PERINEAL HYPOSPADIAS IN A CROSS BREED DOG: A CASE REPORT

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2 Indo-Am. J. Agric. & Vet. Sci., 2014 M Gokulakrishnan ISSN and L Nagarajan, Vol. 2, No. 3, September Meghana Publications. All Rights Reserved Case Report PERINEAL HYPOSPADIAS IN A CROSS BREED DOG: A CASE REPORT M Gokulakrishnan 1 * and L Nagarajan 1 *Corresponding Author: M Gokulakrishnan drgocool_vet@yahoo.co.in Hypospadia is a congenital anomaly of the external genitalia, in which there is a fusion failure of the urogenital folds and incomplete development of the penile urethra. A three year old cross bred dog animal was having abnormally located penis and scrotum. The preputial sheath was absent from the bulbus gland is to tip of penis but the dorsal mucosa of the incompletely formed sheath was present at the ventral abdominal wall. A lateral incision was made in the mucocutaneous junction on either side of midline up to the bulbus glandis, the mucosa was undermined along the ventral abdominal wall. The undermined parietal preputial mucosa was sutured over the exposed penis. The ventral abdominal skin was also undermined and sutured separately over the mucosa. The skin was closed by simple interrupted pattern using silk. The dorsocranial aspect of the mucosa, for the preputial orifice was left intact. Animal had an uneventful recovery. Keywords: Perineal hypospadias, Congenital deformity, Surgical reconstruction INTRODUCTION Hypospadia is a congenital anomaly of the external genitalia, in which there is a fusion failure of the urogenital folds and incomplete development of the penile urethra. The condition is rare and the etiology is unclear. This anomaly can occur anywhere from the penis to the perineum and is often associated with failure of fusion of prepuce and underdevelopment or absence of penis (Mary, 2009). It can be classified as mild, moderate and severe form (Hobson, 1998). In severe cases underdevelopment or absence of penis, failure of fusion of scrotum and failure of the urethra to close in the perineal area can be seen. Other abnormalities associated with hypospadias such as retained testicles, bifid scrotum and failure of the urethra to close in the perineal area may be seen. Other abnormalities such as retained testicles, bifid scrotum as in the present case, renal agenesis, bone and anorectal defects, umbilical hernia, hydroencephalus and urinary incontinence. This study reports successful surgical treatment of hypospadia in a dog. MATERIALS AND METHODS A three year old cross bred dog, weighing 13 kg was presented to Veterinary University Peripheral Hospital with a history of urinary incontinence for past 3 days. The owner reported that animal was having abnormally located penis and scrotum. On physical examination, there was bifid scrotum with exposed penis (Figure 1) and urinary scald around the ventral abdominal skin. The preputial sheath was absent from the bulbus gland is to tip of penis but the dorsal mucosa of the incompletely formed sheath was present at the ventral abdominal wall. The 1 Veterinary University Peripheral Hospital, Madhavaram Milk Colony, Chennai

3 Indo-Am. J. Agric. & Vet. Sci., 2014 M Gokulakrishnan and L Nagarajan, 2014 Figure 1 penile urethra opened 5 cm behind the tip of penis. The exposed penis was dry and inflamed. There was no evidence of neurological deficits and signs in the case. A urinary catheter was introduced into the abnormally located urethral opening to find out the patency. A lateral survey and contrast radiograph was taken and confirmed the normal patency. Corrective surgery was performed to reconstruct the preputial sheath. TREATMENT AND DISCUSSION The premedication and sedation was done with inj. atropine sulphate (0.04 mg/kg, i/m) and inj. xylazine (1 mg/kg, i/m). The anaesthesia was induced with a mixture of inj. ketamine (10 mg/ kg, i/v) and inj. diazepam (0.5 mg/kg, i/v) and was maintained with 1/3 rd of the initial dose. A lateral incision was made in the mucocutaneous junction on either side of midline up to the bulbus glandis, the mucosa was undermined along the ventral abdominal wall. The undermined parietal preputial mucosa was sutured over the exposed penis. The ventral abdominal skin was also undermined and sutured separately over the mucosa. The skin was closed by simple interrupted pattern using silk. The dorsocranial aspect of the mucosa, for the preputial orifice was left intact. Postoperatively the dog was administered inj. cefotaxim (20 mg/kg, i/m) and inj. meloxicam (0.1 mg/kg, i/m) for one week. Daily dressing of surgical wounds was done using povidone iodine with restricted exercise. Urinary incontinence was resolved after 15 days. The animal had an uneventful recovery without complications. This case report describes a case of hypospadia in a 3 year old intact dog with the external urethral orifice on the ventral surface of the penis rather than the tip of the glans. The cause of the hypospadias is not known, it is presumed that the affected foetus may secrete inadequate quantities of testosterone or that there may be inadequate conversion of testosterone to di hydrotestosterone in the target tissues of the urogenital sinus and external genitalia. The severity of the defects present depends on the degree androgen insufficiency in additional exposure of the male foetus to progesterone or anti androgens during gestation especially between 30 and 44 days (Moore, 1982 and Meyer-Wallen and Patterson, 1986). Severe genetic defects including cryptochidism, absence of scrotum, bifid scrotum as observed in the present case and persistent Mullerian structures had been observed in the dogs. Surgical correction is usually not attempted because the urethral cranial to the abnormal orifice is deficient. Although the urethral opening was 5 cm from the tip of the penis in the present case it was patent on catheterization upto the urinary bladder. Other methods of the treatment include reconstruction of the urethra, removal of open prepuce, partial penile amputation and prescrotal or perineal urethrostomy and castration. The present case preputial sheath was incomplete and hence, reconstructive surgery of the penial preputial sheath was done to cover the exposed dry penis (Finco et al., 1979, Hobson, 1983 and Hobson, 1998). It is concluded that in less severe cases of hypospadias an attempt should be made to surgically reconstruct the affected parts. The affected dogs should not be used for breeding purposes. 60

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