A challenging case: Phimosis in a young adult dog
Jan 01, 2008
The shelter officials had noted the stenotic preputial orifice and preputial swelling when the dog was initially presented to them. Fine-needle aspiration of the swelling had revealed suppurative fluid and urine pooling in the prepuce. Repeatedly aspirating fluid from the prepuce had not resolved the problem.PHYSICAL EXAMINATION
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 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 flea infestation. The patient was premedicated with subcutaneous acepromazine and hydromorphone. The preputial swelling was aspirated, and 78 ml of purulent fluid was obtained. Since previous analysis showed a nonseptic suppurative fluid, the shelter officials declined fluid 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 isoflurane. 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 first hour and at 5 ml/kg/hr every hour thereafter throughout the procedures.