The surgery is so expensive because for Dexter to have his best shot at recovery, it requires more than one procedure. I should note that I’m by no means an expert, but I will explain everything as it was explained to me, and hopefully answer a few questions about what is the plan.
The bruise was so severe that it separated his muscle and skin tissue, which allowed fluid to build up. That’s why his pre-surgery picture is so horribly swollen. The first procedure to reattach the tissue was to make two incisions on either side of his rectum and suture the muscle and tissue back together. He then had some drains inserted before being stapled up, to allow any excess fluid to be released. He didn’t really drain too much at this point, and they were removed within 7-10 days. The staples remained in for much longer. However, the tissue did not fully reattach. Since Dexter keeps having to engage the muscles whenever he goes to the bathroom, they did not herniate worse than before, but they did not fully heal.
This procedure he already had is what Dr. Eshelman of Alpenglow Veterinary Specialty and Emergency Center (where Dr. Collins referred me, in Boulder) described as basically step 1 of 3 options for dogs that have these perineal hernias. Step 2 is what he would like to do now, whereas step 3 requires a more extensive muscle graft, I won’t be trying to explain that here. Though I don’t know the name of this 2nd-level procedure, it is basically folding a muscle up and suturing it in place, sort of doubling up on the muscle that is in the perineal region. There should be NO loss of function or mobility from doing this, but it is more advanced procedure. I’ll update this post if I can clarify the name and terminology! It IS a standard procedure for dogs with this issue.
The second part of the reconstructive process is to give his “kinked up”, diverted rectum a chance to be normal again. The easiest way to describe this problem is basically that his poop doesn’t have a straight path to exit his body. There’s a small bend in the path, where it can accumulate or even get stuck, which is making his injured muscles struggle even more. Dr. Eshelman basically said that this isn’t totally uncommon when the hernias happen, because the dog is still straining to go to the bathroom, and sometimes in severe cases the contents of the abdomen even get shifted down into the rear end and require a lot of organs to be moved back into place.
Luckily, Dexter isn’t quite that bad. However, they do need to move his colon and bladder up inside his abdomen and ‘straighten out’ the kinked up problem he has now.
These two things put together will mean that Dexter can have the strength return to his body to go normally again, and also that no more feces can get stuck and built up inside his body.
Finally, the last procedure on the surgery list is to have him neutered. Statistically, intact male dogs have the worst recovery chance after this procedure. Dr. Eshelman said it was thought to be a combination of testosterone levels, colon size, and other various factors, but it isn’t completely understood why this is the case. However, the neuter is not expensive by itself and so I see no reason not to give Dexter his best shot.
Some surgery items have a price range in case something goes wrong or takes longer than expected. Below is a copy from the printed estimate I received.
Echo with consultation (The visit, plus the required cardiac checkup to make sure his heart is ready for a long anesthetized period) $497
Met Check (3 views) (An optional step to check out his lungs for pre-cancer signs, which IS optional). $0-247.75
Chem 27 w/CBC IDEXX (Blood work required before surgery, standard) $205.58
Nursing Care – Level 2 $32.91
Intensive Care – Level 2 $82.69
Fluid Administration – Additional Liters $36.09
Fluid Administration – 1st Liter $77.24
Overnight Hospitalization (1-2) – $173.18-346.36
Catheter-IV placement $66.13
Diazepam ML (2-5) $36.77-38.20
Hydomorphone ML $36.77
CRI set up $38.67
Fentanyl ML $36.77
Propofol Injection – MG (75-150) $38.60
Epidural administration $117.36
Anesthesia Monitoring & Equipment Use $298.60
Isoflurane First Hour $176.04
Isoflurane Additional Hour (0.5-1) $58.68-117.36
Cefazolin injection – MG $38.60
Cefazolin additional inj – MG (0.5-1) $0-27.25
Fluid Pump $18.09
Syringe Pump $18.09
Miscellaneous Anesthesia $50-100
Replacement Line/Ext $17.99
Laparotomy (The actual incision into his abdomen) $366.09
Perineal Hernia (The actual surgery on both sides of his rear end) $922.30
Orchidectomy – Neuter $223.91-410
Cystopexy (The surgery to move his bladder) $366.09
Colopexy (The surgery to move his colon) $366.09
Pack, Disposables, Room Use $500.31
Suture application (2-4) $34.76-69.53
Aerobic Culture and Sensitivity IDEXX (Lab test to see if he has any infection) $210.57
Miscellaneous RX (The drugs I’m sent home with) $94.18-163
Recheck Exam (The follow up 8 weeks later. The only part I don’t need up front!) $55
This donate button goes directly to my PayPal account. All funds will be used toward the surgical costs for Dexter.