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Paraphimosis and phimosis in dogs are flip sides of the same coin: in the first, the dog’s extended penis cannot slide back into the sheath (prepuce) for an extended time; and in the second, the penis cannot exit from the sheath. The sheath is the skin and other tissues that surround a non-erect penis. Dog breeders are likely most familiar with this problem, or perhaps owners of dogs who love their pillows a bit too much.

Paraphimosis occurs when the penis is extended out of the sheath for over 2 hours, but it is not an erection. Priapism is an erection for over 2 hours (most resolve within 30 minutes) and technically is a type of paraphimosis, although they are not the same thing, nor are they treated the same way.

Breeds that are most likely to encounter these issues are Bouvier des Flandres, German shepherd dog, golden retriever, and Labrador retriever.

Remember that even neutered dogs will sometimes get erections.

Paraphimosis: Inability to Retract the Penis

Paraphimosis is quite painful and thus medically urgent. It can also lead to death of penile tissues; an affected dog should be seen as soon as possible by a veterinarian. It usually occurs after an erection.

Paraphimosis is seen more often in dogs than cats, and it is most likely to occur in long-haired cats when the penis becomes entangled in hair. A dog with paraphimosis is unable to mate.

Either genetics or other factors cause the inability to retract. The dog can be born with a narrow sheath, or an injury or disease can occur that leads to the inability. Once the tissue becomes swollen, it becomes even more difficult for the penis to retract into the sheath, and the swelling continues, similar to placing a rubber band around your finger. A common cause is hair getting matted around the base of the penis, creating what is essentially a band of fur that keeps tightening.

The most typical reasons for it other than genetics:

• if the edges of the sheath roll inward
• foreign object gets stuck in the sheath
• problems with mating or masturbation
• an infection
• trauma, such as os penis (the bone that dogs have in their penis) fracture
• weakened muscles
• a consequence of medical procedures, such as reconstructive surgery
• excess blood in the tissue
• some diseases, such as cancer
• after manual collection of semen
• hair ring that keeps tightening at the base of the penis

The only sign of paraphimosis may be the dog licking the exposed penis that has not retracted. Other signs include inflammation, urine dribbling, and excessive licking in the genital area. If the penis becomes a different color or the moist tissues dry out, the dog needs to see a veterinarian immediately.

It’s possible that circulation to the penis can become impaired, after which a lot of swelling is seen. Blood vessels can become compromised by that swelling and lead to blood clots and tissue death. Additional complications include trauma of the exposed penis, drying out the tissue from exposure, an obstruction of the urethra, and hardened tissue surfaces.

Other than a medical history and visual of the erect penis, a urinalysis and biopsy of the affected tissues may be needed for diagnosis. Usually just a visual check of the area from the veterinarian is enough.

Treatment, which is often needed on an urgent basis, often begins with cleaning and lubricating the extended penis, and involves trimming any hair causing the problem, medicating any infection, decreasing swelling, and managing the pain. You dog will likely need sedation or general anesthesia during this treatment. If the urine flow has stopped, a catheter may be needed as drainage has to be re-established. Cold water compresses or sugar dressings can reduce inflammation and swelling, in some cases allowing the penis to return to its normal position. In severe cases, it may be necessary to remove dead tissue (a process called debridement, in which dead or dying tissue is scraped away so that the healthier tissue beneath it can survive). Unfortunately, sometimes this problem is so severe that too much tissue dies and amputation is the best treatment.

While you cannot do anything to prevent paraphimosis that stems from the shape the dog was born with, you can take other steps to discourage this from happening for other reasons. During breeding season, keep your dog’s penis clean just by splashing water over it, and clean it after every mating attempt. It may also help to keep an intact male dog away from bitches in season (heat). If your dog has a long or curly coat, clip the area neatly at the base to prevent matting or knotting. If matting there has been a problem for your dog before, check it frequently to make sure that hair is not causing a problem.

Phimosis: Inability to Extend the Penis Beyond the Sheath

Phimosis, which is rare, is also either congenital or acquired. Congenital phimosis occurs when the dog or cat is born with a sheath opening that is too narrow. Acquired phimosis can be a consequence of inflammation, cancer, trauma, debris collection, chemical irritation, and penile swelling. The most common cause of acquired phimosis is a small sheath opening caused by any source, oftentimes trauma or cancer.

If the penis is discolored, or the normally moist tissues that cover it are becoming dry, your pet needs to see his veterinarian.

Phimosis caused by a small opening in the sheath can interfere with urination. Urine may get dribbled, causing it to pool inside the sheath's cavity. That pooled urine can cause a secondary bacterial infection. Should things get bad enough that the sheath entrance becomes clogged, the pet’s ability to urinate is also blocked.
Affected pets may dribble urine or bloody discharge. Dogs with phimosis are usually unable to mate. They may also retain urine and lick their sheath.

Phimosis is usually treated by surgically widening the opening of the sheath under general anesthesia.