A Little About Umbilical, Inguinal, Perineal, Hiatial, and Diaphramatic Hernias
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An introduction to the different types of hernias of cats and dogs and their medical management or surgical repair.

The word "hernia" refers to an organ protruding through a hole.






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Umbilical Hernias

The umbilicus is the tube containing blood vessels that attaches the fetus to it's mother through the placenta.  The umbilicus is normally bitten off by the mother (or torn or cut and tied off  by the midwife, doctor, etc)

All mammals have an umbilical cord, and all mammals are left with a "belly button".   We all know this, right?  From Science Fiction movies where we can detect the the aliens from the Earthlings because the aliens don't have a belly button.  

The hole left by the bitten off umbilical cord usually self seals within a few days leaving a small scar of various size and appearance that we call a belly button or umbilicus.

Hernia is the medical term for a hole or a too large opening in the body.  An umbilical hernia then, is the medical problem fairly common in puppies where the belly button hole doesn't seal leaving a hole in the abdominal wall covered only by the skin.

This is easy to detect if you get the puppy in the right position and will usually be detected up by your veterinarian during it's first puppy exam. 

Most umbilical hernias ARE NOT SERIOUS  (unlike inguinal hernias) medical emergencies.  But:

1.  If the hernia is larger than a dime, there's a chance that a loop of intestines may be trapped in the muscular hole causing possible severe, fatal consequences if ignored.

Because of this possibility, even though not common, we recommend surgical repair of the hernia if it's large.

2.  Umbilical hernias can be passed on genetically.  Because of this, we recommend spaying and neutering of these pups to prevent the problem being passed on to future generations.

Note: we often fix the hernia at the same time as we spay or neuter.

The surgery itself is minor and uncomplicated.  The only danger being the relatively slight danger inherent in any anesthetic-surgical operation.

Note:  This pertains to all types of hernias:  The main danger with herniations is that if the intestines do get trapped within the muscular ring making up the hernia, then it's very likely that the veins supplying those trapped intestines will twist and swell and swell and swell.

Inguinal Hernias

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The radiograph to your left is revealing  All the gas filled black areas where I placed little red stars are intestines jammed into the chest cavity.  To be in the chest, there must be a hole or tear in the diaphragm.  No wonder this patient has labored breathing.
Perineal Hernias

(Also known as a caudal hernia, a colopexy, a
ventral hernia, a dorsal hernia, or scaitic hernia.)

There is a muscular ring in the pelvis
that allows the rectum and urethra to pass through but keeps the rest of the abdominal organs out of the pelvis.

When this muscular ring tears or becomes stretched out the bladder or colon can enter the pelvis.  This is
uncomfortable and the patient strains which then forces these organs through the pelvis creating a huge bulge near the anus.

Repair can be tricky... I usually refer these to a specialist.
Inguinal hernias are much more serious than umbilical hernias.  This is the type of hernia old men are prone too.  The inguinal rings in the normal puppy (or any other mammal) are tight, muscular openings on either side of the crotch between the lower abdomen and the rear legs.

It's there as a passage for the nerves, veins, and arteries going to and from the trunk and legs. 

Inguinal hernias are more likely to entrap the intestines causing severe intestinal pain and possible rupture.  Therefore the recommendation for surgical repair is a little more urgent than with umbilical hernias.  How urgent depends on the size of the hernia, the activity level of the patient, and how much risk you're willing to take as care taker of the patient.

Inguinal hernias are also likely to be genetically passed on to individuals of future litters, so once again, we highly recommend spaying and neutering to prevent this.

Diaphragmatic Hernias

There are 2 types of diaphragmatic hernias.  The diaphragm is the muscular sheet of tissue separating the heart and lungs from the abdomen.

If there is a tear in the diaphragm ... typically from being hit by a car ... the abdominal organs can enter the chest and squish the lungs to various degrees.  Symptoms range from coughing to severe breathing disorders.  Sometimes the tear is large enough that the abdominal organs can slop back and forth, into and back out of the hole in such a manner that if you stand the patient up like a human, it can breathe easy.

Another type of diaphragmatic hernia is where the muscular ring in the diaphragm where the esophagus passes through to join the stomach becomes stretched out, enlarged, or torn, allowing part of the stomach to protrude into the chest.  This is called a hiatial hernia.  It can be caused by major trauma too, but is more often due to a genetic defect of the muscular ring

Diaphragmatic hernias are very serious and surgical repair can be difficult and complicated.  Your vet may recommend referral to a surgical specialist for best results

The intestines should not be down here   >
This poor dog has a large inguinal hernia. It might not hurt much or cause much trouble.... until the patient becomes constipated.  This needs to be repaired.