A 1.4-year-old sexually intact male Standard Poodle weighing 24 kg (53 lb) was referred to Angell Animal Medical Center with a history of urinating on its left forelimb and lower portion of the thorax. This problem became evident to the owner when the dog was < 6 months of age. The dog also had a history of intermittent pneumonia that responded to antimicrobial treatment that was based on microbiological culture results and cytologic evaluation of tracheal samples.

On physical examination (day 1), there were no observable abnormalities; the prepuce and penis were normal in shape and proportion. However, the dog had a distinctly elevated or tucked abdomen and a prominent dome-shaped thorax on lateral profile. The dog also had a 4-legged stance while urinating. As a result, both the angle and elevated position of the prepuce and penis caused the downward trajectory of the urine stream to partially strike the xiphoid area tangentially before continuing forward to the caudal aspect of the lower portion of the left forelimb and foot. Although the owners conscientiously washed the soiled areas after every micturition, the dog retained a distinct urine odor. Results of a CBC and serum biochemical analyses were within reference limits.

To alleviate the problem of soiling its body during micturition, the dog was scheduled for surgical modification of the preputial ostium to redirect the urine stream. Prior to induction of anesthesia (day 2), the dog received morphine (0.1 mg/kg [0.05 mg/lb], IM) and medetomidine hydrochloride (0.04 mg/kg [0.02 mg/lb], IM). Anesthesia was induced with thiopental (11 mg/kg [5 mg/lb], IV). The dog was intubated, and anesthesia was maintained with isoflurane and oxygen. Lactated Ringer's solution was administered IV at a rate of 5 mL/kg/h (2.3 mL/lb/h) until completion of the surgical procedure. The dog was placed in dorsal recumbency. The hair over the caudal aspect of the abdomen, prepuce, and scrotal area was clipped, and the sites were prepared for surgery with chlorhexidine surgical scrub solution^a alternated with sterile saline (0.9% NaCl) solution.

After draping of the surgical area, a prescrotal approach was used to castrate the dog. To divert the urine stream in a ventral direction, the mucocutaneous junction was resected along the upper half of the preputial orifice (Figure 1). Interrupted, 4-0 polydioxanone sutures^b were used to align the opposing mucosal borders, followed by a series of simple interrupted skin sutures.

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Photographs of the surgical modification made to the preputial ostium in a 1.4-year-old sexually intact male Standard Poodle that had a history of urinating on its left forelimb and lower portion of the thorax. A—Excision of the mucocutaneous junction of the upper half of the preputial ostium (arrows). A skin hook was used to elevate the mucosal margin, facilitating this procedure. B—Partial closure of the ostium. The opposing sides of the mucosa and skin were closed independently with 4-0 absorbable sutures. To regain the normal diameter of the orifice, a ventral midline incision (arrow) was required that approximated the dorsal area closed. C—After completion of the procedure, partial extrusion of the penis highlights the newly created preputial ostium.

Citation: Journal of the American Veterinary Medical Association 235, 9; 10.2460/javma.235.9.1067

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Following closure of the upper preputial ostium, the ventral border of the preputial orifice was incised, creating a V-shaped incision that approximated the length of the closed dorsal ostium (Figure 1). The adjacent cutaneous and mucosal borders were sutured, restoring the overall size of the preputial ostium. The dog was then allowed to recover from anesthesia. Post-operatively, the dog received butorphanol (0.9 mg/kg [0.4 mg/lb], SC, q 8 h) during hospitalization.

After complete anesthetic recovery, the dog was taken outdoors for a walk. The dog urinated with the stream now diverted directly downward. The dog subsequently urinated in an identical fashion before being discharged from the hospital the following morning (day 3). The owners were instructed to give the dog butorphanol (0.86 mg/kg [0.39 mg/lb], PO, q 8 h) for 3 days. Skin sutures were removed 10 days after surgery. At 6 months, the owners reported that the urine stream continued to exit the prepuce in a straight line, perpendicular to the long axis of the dog, without striking any portion of the dog's body.