Hernias in Puppies - Myra Savant Harris 2012
There is a lot of confusion regarding hernias, what they are, are they fixable, and how to identify them. It will help if we run over some of the different kinds of hernias and have a generalized discussion of what they are, what causes them and what their basic prognosis is.
The word, “hernia” refers to a split in the muscle wall that allows tissue from other parts of the body to come through the split. That definition is key and will help you in your assessment. OTHER BODY PARTS COME THROUGH THE OPENING IN THE MUSCLE. These hernias are located primarily in one of three areas of interest to dog breeders: 1. the umbilicus, 2. the groin or 3. the testicles. The most common for dog breeders is the herniated muscle surrounding the Umbilicus or Umbilical cord. These hernias occur in almost all species, most definitely in humans as well.
There are two types of tissue events that are referred to as umbilical hernias in puppies but only one of these “tissue events” is an actual hernia. So, let’s first eliminate the one that is not an actual hernia, requires no treatment, and is not significant at all from a health point of view. It can easily be removed for cosmetic reasons if desired, but removal is not necessary and it is viewed strictly as a removal; not a repair.
The cord carries three important blood vessels that transport blood from the mom, through the placenta and into the baby’s body. Naturally there is a small, rounded hole there in the abdominal wall that allows those blood vessels to enter the baby’s body. Sometimes that naturally occurring, very small, rounded hole doesn’t close off in time and a small amount of subcutaneous fatty tissue from the abdominal wall can migrate through that little tiny but necessary little hole and get trapped between the skin and the muscle when the little hole finally seals off. This little piece of tissue is easy to identify. It is firm to the touch and when you press against it, it pops immediately back. When you gently palpate the abdominal wall, you can feel that it is sealed and you cannot place your finger well into the abdomen. When you place the puppy on its back, the little piece of firm tissue remains in place and does not sink back into the body, nor can you manipulate it to make it go back into the body when puppy is in a back lying position. This is not a true hernia, does not present a danger to the health of the puppy and does not require surgery unless you want to have it removed because you do not like the way it looks. Some of these hernias “grow” as the puppy grows and some of them do not. It depends on exactly what type of tissue got trapped between the skin and the muscle wall that will determine if it experiences growth as the puppy grows. This would ever be considered a repair, only a removal. It will not grow back and once it is removed, it is gone forever.
Some breeders feel that this little ‘tissue event’ is due to moms who are a bit too energetic while chewing the cord. Other breeders feel that there is a genetic component to the formation of these little inaccurately named ‘hernias’. There have never been any actual studies on the cause of these hernias, but it is well accepted that they occur as frequently in c-section births as in free whelps so perhaps that discounts the idea that moms cause them by chewing the cord with a bit too much enthusiasm.
The second kind of umbilical hernia is entirely different; almost the polar opposite of the first kind of ‘tissue event’ that is not an actual hernia. A true umbilical hernia is most likely genetic in nature. If you have a puppy with a true umbilical hernia, you might consider not repeating that particular breeding next time around if you feel that genetics played a role. After reading the next section, you will easily be able to discern between the two umbilical tissue events.
The wall of the abdomen sometimes splits open in the muscle around or near the umbilicus. This is a serious birth defect, must be repaired, can reoccur after it is repaired and can present a serious health risk to the puppy or adult dog at any time. This split will always be split in the direction from the head to the toe, never sideways. Portion of the intestine will protrude from the hole and can get trapped or “strangulated” leading to intestinal necrosis (dead tissue), infection and
death. It’s easy to determine the difference between the two types of hernias. When you gently palate this area, the most noticeable thing you will feel is that the stuff that is protruding from the hole in the muscle is soft…soft…soft…..so soft that you can’t imagine it until you actually feel it. Your finger can go all the way inside the puppy to the spine. The ‘feel’ of that protruding tissue is much softer by far than the texture of a water balloon. Just imagine how a water balloon feels and then imagine something 100% softer. If you place a stethoscope on that soft protrusion, you can hear the bowel sounds (sounds like when your stomach ‘growls’) clearly. If you place the puppy on its back and gently push that sooofffftttt tissue back inside the abdomen, it stays inside until the puppy gets up again. Gravity will pull the intestine back and away from the split in the muscle wall. It doesn’t pop back out. It stays inside the puppy and in that position, you can sometimes gently palpate the actual hole in the muscle wall. You can feel the perimeters of the split in the muscle fibers.
So, in review, the first kind of ‘tissue event’ is not a hernia. The muscle wall is intact behind the little lump of firm tissue. You can feel the intact muscle wall and you can feel the little scar where the hole used to be that the blood vessels traveled into the puppy’s body. When you push it into the stomach area, it pops right back out whether the puppy is on its four feet or on its back. This is not a hernia. Sometimes it grows as puppy does, sometimes not and can easily be removed for
cosmetic reasons if you desire. You can educate your puppy buyers about this little ‘tissue event’ and they can have it removed at time of spay or neuter if desired for cosmetic reasons.
The second kind of hernia has a body part (intestine) coming through it, is soft, soft, soft to the touch and would allow your finger to go well into the abdomen and stay there. This is a true hernia. If the puppy is on its back, you can push the soft tissue (intestine) back into the large sized hole and it will stay inside the body and look normal. This true hernia is much softer than a water balloon and has the sounds of a ‘stomach growling’, which are actually the sounds that intestines make all day as they digest and process food and fluids. This hernia requires surgical repair as soon as your vet feels that the puppy is old enough for the surgery.
Another hernia that dog breeders see is an inguinal hernia, which occurs in the area of the abdomen where the rear legs attach to the abdomen. Inguinal hernias in the muscle wall also occur in the head to toe direction versus side to side. It is usually a smaller hole in the muscle wall than the umbilicus hernia. It is not as common as the first type of umbilical tissue event that we discussed, but it is more common than a true umbilical hernia. If the hole in the muscle wall is large enough, a small portion of the intestine will protrude through the hole and the same assessment tool applies. If you gently palpate and push the intestine through the hole after you have placed the puppy on its back, and if the escaping tissue
(intestine) stays in perfect position, you are safe to assume that this is a true hernia. The prognosis is more varying on the inguinal hernia. If the hole is small enough, it may disappear as the puppy grows. The muscle fibers are in a head to toe arrangement and as the puppy grows in length, sometimes the growth of those long muscle fibers allow it to close and it is no longer a problem.
If it has not closed over by the time the puppy has achieved about 85% of its body growth, you should consult a vet to see if the vet recommends its surgical closure. Prior to breeding a bitch with this type of hernia, you would want to have it repaired because the pressure within the abdominal cavity that is associated with gestation could force the intestine through the hole. The presence of the full uterine horns could be severe enough that the intestine could not return to the abdomen and become ‘strangulated’, trapped and necrotic. This type of hernia is less likely to reoccur after repair but it can happen so it’s a good idea to include a brief assessment of the area during every bath.
The last type of hernia that dog breeders could conceivably see is rare in the canine because their center of gravity is different than for a human. It is not common in humans either but because it can occur suddenly and without warning in any dog of any age, I would like to bring it to your attention. You are unlikely to see it, but it can happen.
Testicular hernias occur when the muscle wall between the testicle and the abdomen has a small split that allows a portion of the intestine to travel into the scrotum. It would be evidenced by a larger, swollen look to the testicle, suddenly occurring and not particularly painful. This would require repair immediately. It would not be likely to recur.
I hope that this little discussion on hernias is helpful to you and can be useful to you when assessing…particularly the difference between a true hernia, and a mere ‘tissue event’ for lack of a better term.
