straining

Your Pet: My Dog Is Straining to Poop Truck is a ten year old boxer dog who appears to be uncomfortable. For the past couple of weeks, he has been straining to defecate. He will go out into his yard and try multiple times to produce stool and only after these multiple attempts will he have have some success. By some success, I mean some stool production but according to Dan, Truck's caretaker, not the production he used to produce. In addition, recently, Dan has noticed some swelling to the right and below Truck's tail stub. Dan knows Truck is uncomfortable but does not think he is painful. He also knows he needs to take Truck to his veterinarian. Since Truck is a male dog, we can be fairly sure his straining is indeed involving defecation. In female dogs this straining behavior can be either urination attempts or defecation attempts since they squat for both events. In males as most of you I'm sure realize, urination is usually accomplished in a standing position. Now that I've shared this revelation, let's try to figure out what is wrong with Truck. Certainly, constipation is a possible cause for Truck's difficulty in defecation. That said, since he does seem to produce stool, albeit with an abnormal amount of effort and attempts, it is less likely we have a simple case of constipation. A simple radiograph of Truck's abdomen should help to support this theory. Before taking the pictures however we need to take a look at the swelling Dan mentioned on Truck's backside. That may be the key to unlocking the mystery of Truck's problem. I suspect Truck has developed a hernia. The swelling described by Dan as being just bellow Truck's tail stub may actually contain abdominal contents owing to a breakdown in the rear portion of the abdominal wall. This is called a perineal hernia. This type of hernia can develop as a result of excessive straining or in the case of a weakened area to begin with, normal amounts of pushing associated with defecation. Trauma can also lead to a perineal hernia. There are a couple of reasons for the straining during defecation associated with herniation in this area. One is a simple matter of mechanics. Since the abdominal wall is no longer closed off, when the muscles are contracted in order to push out stool from the colon, tissue from inside the abdomen is instead pushed outside through the hernia. This effectively decreases the pressure applied to the colon. Another cause of straining in some of these cases is the fact that the colon and/or rectum can become trapped in the hernial opening and block the stool from being able to pass. When the straining continues for longer periods of time, the rectum can actually develop out pouching where stool can become entrapped leading to even more staining. If Truck has developed a perineal hernia it should be relatively simple to diagnose on physical examination and hopefully it is obvious now that it is important to diagnose as soon as possible. This in order to avoid the secondary problems I discussed. It is usually fairly straightforward to palpate a perineal hernia but it is very important to realize it is commonly a bilateral condition. Sometimes one side appears larger as it may contain more abdominal contents but the other side may be torn open as well. Incidentally, there are cases of perineal hernia that can cause straining not only to defecate but also to urinate. Care you guess why? Along with the colon, other tissues from the abdomen can become pushed out of the hernia. This can include the prostate gland, small intestine, abdominal fat, and........the bladder! If the bladder becomes trapped, it can lead to blockage of urine flow resulting in straining to urinate. If left untreated, this can be fatal. If it turns out that Truck has a perineal hernia (or two), surgery will be necessary in order to correct the problem. Depending on the extent of the hernia(s), we may need to use some synthetic mesh to close the gap but many times it simply requires closure with well placed suture material which remains permanently in place. If the rectum has developed out pouching as I mentioned above, that will need to be repaired as well. Another important fact associated with this condition is that it is predominantly a disease of un- neutered male dogs. This is thought to be the case because the excess testosterone found in these dogs weakens the abdominal wall in this area. This has not been proven, but it is strongly advised to neuter a male dog that has developed a perineal hernia. That is of course if that has not already occurred. Prognosis with surgery is excellent for return to normal function.