In this Maltese, I advised twice. Lately, he had generalised skin infections including tail biting and scootering. A creamy pus in some volume was expressed from both glands. The large right hernia mass was not painful. The dog could still pee and poop normally.
"I can feel the large intestines trapped inside the right hernia. A gas-like crunching sound. The mesh repair is needed. Now the dog's intestines are not twisted and so the dog behaves normally. One day, the intestines will twist and the dog will be in great pain and shock. An emergency surgery will be needed and the dog may die on the operating table."
The father went home to discuss with the career daughter who phoned me.
"The skin disease is generalised and so the dog is not fit for surgery," I said. "Wait one month."
As a first attempt, the vet will not use the mesh repair to reduce costs. But in some severe cases, there is no choice and the owner must be well informed.