergies.

2. The allergies have led to secondary skin infection on her feet. The licking causes infection, and dogs make their sore feet feel better by licking them. This is a cyclical snowballing syndrome. 

Her parents tried to discourage the foot licking by putting socks on her. But socks don't stay in place without help. So, they put a rubber band around the socks on her feet to keep them in place.

My Never Ever part of this story is, NEVER, EVER use a rubber band on a pet. In fact, I would even go so far as to say, if you have a pet in your house "don't have rubber bands in your home."

 This is even more important if you have small children and cats.

One of my worst rubber band story came from a cat who has an obsession with playing AND swallowing them. Two abdominal exploratory surgeries later, (to the tune of about $2500), and in all we have removed over 50 elastic bands from this "My Strange Addiction" feline edition episode.

My other "worst rubber band" story came when a cat was brought in for limping. Turns out the cat was frequently the Barbie doll replacement for the young daughter in the family. She routinely dressed up the cat, brushed her, and played house with the family cat. At some point she also tried to 'do her hair'. This included placing a rubber band on her leg. By the time I saw the leg it was swollen and the cat was unable to walk on it. It wasn't until we did surgery to amputate the leg that the rubber band was found acting as a tourniquet and cutting off the blood and nerve supply to the leg. Rubber bands have been found on tails, feet, legs, necks, and all with the same dire results.

In Samantha's case the sores from the rubber bands go all the way around her ankles and wrists. She may never grow hair back here. But, she walks normally, and it seems that no permanent damage to her feet or legs has occurred.

Samantha is a very loved dog. Her family didn't ever intend to hurt her. Accidents happen. It is our hope that her story will help others avoid the same situation.

If your dog is licking their feet excessively the answer lies in identifying and treating the underlying cause of the itch. This is almost always require a trip to the vet. There are some very good, very effective, and even much safer medications available these days. In cases where licking is severe and red, inflamed, smelly feet have resulted it is also important to get an antibiotic/antimycotic for the infection. If cost is a concern ask about over the counter options; Like foot soaks, topicals, or even over the counter antihistamines. As always, cheaper options are often available online, or at the local pharmacy.

It is also important to discuss prevention products like e-collars, booties, and pet shirts so pets cannot access the area that is bothering them. If you are considering stopping the licking by denying access to the area (with the use of an Elizabethan collar, booties, socks, muzzle, whatever) please remember that you are not helping your pet in an effective meaningful way. I see these as torture devices if used inappropriately, or incorrectly. How would you feel if you had poison ivy, allergies, an itch that was so compelling you couldn't stop itching it, and then someone put handcuffs on you? Don't put anything on your pet without asking your vet if it is ok to do so.

Stay tuned for more tips and Never, Evers!

If you have a story to share, or a pet mishap that you think others might benefit from please add it in the comment section below.

If you have a pet related question you can ask it for free at Pawbly.com. For more pet related information find me at my YouTube channel, my veterinary clinic's Jarrettsville Vet Facebook Page, or Twitter @FreePetAdvice.

Dig Until You Get An Answer,, Even If You Are Fishing In Unfamiliar Waters. Isa's Canine Leukemia.

Isa

There are a few hidden talents to a vet who has been in the trenches for a few years. It is the simple accumulation of enough stories that allows you to see a common plot in a new patient with a particular shimmer of a tiny clue in the blink of their eyes. It is hard to explain, but the longer you practice the more your gut guides you.

I met Isa on a busy over burdened Sunday afternoon. She and another pup were waiting at the door twenty minutes before we opened with sobbing parents, (never a good sign).

Isa's vet visits had begun with diarrhea 5 days ago and progressed to include vomiting 2 days later. Isa, an older German Shepherd, was now lethargic, despondent, inappetant, and withdrawn. She was also pale, weak, and unable to walk.  Her mom was understandably emotionally exhausted and fearing the worst.

Over the previous two days blood work and x-rays had been done at the ER where she had been transferred for the weekend. And, yet, here she was back at the place that had been searching for her answers for over 72 hours looking like time was no longer on our side. We knew she was sick and we knew she was getting sicker... we just didn't know why.

That's what medicine is. A battle between wits, guesses, diagnostics, and determination. It can be frustrating. Sometimes you get a case that has minimal tools to help you through your puzzle, whether they be a lack of resources to chase down every possible disease, lack of free time to dilly-dally when your patient is making a run for the white light, or a client who lacks the patience to allow you to sift through the most likely culprits to get to that elusive rare disease hiding in the rule out haystack.

Isa had been tested and cleared of all of what we thought were the most likely "treatable" diagnosis scenarios. Yet, here she was still sick and now flirting with dying. Every seasoned vet will tell you that most likely scenarios don't have a name. They have a breed and an age and a prayer to build a wish upon. Terribly cold labels to paint on a beloved family pet. But, there is truth to those old broad sweeping, emotionally void labels. Isa was still an older German Shepherd  who looked like the first guess on the suspicion page and the least wanted scenario. She looked like cancer. We just couldn't find it. Everyone of us knew that we had to be looking for this, we just didn't know where it was lurking. She was now at the door, sicker, paler, and weaker than ever before.

The ER had suggested to Isa's family that she have an exploratory surgery. It was a realistic request, the problem was that this was a Sunday and an exploratory surgery requires more staff than we have on hand and an intense follow up after care plan. I tried to apologize to Isa's desperate mom, and I felt awful about it. I knew that there was a chance she wouldn't live another day, I knew the answer might lie in her belly, and I knew that even if I could open her up and reveal her mysterious illness she would have to go back to the ER.

I did what I always do in this pinch with my heavily burdened conscious. I left my phone number and told Isa's family to have her back with us in the morning. If they wanted an answer I was sure as heck not going to give up looking for it. There is truth to the adage "where there is a will, there is a way."

Isa, we believed, was in need of an exploratory surgery to remove a mass in her belly. The x-rays seem to suggest this, so we decided to confirm it with an ultrasound. Her ultrasound concurred there was something abnormal in the area of her stomach. As much as clients hope that we can come to a diagnosis affordably there are times that we have to run every single one we have in our arsenal.

By 10 am on Monday morning, after about a week of diarrhea, inappetance, and lethargy we were going to try to get an answer to Isa's woos. Isa's mom consented to the exploratory surgery she had asked for the day before. There was a new sense of optimism that we had her villain in the cross hairs.

Isa was on the operating table by 1030 am.

Her exploratory started out as good as one could hope. No visible bleeding in the abdomen, and doing well under general anesthesia.

 Isa's first big reveal. A very large spleen, and I do mean very large. 

The search widens..

And reveals,,,nothing. Another dead end.

Every inch of Isa's abdomen was inspected. Some by touch and some by visual recognition. But no organ, no area, no corner, nothing was missed. I reluctantly, begrudgingly closed her up.

And, damn it, as hard as you try, as much as you want it, there are those cases that stump you at every move. Isa was one of those girls. She was a shorter list of rule outs, a list of attempts, and a girl who still smiled, still wagged, and still wanted to be her families guardian. 

A week of every diagnostic option tried, and crossed off the list, and still we didn't have an answer, a reason, or guiding advise for Isa. There were three vets on her case and all of us knew the answer was out there. We also knew that when the easy answers are exhausted you sometimes get cornered into cancer. It was now at the top of the list. We needed Isa's family to allow us to keep digging, even after we admitted there was a slim chance that there would be a happy ending.

What do you do when you have looked and not found an answer?

You look again.. and you keep looking. I know it is hard to accept, infuriating to pay for, and yet it is real-life. So we started from the top. We re-examined her. questioned every decision over again. We talked about her case with every other vet in the building and repeated Isa's blood work. We were starting her on the only treatment option that we had left, steroids... massive amounts of steroids.

When your patient won't eat call in convincing reinforcements.

Isa's bloodwork now 2 weeks later was being sent to the lab again. This time the lab noted that there were significant unusual abnormalities and sent her blood to a pathologist for review.

And, there it was, finally an answer. Isa's diagnosis was confirmed by two pathologists at the reference lab. She had leukemia. It was a diagnosis we had feared and suspected all along, even if it took us a week to get.

Isa was started on steroids. It was her only option left. 

Her disease had quickly annihilated her bone marrow,, therefore she grew weaker and more anemic as the supply of her red blood cells collapsed. She, the prodigal German Shepherd was dying of a cancer we rarely see and more rarely have the opportunity to diagnose. She passed away two days later with her family who were grateful to know the answer to her illness and happy that she was with them until there was nothing left to do. She was loved. She was given every possible chance, and she was a smiling, gentle, majestic friend to all. I called her mom to send our condolences. A half apologetic somber extension of my grief, my angst, and my sorrow. Her mom just thanked us for never giving up on her, never being anything but kind and generous and always being supportive of her quest to save her girl. I told her how grateful we were to know her, to be a part of her life's journey. 

Leukemia, especially acute leukemia is a fatal insidious thief who steals life in about two weeks. Just like Isa the clinical signs are often lethargy, vomiting, weight loss, diarrhea, and anemia. It is most often diagnosed with a blood profile and bone marrow aspirate. There are no well documented treatment options with much measure of success. Here is the best article I found on more on this disease. National Canine Cancer Foundation, Lymphoid Leukemia.

I want to add a personal note to Isa's family. I will never forget you and Isa. She was a regal majestic sweet girl who reminded me to always keep focused on finding answers, fighting for every precious day and just being grateful to have them.

If you have a pet question, concerns about your pets condition or disease, or curious about what  might be happening with your pet please join me at the community dedicated to educating and inspiring other pet lovers, Pawbly.com. Pawbly is free for all to use and enjoy!

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I am hoping to make veterinary medicine more transparent. I know that cost is a significant barrier to many people in the care of their pets.

Here is Isa's treatment plan and associated costs;

First visit for diarrhea; Exam $50, probiotics $29, fecal exam $30.

Second visit; Ultrasound $200, exploratory surgery w anesthesia iv catheter, fluids, antibiotics, pain management $700. 

Third visit; steroids and inpatient care per day $50. Isa stayed for the day for four days. Repeat bloodwork $130.

Fourth visit; euthanasia and private cremation $350.

The Pearl in the Gut. AKA Swallowing Rocks, And Fishing To Extract Them

This is Titus. He is a rambunctious, energetic, animated, effervescent 18 month of Doberman.

He is the puppy of an avid life-long Doberman breeder who has come to realize that "a puppy is an awful big handful when your life is slowing down and you are well into the comforts of retirement." He is loved, but he is too much to handle for his mom. It was a hard pill to swallow and an even harder confession to make. But, her ability to care for him, hold him safely and confidently at a walk (or lunge), and her ability to meet all of his mental and physical needs.

I give her kudos and credit. It is often a difficult thing for people to admit, but it is imperative to be making tough decisions that are in the best interest of your pet. Be honest, be open, and be kind. If you can follow these all things are possible and in the end you can live with the decisions that are made.

When titus came to visit it was because he had developed a very bad habit. He was eating rocks. When it was reported to me I asked "Why? Why do you think that he is eating rocks?"

"Well, because he is a Dobe," she replied.

"I don't know what that means?" I answered.

"Because they are all stupid. They do stupid things."

"I just don't eat things without a reason." I said it and I stand by it. I always believe there is a reason.

When I find a pet doing an odd, nonsensical thing I start to dig. I encourage my clients to start digging and we don't stop digging until we figure out the reason, we solve the problem, and we are prepared for a recurrence. That's our duty as guardians.

Things to investigate;

1. Diet
2. Intestinal fecal check
3. Boredom/behavior/anxiety/fear, etc
4. Check a full blood work panel and urinalysis (including thyroid).

When Titus arrived he was not his normal hyper-crazed self. He was a bit subdued, and he had been vomiting off and on for a few days. He was dehydrated, and his belly was sore to the touch.

We took an x-ray and there is was. a big honkin' stone stuck dead smack in the middle of his intestines.

OK, here is the big dilemma when we are humming and hawing over whether or not it is time to go in and explore a belly. 

If you have a dog that is vomiting every time they eat, or vomiting everything they eat, or stops producing feces it is my vote to go in and take a look. I have regretted waiting and not going in far more often than I have regretted going in. Keep an excellent history, monitor very closely and use x-rays and ultrasound and most importantly your own gut feeling when deciding whether or not to do an exploratory surgery.

I have gone into dogs bellies and expected to find an obstruction and instead found only a quiet not moving gut. But even in those cases after massaging the intestines, exploring every inch of it, those dogs have woken up and felt better. 

I spoke to his mom about my concerns. That stone was too big to make it through the intestines. I was pretty sure of that. She wanted to wait overnight, and if his vomiting continued she would be back in the morning.

The next morning we were met by an early call from a very concerned mom. Titus wasn't eating and he was vomiting persistently. He arrived a few minutes later. A repeat x-ray showed the same big stone in the same place.

Getting prepped for surgery.

The stone is next to my left hand, and the intestines beside my right hand is significantly bruised.
This is where the stone was stuck, and the gut bruised and then the stone moved a little bit further down stream.
Repeated bruising to the gut leads to scarring, inability to function, perforation and even death.

The stone has been removed and the intestine is surgically closed,
being very careful to not spill any intestinal contents and
suturing very carefully so that the incision doesn't open.
The gut is a very strong muscular tube. It has to be able to withstand liquid moving through it,
and lots of motion.
Dehiscence (opening of the incision is a real concern).

An omental wrap is placed to help keep the incision closed and aid in healing.

After a leak test (move ingesta through the area of the intestines where the incision was made another look through the abdomen is done, and lastly we flush the belly with warm saline to remove any ingesta that may have spilled or leaked.

Closing the abdomen.

In an exploratory surgery it is often required to make a large incision. In almost all cases the incision extends from the rib cage to the pelvis.

Titus's pearl.

Now all we have to do is figure out why he thinks he should eat stones and prevent him from doing it again. (AKA, now the real work begins).

If you have any questions or comments please leave them.

If you have any pet related questions you can reach me at Pawbly.

Baby Titus

On October 15, 2013 Titus was put down due to severe aggression and dominance issues. I was not present, and I could not participate. It was the decision of his family who feared that after biting three people he could not be trusted. I am sorry to all who were a part of this awful conclusion and deeply saddened by the sequence of events. Life just isn't fair and there are sometimes no reasons to try to accept the hand that life deals you.