Soft Tissue Procedures

Total Ear Canal Ablation and Lateral Bulla Osteotomy is a salvage procedure for dogs with end stage ear disease or tumours of the ear canal. Ear infections are painful and can be difficult to treat. By removing the ear canal, eardrum and flushing out the middle ear it is possible to relieve intractable pain.

Indications for TECA/LBO surgery are:

1. severe untreatable or resistant infections of the ear canal (otitis externa)

2. infection of the middle ear (otitis media)

3. ear canal narrowing due to chronic ear disease

4. tumours of the external ear canal

5. difficulties in administering ear drops for otitis externa

Brachycephalic dogs are those bred with short noses and often dome-shaped heads for example Pugs, English Bulldogs, French Bulldogs, Boston Terriers, King Charles Cavalier Spaniels, Shih Tzus and many other breeds. Cats can be brachycephalic too - Persian cats have a very flat facial conformation. The breeding of these dogs and cats to have very flat faces means that they have excessive soft tissues in their upper airways, which blocks airflow through their mouths and noses.

We cannot fix all the problems associated with the brachycephalic structure, but by reducing the amount of soft tissue in the upper airways, we can improve airflow, make their breathing easier and reduce the risk of problems in later life.

BOAS makes it difficult for dogs to eat, drink and breathe at the same time. Approximately 30% of these dogs regurgitate food or saliva (often seen as ‘licking the air’). Many will improve after BOAS surgery but may require antacid medication. If a hiatal hernia (also seen in some brachycephalic dogs) is present and causing regurgitation, medication for life or further surgery may be required.

Perineal Hernia is a weakness of the muscles of the pelvic diaphragm. This allows abdominal organs or the rectum to displace sideways into the pelvic canal. This causes excessive straining to defecate, pain and sometimes difficulty urinating. A swelling is often seen on one or both sides of the anus. The diagnosis is made by rectal examination and radiography.

The surgery involves closure of the defect in the pelvic diaphragm, either directly or by using a flap of muscle. The suture material used is non-absorbable, and will stay in the pelvic diaphragm forever.

Surgery is indicated in cases of recurring obstruction, persistent pain, or recurrent infection. Sometimes a tumour will grow in the anal sacs and this necessitates removal of the affected gland too. The anal sacs are removed with 2 small incisions next to the dog’s anus.