Tuesday, February 21, 2017

Retained Testicles: Diesel's Story

by  Krista Magnifico, DVM

Diesel is a two-year-old Shiloh Shepherd who was rescued by our good friends at Black Dogs and Company Rescue. He is truly handsome with that black face and mesmerizing eyes, but he has a secret; a hidden, potentially deadly secret.

Diesel he has not been neutered and his testicles never descended into the scrotum.

He is what we call a bilateral (both sides) cryptorchid.


When it comes to the old saying about "what you can't see.." well, it turns out it can hurt you.

Not having testicles in the place they belong ... well, that can kill you. 


Retained testicles are rare. In 10 years I have seen two large breed dogs have a complete failure to launch. In the first case, the client just forgot to take heed to my warnings when I could not find his testicles at his puppy visits. He also refused to allow me to go searching for them in his dog's abdomen when he arrived for his neuter and they were nowhere to be found.

We found them three years later when he was very sick and dying from massive amounts of cancer in his abdomen. 


The retained testicles had grown into large cancerous masses that had invaded every organ they were engulfing. Why does this condition have the potential to be so dangerous?

Testicles are intended to be carried around outside of the body where it is cooler. 


Let's talk about anatomy and normal male development;

Testicles are supposed to descend out of the abdomen within the first few months of life. 

Real-Life Tip: If they have not descended in to the scrotum by 5 months old it is very unlikely that they ever will. By 9 months old I recommend that my clients schedule their pets neuter and we palpate for them under sedation or anesthesia. Either way go find them and remove them! Don't sit back and think there isn't a problem because you cannot see it. There is a problem, don't wait for it to become one that costs your dog his life.
Real-Life Tip: All cryptorchid pets should be neutered. There is a genetic component to this condition and the retained testicles are very likely to become cancerous. Estimates are that this type of cancer is 13 times more likely than dogs whose testes are in the scrotum. In my opinion if they are retained in the abdomen THEY WILL BECOME CANCEROUS AND BY THE TIME YOU FIGURE THAT OUT IT WILL BE TOO LATE TO CHANGE YOUR DOGS PROGNOSIS. Most of these dogs will not be clinically affected by the retention of the testes until they are older than 2 years. Some of these dogs can also suffer from testicular torsion.  The cords that the teste descends from twist like a yo-yo on the end of a string, cause strangulation of the blood supply, swell and then begin to die. This is an acutely painful condition that requires immediate surgical intervention.

Diesel, like most pets with this condition, looks and acts completely normal. This is the biggest reason most people don't think that they need to intervene in this condition.

It is a secret, silent hidden killer. 


For all of the cases that I see like this I recommend that my clients allow me to place their pet under general anesthesia so I can palpate the entire area between the scrotum to the inguinal rings (the small opening in the bottom of the abdomen that is the passageway from  the abdomen to the scrotum) and along the distal part of the inguinal area. In some dogs, there is a pocket of fat just in front and along the sides of the base of the back legs.

An undescended testicle is often smaller than normal and often buried in this fat pad. 


Often I cannot palpate these until the pet is completely relaxed (under anesthesia) and allows me to probe the area.

I get lots of calls for estimates on these surgeries. I always tell people that in some cases these surgeries can be rather long and somewhat frustrating. If the testicles are not between the inguinal rings and the scrotum you have to go inside the abdomen and look for them. In the abdomen, they can be significantly smaller than normal and live anywhere between the kidney and the caudal (towards the tail) part of the abdomen/pelvis. In some cases, I have felt like I was trying to find a needle in a haystack.

I once had a cat with bilaterally retained testicles. It took me over an hour to find them. One of them was so small (about the size of a grain of rice) that I had to submit it to the pathologist to positively identify it.

Diesel's surgery ended up not difficult at all. 


His testicles were easily found just inside the caudal abdomen. His surgery was about $400.

If you have a puppy or unneutered dog that does not have descended testicles, please talk to your vet about it. Please also discuss when it is best to neuter. If your vet can't give you an estimate that you are comfortable with, seek a second opinion or ask for intra-operative photos with your invoice.

Take Home Points:

  1. Neuter a cryptorchid by 8 months old.

  2. Ask for an estimate before surgery. The most expensive cryptorchid surgeries are when the testicles are within the abdomen. An experienced veterinary surgeon should be able to find them quickly and easily in a young dog, and most of these surgeries can be done relatively close to the routine neuter estimate. In some rare cases, we cannot find them at all. These cases must be monitored closely post-op. 

  3. Older dogs with retained testicles are at a significantly increased chance of testicular cancers. An exploratory surgery should be done as quickly as possible to remove the testicles if they are not in the scrotum.


For full story including surgery photos, see the original article.

***

If you have a pet in need, you can find a community of helpful people at Pawbly.com. Pawbly is free to use and open to anyone who loves their pet and wants to help them.

I am also available for personal consults at Jarrettsville Veterinary Center in Jarrettsville Maryland. Or find me on YouTube or Twitter @FreePetAdvice.

Articles by Dr. Magnifico:
Don't Make This Mistake: Ruby's Death To Heat Stroke 
Parvo: Cora's Story 
Jake's Laryngeal Paralysis
The Tip Of The Iceberg: The Unexpected Dental Dilemma
The Ear Ache That Wasn't Going Away: Tottsie's Story
Cody's Eyelid Tumor
Ruger's Mysterious Illness
The Day The Heart Stood Still: Timber's Story 
Different Definition Of Comfort Food: Levi's Story 
Savannah's Pancreatitis  
Histiocytoma: Rio's Mysterious Bump
Von Willebrand's Disease: Greta's Story 
Alice's Heart Murmur  
Jekyll Loses His Tail Mo-Jo 
Pale Gums Are An Emergency: Bailey's Story 
To Amputate Or Not To Amputate: Heidi's Story
Lessons From A Real-Life Veterinarian 
Charlie's Life-Saving Lipoma Surgery  
Understanding and Diagnosing The Limping Dog, Why To Probe The Paw 
Angus' Dog Fight And The Consequences
When To Induce Vomiting And When It's Not A Good Idea  
Abby's Survived Being Run Over By Car But Succumbed To A Mammary Tumor 
Palmer's Hemoabdomen: Nearly An Unnecessary Death Sentence
A Puppy That Doesn't Want To Eat Or Play Is An Emergency: Aurora's Story
Does Your Dog Like Chewing Sticks? Hank's Story  
Lexi's Bump 
Pyometra: Happy Ending for Pheonix 
Never Give Up: Bella's New Legs 
How Losing His Spleen Saved Buddy's Life 
Pyometra Emergency: Saving Chloe  
Limping Dog Checklist (part I): Did You Check the Toenails?
Limping Dog Checklist (part II): Did You Check between the Toes?
Limping Dog Checklist (part III): Foot Pads
Limping Dog Checklist (part IV): Broken Bones  
Limping Dog Checklist (part V): Joint Injuries
IVDD: Recovery, Post-Op Problems And How To Conquer Them All
Has Your Vet Given Up On Your Pet? Or You? Would You Even Recognize It If They Had?
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