Hi stranger! Signing up for MypetMD is easy, free and puts the most relevant content at your fingertips.

Get Instant Access To

  • 24/7 alerts for pet-related recalls

  • Your own library of articles, blogs, and favorite pet names

  • Tools designed to keep your pets happy and healthy

or Connect with Facebook

By joining petMD, you agree to the Privacy Policy.

petMD Blogs

Written by leading veterinarians to provide you with the information you need to care for your pets.

The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

Paraphimosis: Pet Emergency or Owner Embarrassment?

My client sent me an image of her fluffy, white male Shih Tzu-Poodle (a Shihpoo?) mix lying on his side, which exposed his belly and a little, pink surprise: the glans penis extruding from his prepuce (foreskin-like sheath that covers the penis).

The text inquired: "Why is it still peeking out? What should I do?"

Having faced this issue many times in emergency practice, especially while doing emergency work, I recognize that this clinical presentation can alarm the pet owner and potentially escalate to a more severe health issue if not properly addressed.

Paraphimosis is the medical term for this condition. Mirriam Webster defines the term’s components as follows:

Para — beside, alongside of, beyond, or aside from

Phimosis — tightness or constriction of the orifice of the foreskin arising either congenitally or postnatally (as from balanoposthitis) and preventing retraction of the foreskin over the glans

When it comes down to it, paraphimosis occurs when the glans penis is unable to be properly retracted within the foreskin (prepuce).

Is Paraphimosis a Serious Health Concern?

The condition becomes more serious when irritation and dryness occur on the surface of the penis after the glans has protruded for minutes to hours (to days?) and comes into contact with environmental surfaces (the ground, carpets, etc.).

Additionally, edema (swelling) will occur as a result of restriction of blood flow back from the head of the penis. This further prevents the glans from retracting and restricts the proper flow of urine through the urethra, which leads to bladder enlargement and discomfort.

How Is Paraphimosis Resolved?

Resolving paraphimosis can be relatively simple or complex, depending on the length of time that the problem occurs and the amount of irritation, trauma, and swelling occurring in the glans penis.

An owner can apply some lubricant (personal, sterile surgical, moisturizing lotion, other) to the glans penis and gently try to press it back into the prepuce (or slide the prepuce forward over the glans).

If hair from the prepuce is sticking to the glans and preventing proper repositioning, then electric trimmers can be used to carefully trim away the hair. Scissors are not recommended, but they can be used if trimmers are not available, the scissor operator can work with confidence to cut only the hair (and not skin), and the animal can be properly restrained.

Additionally, a highly-osmotic solution, like 50% dextrose solution, can be applied to the surface to promote the movement of liquid out of the penis. On a more severe scenario, the prepuce tissue may need to be surgically cut to create a larger opening for the penis to be retraced.

It’s most ideal that a trained veterinary professional performs the treatment beyond the owner’s ability to lubricate and readily replace the penis to its natural position.

Can Paraphimosis Be Prevented?

One of my top paraphimosis prevention tips is to keep the hair at the tip of the prepuce cut short. This reduces the likelihood that hair will stick to the penis to prevent it from properly retracting into the prepuce.

It pains me to see a dog return from being groomed sporting a fresh haircut and an artistically-styled frond of hair at the tip of the prepuce (like a Merkin … Google it). Not only does this increase the likelihood that paraphimosis will occur, but the collection of urine, environmental debris, white blood cells, bacteria, and other substances can contribute to urinary issues, including infection, that ascends into the urinary tract from the outside world.

Additionally, prevent your male dog from humping other dogs, your mother-in-law’s leg, and his favorite stuffed animal.

Fortunately, my client’s dog’s paraphimosis was resolved the DIY (Do It Yourself) way with a gentle, lubricated push. From now on the hair is being trimmed shorter, so I hope his manhood stays put in its proper place.

Dr. Patrick Mahaney

Image: tenten10 / via Shutterstock

Comments  20

Leave Comment
  • Google
    06/11/2013 10:30pm

    I Googled "Merkin" and was a bit surprised. Who knew things like this existed and who knew I'd learn about it on a pet blog!

    It mystifies me why a groomer would leave a bunch of fur around a critter's private parts for just the reasons you mentioned. That surely can't be healthy and if this problem arises, it must be really REALLY uncomfortable.

    I've had more than one cat's backside shaved when they don't keep themselves clean. I call it a "potty strip".

    That aside, it's good to know your client was able to get the problem corrected. Happy endings are always good, regardless of the source of the problem.

  • 06/15/2013 05:23am

    Glad to hear that I could introduce you to the phenomenon that is the "merkin".
    Yes, I'm always amazed when I see a large frond of hair attached to a male dog's prepuce!
    I am a big advocate of the "sanitary clip" for both dogs and cats around the anus, penis, and vulva. There are so many occasions when urine, feces, or other discharge accumulates on the hair and irritates the skin, thereby causing inflammation and infection. Sanitary clips for all!
    Thank you for your comments!
    Dr. PM

  • Persistent Erection
    06/13/2013 11:19pm

    Over the years I have seen two cases of paraphimosis caused by the intact male dog having an erection and then the prepuce acting like a rubber band around the base of the penis, not allowing it to "deflate" properly. The dogs didn't have a problem unless they had an erection so I'm not sure if the preputial opening was too small or not.

    I had read that applying ice to the engorged penis would constrict the blood vessels and reduce the size of the penis quickly. From experience, I would warn you that it must not be comfortable to the dog to apply ice to his penis because I was bitten once when I did it.

    Be careful. Muzzle the dog in some way before ice application. It does work so that the penis "deflates" and can retract into the prepuce quickly. However, if the penis is traumatized in any way, the dog should be seen by a veterinarian as soon as possible.

  • 06/13/2013 11:22pm

    I forgot to include my name...

    Dr. Bob Turrou

  • 06/15/2013 05:27am

    Thank you Dr. Bob!
    Great to have a fellow veterinarian sharing his experience on this particular topic. I've never seen it occur in an intact animal, yet I speculate that the dogs' mating drive and inevitably more frequent excitation/engorgement would create plenty of opportunities for the glans penis to get stuck outside of the sheath.
    Note to self: No ice to be applied to the glans penis. I've done the 50 % Dextrose solution trick and it has worked (along with NSAIDs or steroids, sedation, etc.).
    Thank you for also suggesting to other readers that a muzzle should be placed!
    I hope to see you again back on my PetMD page.
    Dr. PM

  • 11/11/2015 11:26pm

    my dog appears very similar ,to the picture above. he is a bolognese dog, small, white, fluffy and loves to relax and sleep most of the time. to describe his paraphimosis, it is only the very tip that protrudes and it only occurs sporadically. Usually it doesn't bother the dog, but if I notice him licking a lot or appears to be in discomfort I will go in and treat it by removing any hair, lubing and manually reinserting. this is usually enough to fix it. I have read about surgery to enlarge the opening, but to me that would almost seem counter productive as I would think that it would actually make things worse. My question from a surgery perspective, would it be possible to actually make the opening smaller thereby inhibiting the tip from protruding, and has such an operation been done with success? Thanks.

  • 11/12/2015 04:52am

    The first time my dog had surgery to make the opening smaller, it didn't last. My vet says that is common. I think he said something like 40% of the time it doesn't last. About six months or so, I took him in for a second surgery. My vet didn't charge me, and they are wonderful. It worked like a charm the second time around. The opening is smaller and no matter how much he licks, it stays in. Thank goodness. It is painful for them when it dries out and painful when you have to put it back in. No more. YAY!

  • 12/18/2015 06:32am

    Good to know. thanks :)

  • ThingsWeNeverHearAbout
    06/15/2013 01:26am

    When our family moved to Acapulco for a few years, we brought our animal children with us also. One of them was a rather large Samoyed named Boyo.

    One day, as Boyo was walking across the dining-room I noticed some drops of blood on the tiles. Upon inspection, I discovered it was coming from somewhere around his penis area. I immediately rushed him to the vet.

    Acapulco can be a very hot place and flies abound. It seems one of them had decided to lay eggs under the (warm and moist) prepuce and horror of horrors, it was full of maggots. I almost fainted.

    The vet then explained to me what I had to do and, believe me, it wasn't fun for either of us. With a bucket of boiling hot water beside me, and a pair of tweezers, I had to retract the prepuce, pull them out with the tweezers and put them in the bucket of hot water.

    Boyo, on his back, was an 'angel' through all this...even counting the odd time I missed (that must have been extremely painful for him), there'd be a small groan from this 'almost Polar Bear'.

    Seemed like it took forever, but I was finally certain I had them all...cleaned Boyo up and applied the medication the vet gave me.

    I wasn't at all concerned that he would bite me through all this, I was concerned that he'd lick me to death saying 'thanks' the days following!

    Anyone else ever had an experience like this???

  • 06/15/2013 05:32am

    Thank you for sharing your story.
    Pulling maggots out of an animal certainly one of the most unpleasant experiences any veterinarian or technician must endure in clinical practice.
    Removing them from the prepuce or penis is certainly something that is especially off-putting (especially for we men).
    Hopefully, Boyo will have this site closely monitored with the hair clipped short and kept clean to prevent any accumulation of material that could permit the growth of insect larvae!
    I hope to see you back again on my PetMD page.
    Dr. PM

  • 12/18/2015 06:35am

    I hope I don't have to go though what you did. I will cry. I'm glad your dogs fine now.

  • backyardwolf
    12/11/2013 05:53pm

    I am fostering Greyson, an adorable little 4.6 pound chihuahua that we rescued. This poor little guy has gone through two surgeries now because his penis continues to peek out. Now I have just returned from the vet again today and was informed that he will just have to live with it, use ky jelly daily and watch for swelling. I was basically told that his penis is just too long for his sheath. Is this really possible??
    Before he was neutered it stayed in, except when excited, just like any normal dog. But after being neutered it stayed out. We just assumed it would go in when the pain from the neuter went away, but it didn't. Then it did get swollen and that was when he had his first surgery. After that first surgery he healed for 7 weeks with no change at all, just sported a new scar that ran alongside his penis. Then the vet operated again and that new scar was on his belly in front of his penis. Now today it is two months later after his second surgery and he still sticks out. Most of the time it sticks out about 1/2 inch but at times it sits out at 3/4 inch or even more. (On a four and a half pound chihuahua!)
    I don't know how to explain to potential adopters what his future may hold. Mostly because I really don't know what will happen. Do I need to warn them about possible lifelong issues? Is a tube of Ky jelly really the answer? Is it going to swell up again? If so how often? Is he going to need surgery over and over again? Is there really nothing else we can do for him?
    Other than his peek-a-boo penis, Greyson is very healthy 18 month old neutered chihuahua. He is a happy go lucky dog and definitely Mr. Personality. This little guy thinks everybody is his best friend! His hair is extremely short and he really does leave his penis alone, only occasionally licks it clean after going potty. Everything else about his penis is normal. He passes urine normal. He has normal erections when he gets excited. Then when he calms back down it goes back in, almost.
    This poor dog has gone through three surgeries in the last eight months. I thought I was doing what was best for him, but now I am not so sure. If you have any ideas or any thoughts that may be of help to him they would be greatly appreciated. I want to be certain that I did all I could for this special little boy before I adopt him out.

  • 02/12/2014 11:49pm

    My 13 year old min pin has paraphimosis and I have been lubricating his penis every other day and pushing it back in. It annoys and hurts him. Since it kept coming out, I took him to my vet and he said it is simply his age and that muscle is too relaxed now. He is scheduled for outpatient surgery one week from today. They will be sewing his sheath opening so that it has a smaller opening. This way, it shouldn't come out anymore.

  • 11/11/2015 10:52pm

    I am curious about the result of this course of treatment for your dogs paraphimosis? My 8 year old bolognese male has this issue from time to time and if he seems to be licking a lot I will undertake the procedure to shave any hairs, lube a little bit, and manually re insert the tip back into the sheath. this generally has been the remedy for me. but as a more permanent solution I was hoping your surgery would help me to decide about discussing the technique with my vet. Up to now, I have only read about making the opening larger with surgery, but you'd think that would make it stick out worse. However, I have not read anywhere or seen any vet suggestion of actually making the opening smaller. Best Regards to you.

  • 11/12/2015 04:54am

    Did you get my update sweetbaby21?...... [email protected]

  • 11/12/2015 07:02pm

    Thanks for the update designwise. It sounds like it was a success! The above article mentions surgery would involve cutting to make a larger opening? However, It makes a lot more sense to me intuitively, that if surgery was recommended that it would be to make the opening a little bit tighter so that it would inhibit and restrict the tip from dropping out of the sheath, but still allowing normal urinary flow in the neutered animal. Your successful surgery helps to confirm my theory. Still, I feel I need a lot more information on this subject before knowing quite what to do. Thanks for your experience.

  • 11/01/2014 06:58pm

    My shepherd has the same problem! He was fine before neutering, and now that he has been neutered it sticks out 1/2 an inch about 75% of the time and I have to put it back in for him.
    What did your vets say about your foster dog when they recommended surgery?

  • paraphimosis yorkie
    04/02/2014 05:13pm

    Your article was the most helpful and a thorough discussion on this problem. My yorkie, unfortunately, has this condition daily. It looks just like the poodle picture you posted. So, at the end of the day, I either have to put it back in myself with lubricant or my vet told me to put a little hemorrhoidal cream on it. But since he licks it off, I have to put a bandana around the area until it has soaked in.

    I don't want to deal with this daily. It does go back into the prepuce, but I have to keep an eye on it constantly. The hair is trimmed short in that area. We do allow him to be outside with us for at least an hour/day. We live on 10 acres of short grass prairie. He gets a bath at least once/week.

    What else can we do? I do not want any kind of surgery. Thank you.

  • Same Problem Daily!!
    11/01/2014 07:04pm

    Hi there,
    My shepherd has had the same problem daily since being neutered. He was a cryptorchid neuter, so our vets originally said the reason for his penis sticking out was because of nerve damage during surgery and that it would heal in 6 months. It has been over 6 months now though and it's still a daily issue where I have to lube it up and put it back in. Each time I go to the veterinarian it's the same thing though, "just wait and it'll get better". I live in Germany so I don't know if it's a language barrier or just difference in practice?
    Another vet suggested that maybe his penis retractor muscle was reattached wrong or not at all during surgery?
    Anyway... if it is simply a daily paraphimosis that he'll have for the rest of his life, what are the options to fix it surgically?

  • Paraphimosis Resolved :)
    12/18/2015 06:25am

    Thank you very much. I did the easy way and it was gone. I shaved that area and with a little fight .... success. Now he has the cone of shame as he still keeps on licking that part and it was starting to come out again. I notice that only happens in winter when I let my poodles hair grow.

Meet The Vets