Paraphimosis is the inability to retract an extruded penis back into the preputial sheath, which is the skin that covers it. This can quickly turn into an emergency situation, as constriction of blood flow will lead to greater engorgement, necrosis (dying off of the tissue), and potential damage to the urethra.
More common causes of this condition can include chronic licking, sexual excitement, or foreign bodies getting up under the skin. However, there are more serious causes including neurological disease (such as a herniation of a disc in the spinal cord), penis fractures, or muscular issues. Paraphimosis also needs to be differentiated from priapism, which is a state of continuous erection, usually due to a neurological problem.
A diagnosis of paraphimosis is generally based on simple observation of the penis extruded from the prepuce without any physiological reason. Paraphimosis accounts for approximately 7% of penile problems in the dog, and while not common, it can cause distress to pets (and their owners) and can have more serious consequences if left untreated or if it becomes a recurring issue.
Treatment is generally conservative in nature, and many of these interventions can first be tried at home. Here is what you can do if this condition if noted in your pet:
First, thoroughly clean the exposed penis and inspect it for any foreign material such as foxtails or long fur that is “strangulating” the tissues of the penis.
Mix up a “sugar paste” using ordinary white sugar and enough water to make it into a thick slurry. Apply this mixture liberally to the extruded penis. The sugar works as a hyperosmotic agent, “pulling out” fluid from the tissues to help to reduce the swelling and shrink the penis.
Wrap up a bag of frozen peas in a light towel and place over the area for 5 minutes at a time, which also helps to reduce swelling of the tissues. Packaged peas work well because they are very moldable around the dog’s anatomy.
Lubricants, such as K-Y jelly, should then be applied. Lubrication helps aid in returning the penis back into the sheath.
If the swelling does not resolve within 30 minutes, and if the penis does not stay retracted into the prepuce despite the interventions above, then immediate veterinary assistance is needed. I have unfortunately seen several cases where the tissue of the penis had died off due to lack of blood supply, and these poor pups required a partial penis amputation—this is a true emergency in our pets.