Author: Karen L. McGlothlin, DVM, PhD
Veterinarian: Dr. McGlothlin
Patient: Ella Shore
Breed: Labrador Retriever
Current Age: almost 2 years old
Background: Back in the Summer and Fall of 2018 Lauren Shore, who was one of our receptionists at Lawndale Veterinary Hospital, was dealing with some urinary issues with her Labrador Retriever puppy, Ella. Ella had been having urinary accidents in the house, on and off, even though she was house-trained and had multiple opportunities daily to go outside. Lauren had brought Ella in for a urinalysis and she was found to have rod-shaped bacteria and blood cells (both red and white cells) in her urine.
Ella was prescribed antibiotics, but her urinary accidents continued. In addition, Lauren started noticing a foul odor associated with Ella’s back end. Dr. McGlothlin saw Ella and recommended that urine be submitted to IDEXX Laboratories for a urine culture, since Ella had recently been on antibiotics. She also noticed at the time of examination that Ella’s vulva was slightly enlarged and partially covered by a fold of skin and fat – this is known as a recessed or hooded vulva. The urine culture did not produce any bacterial growth and it appeared that Ella was going into heat, based on the appearance of her vulva.
Ella did not go into heat, as suspected. She continued to have random urinary accidents in the house and the smell associated with her back end seemed to become more noticeable. A repeat physical examination by Dr. McGlothlin revealed that Ella had developed a significant bacterial infection (pyoderma) and yeast infection of the skin located under the skin/fat flap that was partially obstructing the vaginal opening and vulva.
Since there was a solution for dealing with a recessed vulva and Ella had not progressed into her heat cycle, Lauren elected to have Dr. McGlothlin spay Ella and have the excess skin that was hooding the vulva removed in a procedure known as an episioplasty or vulvoplasty.
What is an episioplasty/vulvoplasty? This is a surgical procedure that is performed with the goal of correcting a recessed vulva. During the procedure, a crescent-shaped portion of excess skin and fat that hang over and round the sides of the vulva is removed. The amount of skin that is removed depends upon the extent of hooding or the amount of redundant tissue that hangs over the vulva. After the crescent is surgically removed, the edges the remaining skin are sutured together, pulling the vulva back and into a more normal anatomical position. Once the excess skin and fat are removed, there is usually a resolution to the chronic urinary and/or skin issues that may have plagued the patient prior to surgery.
Update on Ella: Ella was spayed and had her episioplasty performed in March, 2019. Ella did great under anesthesia and recovered without complication from both procedures. Ella continues to be an active young Labrador Retriever and she has not had any additional urinary problems since her episioplasty.
If your female dog has a history of recurrent/chronic urinary tract infections, chronic vaginitis, or recurrent skin infections around the vaginal opening, she may have a recessed or hooded vulva. Contact us at Lawndale Veterinary Hospital and set up an examination, if you suspect that this may be an issue for your pet.
American College of Veterinary Surgeons