An umbilical hernia is a condition in which abdominal contents protrude through the abdominal wall at the area of the umbilicus. Small hernias are generally not a problem. It is recommended to electively repair a larger hernia due to the risk of intestinal loop strangulation.
The exact cause of an umbilical hernia is unknown although most are thought to be inherited. It is most commonly a congenital malformation caused by flawed embryogenesis. The umbilical opening is normal until birth as it contains blood vessels that pass through from the mother to the fetus. This opening closes at birth in the normal pet and a hernia results if the opening fails to close.
Umbilical hernias are more common in dogs than cats. They occur on the midline of the abdominal wall through the umbilical ring and can be a variety of sizes from very small to very big. The hernia appears as a soft abdominal mass at the area of the umbilicus. Depending on the size of the opening, abdominal structures such as falciform fat or omentum can float into the opening. This generally does not cause a problem. However, if the opening is large enough, an intestinal loop can become trapped which can become a life-threatening problem. For this reason, it is recommended that larger hernias be closed after diagnosis. This is most often done concurrently with the spay
or castration surgery
Some male dogs with umbilical herniation may also have the concurrent abnormality of a retained testicle, referred to as cryptorchidism
Some breeds are predisposed to umbilical hernias; including Airedales
, and basenji
.What to Watch For Soft abdominal mass at area of umbilicus
Signs of intestinal strangulation:
Larger painful hernia sac that may be warm to the touch
Abdominal discomfort or pain
Definitive diagnosis of an umbilical hernia is by physical examination. Generally the contents of the hernia sack can be displaced back into the abdomen. This allows your veterinarian to determine the size of the hernia opening. The size of the hernia that is of most concern is that size which is similar to an intestinal loop. This size has the risk of allowing a loop of intestine to drop into the hernia and become trapped causing a life- threatening "strangulation". Hernias that are smaller, thus too small for a loop to enter, or larger, in which loops can freely come and go, are at lower risk for potential strangulation.
Occasionally, radiographs with contrast material may be used to diagnose strangulated hernias.
Abdominal ultrasound may be used to determine the size and contents of the hernia in some cases.
Small umbilical hernias may close spontaneously in young animals. Spontaneous closure may occur up to 6 months of age.
Some small umbilical hernias may not be repaired and pets may live their entire lives with them without any problem.
Larger hernias should be repaired. This repair is commonly performed at the time of the spay or neuter surgery since the pet will be already anesthetized. The surgery consists of manually reducing the contents of the hernia into the abdomen followed by the surgeon making an incision over the hernial sac. The border tissue of the hernia is removed and the abdominal wall is closed. This surgery is fairly routine. The location of the surgery for an umbilical hernia is very close to the location in which an incision is made in the body wall for a "spay" procedure in a female. For this reason, most all umbilical hernias, regardless of size, may be repaired at the same time as the spay in female pets.
Home Care and Prevention
Bring your pet to the veterinarian if he has a history of a hernia and if the hernia appears larger, the abdomen is painful or your pet is vomiting, depressed or not eating. These signs can be a medical emergency.
If surgical management is done, watch for potential complications after surgery, including:
Incision problems such as redness, swelling or discharge
Recurrence of swelling
Because the condition is thought to be inherited, it can be prevented by not breeding pets with umbilical hernias.