Umbilical Hernias in the Foal

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Umbilical Hernias in the Foal

• By Pam Nolasco
• AVS 466

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Definitions

• Hernia
• Protrusion of an organ or tissue through an
  abnormal opening
• Umbilical Hernia
• Occurs when a piece of intestine protrudes down
  into a body wall defect in the umbilicus (naval
  area)

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What Causes an Umbilical Hernia?

• Congenital hernia present at birth and occurs
  during development of the fetus
• Abdominal wall surrounding the umbilicus is one
  of the last areas of the body wall to close
• If the body wall does not completely close, it
  will result in an umbilical hernia
• Acquired hernia Not present at birth, occurs at
  3-4 weeks of age
• Straining to defecate or micturate
• Infection of umbilicus
• Trauma at birth
• Improper handling and/or management
• Hereditary defect

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Prevalence

• Occurs in 0.5 to 2 percent of births
• More common in fillies then colts

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Types of Hernias

• Hernias are oval in shape and one to several cm
  in diameter
• Minor aka reducible hernia
• Any bowel in the hernia that is still healthy can
  be pushed backed through the abdominal hole

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Types of Hernias cont.

• Severe Hernia
• Intestine pushing through hole of the wall may
  strangulate
• A section of intestine becomes trapped leading to
  loss of circulation to area, bleeding, infection,
  inflammation, necrosis, and/or death

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Treatment

• Majority of small hernias are self healing
• Close spontaneously
• It is common practice to wait for the foal to
  turn 6-12 months before turning to surgery

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Treatment

• Minor Hernias
• Allow abdominal wall to close over and fix itself
  
• Use daily reduction technique
• Can be used for hernias 3-4 fingers in size
• Use your fingers to push contents of hernia sack
  back into the abdomen on a daily bases
• If hernia can no longer be reduced and isnt
  fixed, surgical correction should be considered

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Treatment cont.

• Larger hernia or un-reducible types
• Surgery
• Closed Technique repair hernia without opening
  abdominal cavity
• Advantage simple
• Disadvantage not seeing what is in the hernia
  sack.
• Open Technique
• More precise
• Hernia sack can be opened, evaluated, fixed and
  repaired

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Treatment cont.

• Elastrator Ring
• Closed surgery
• Procedure
• Give general anesthetic and roll foal on its back
• Abdominal contents are pushed through the hole
  and rubber rings are used to hold skin tightly
  over hernia spot
• This should keep contents from coming back out
  and allow abdominal cavity to close

• Becoming a very common technique

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Treatment cont.

• Elastrator Ring
• The ringed-off clump of skin, becomes deprived of
  blood, dies and rots, then falls off

2 wks after treatment
18 days after treatment
Source Horsetalk- http//www.horsetalk.co.nz/heal
th/hernia.shtml
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Treatment with Elastrator Ring
Once dead skin falls off wound can begin to heal
3 weeks after treatment
4 weeks after treatment
Source Horsetalk- http//www.horsetalk.co.nz/heal
th/hernia.shtml
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Treatment with Elastrator Ring
7 weeks 4 days after treatment
7 weeks after treatment
Source Horsetalk- http//www.horsetalk.co.nz/heal
th/hernia.shtml
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Treatment with Elastrator Ring

• Risk
• Infection from site affects too much healthy
  skin, causing wound site to burst open
• Infection can enter abdomen and cause serious
  problems

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Key to Success

• Early Assessment
• Veterinarian Treatment
• Take Action

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Sources

• Ball, Michael D.V.M. Umbilical Hernia. The
  Horse. 16 Feb. 2008. lthttp//www.thehorse.com/View
  Article.aspx?ID482dpt4gt.
• Battle of the Bulge Dealing with Umbilical
  Hernias. 24 Feb. 2006. Horsetalk. 16 Feb. 2008.
  lthttp//www.horsetalk.co.nz/health/hernia.shtmlgt.
• Paradis, Mary Rose D.V.M. Hernias in Foals. Pet
  Place. 16 Feb. 2008.
• lthttp//www.petplace.com/horses/hernias-in-foals/
  page1.aspxgt.
• Mair, Tim, S. Love, J. Shumacher, and E. Watson.
  Equine Medicine, Sugery, and Reproduction.
  Elsevier Health Sciences, 1998.