My assistant, Heather, is pet sitting for a 10 week old puppy patient of ours. Owners are in Florida and Heather is a veteran pet sitter. Heather has been sitting on Buddy for a few days now and she mentioned this morning that it takes Buddy a heck of a long time to pee. And when he’s done peeing Buddy will walk away and continue to dribble urine for quite some time.

I was in surgery removing a lump so Heather had Dr. Boss take a look at Buddy. This type of behavior is not normal, right?

No, in fact, it’s not normal. It’s REALLY not normal.

Buddy, as it turned out, had almost no opening to his penile sheath (the prepuce). Buddy’s penis is normal (we found this out later) so he could urinate, but he was just filling his prepuce with urine and it was dribbling out a preputial orifice that was just shy of the diameter of a pencil lead (about 1mm diameter). For the sake of comparison the normal preputial orifice in a dog Buddy’s size would be about the diameter of a pencil (abut 5mm).

Peeing for Buddy had to have been sort of like hooking a fire hose up to a drinking straw. Not a very good way to go about things.
Buddy’s people hadn’t ever had a dog, let alone a puppy, before. Buddy’s people thought it was normal that it took Buddy a good long time to pee.

Any physical anomaly is going to grab the interest of those of us in medicine. We’re weird that way. So when I was done removing the lump I had to go take a look at Buddy’s penis.

At which point the question became….. so what do we do with it?

I posted photos to the soft tissue surgeons that monitor the surgery board on the Veterinary Information Network. I fired off an e-mail to our local referral surgeon to see what his take on it was. Then I opened the surgery book and looked.

And as it turns out, what you do to puppies whose preputial orifice is too small is to (gentile male readers of UADN you may want to hide your eyes) circumcise them.

It was a little more complex than that. (Male readers of any stripe may want to hide your eyes.) I actually removed a piece of skin from the tip of the prepuce and then made an incision along the mucosa (the lining of the prepuce) to open up the little teeny opening. Then I spatulated it.

Isn’t that a great word? Spatulated?
Spatulated! It’s got to be one of my favorite medical words, right behind recrudescence.

Anyway, spatulation. Right.
Basically I sewed the cut edge of the mucosa to the cut edge of the skin creating a big, wide opening. I could push the entire penis through the new opening (a big, BIG improvement on the original design) and, as it turns out, Buddy can pee right swiftly through it. No straining, no dribbling.

There were all sorts of jokes about my having performed a bris. When I got home Andrew pointed out that should the dog live to 13 years of age we really need to throw him a Bar Mitzvah.

I’ve got photos too, but since the thought of the photos was enough to make Andrew, a veteran veterinary spouse, a little weak in the knees I think I’ll not add them to this post.
Unless, that is, y’all want to see them.

Veterinary medicine is so cool.