Key Points
+ Abdominal hernia is a condition that occurs in both dogs and cats in which there is an abnormal displacement of abdominal organs (small intestine, rectum, prostate, bladder or fat) into the subcutaneous region through a defect in the abdominal wall.
+ Abdominal hernia is most successfully treated primary suturing of the abdominal wall, muscle flaps, polypropylene mesh or collagen grafts.
Downloadable forms/information for clients for initial visit:
History form - initial consultation for abdominal hernia
Downloadable forms for referring veterinarians:
Anatomy
The abdominal wall consists of three sheets of muscles and the rectus abdominis muscles. The three sheets of muscle include the external abdominal oblique, internal abdominal oblique and transversus abdominis. Two straps of muscles called the rectus abdominis muscles are on the front of the abdomen and in man they are the muscles that give the "six pack" appearance to the abdomen. The inguinal canal is a natural hole on the left and right sides of the lower abdomen (groin) through which the spermatic cords transcend to the testicles. Females also contain a similar inguinal canal through which a tube and fat called the vaginal process passes. The umbilicus, or belly button, is the other natural opening through the abdomen that normally seals closed within a few weeks after birth.
Abdominal hernia – definition and clinical signs
An abdominal hernia is a condition that occurs in both dogs and cats in which there is an abnormal displacement of organs (small intestine, rectum, prostate, bladder, spleen or fat) into the fatty layer beneath the skin called the subcutaneous layer. This condition occurs secondary to a weakening of the muscles and in some cases due to tearing of the abdominal wall due to trauma. Signs of this condition include straining to urinate or have bowel movements, constipation, and a subcutaneous swelling. If an internal organ's blood supply is compromised when it is herniated through the body wall, the patient becomes ill and typically is painful, anorexia and may vomit. If the colon is trapped in the hernia, constipation may be present.
Umbilical hernia is a defect in the body wall at the level of the umbilicus. Frequently these are small and only contain fat from the abdomen (falciform or omental fat), yet may be large and contain abdominal organs. These hernias commonly have a genetic basis.
Inguinal hernia is widening of the inguinal canal through which abdominal fat, intestine, uterus, bladder and colon may be displaced. Sometimes pregnant animals will have the uterus trapped in an inguinal hernia as the fetuses grow. These hernias commonly have a genetic basis.
Prepubic hernia is commonly due tearing of the abdominal muscles (prepubic tendons of the rectus abdominis) and is usually due to a severe injury, such as being hit by a motor vehicle. These patients commonly have other injuries like broken bones.
Lateral wall hernia in some patients may be due to trauma; however, some animals have a collage defect that weakens that muscles, thus resulting in a hernia.
Diagnosis
The condition is usually diagnosed by digital palpation during a physical examination. X-rays, CT scan or ultrasound may be required to further define the hernia and your pet's overall health. Below is a CT scan demonstrating an inguinal hernia with the contents being only abdominal fat in a male dog.
The Day of Surgery
In preparation for surgery, your pet should be fasted starting at 10 PM the night before surgery; however, water does not need to be with held. To help prevent heartburn after surgery, a single dose of Pepcid AC (10 mg tablet per 20 pounds of body weight) should be administered at 6 AM at home on the day of surgery. Our anesthesia and surgical team will prescribe a pain management program, both during and after surgery, that will keep your companion comfortable. This will include a combination of general anesthesia, injectable analgesics, and oral analgesics.
Surgery
Abdominal hernia does not usually require emergency surgery. If the blood supply of an organ within the hernia is compromised, emergency treatment may be needed, as the pet may die not this condition.
Abdominal hernia is most successfully treated with surgery, by suturing the abdominal muscles together along the edges of the hernial ring. In some cases the hernia is so large that a plastic mesh or collagen graft is needed to repair the hernia. Prepubic hernias require making small holes in the brim of the pelvis to anchor sutures that bring the abdominal wall back into place. Inguinal hernia repairs typically require castration and in some of these cases either collagen graft or use of a sartorius muscle flap from the hind limb.
Convalescence period
By 10 to 14 days after the surgery most of the swelling at the level of the surgery will have resolved. Some pets will develop a seroma over the surgical site and may look like the hernia has recurred; this swelling generally resolves over a period of 3 to 4 weeks. By 6 to 8 weeks after surgery, complete healing has taken place.
Success
Surgery is successful 90% of the time.
Potential complications
Infection is an uncommon complication of this procedure. Recurrence of the hernia is possible and this complication is reduced by restricting the pet's activity in the postop period. Anesthetic death is an uncommon complication with elective hernia repair.
Postop care
Pain medication will be prescribed to minimize discomfort. Licking the incision can be prevented by using an Elizabethan collar. Sutures do not need to be removed as these usually are internal and will dissolve with time. During the first 4 weeks after surgery, activity is restricted to short leash walks outside. Running, jumping, or rough play is forbidden. Gradually increasing the activity, following the fourth week after surgery allows for a safe recovery.
