Presented by
ROSSDALESHERTFORDSHIRE
Rossdales Hertfordshire, 13Weston Barns, Weston,Hertfordshire SG4 7AX
T. 01462 790221
E. [email protected] www.rossdalesherts.com
Sarah Moore BVetMedCertAVP(ESM) MRCVS
Sarah qualified from theRoyal Veterinary College in2009. She joined RossdalesHertfordshire in 2013 afterperiods working in a mixedpractice in Norfolk and inthe equine department atSwanspool Veterinary Clinic.In January 2016, she wasawarded the RCVSCertificate in AdvancedVeterinary Practice (EquineStud Medicine).Sarah is a key member ofthe Rossdales Hertfordshirestud farm services team butenjoys a busy and variedcaseload, seeing all types ofhorses and ponies. Herparticular interests are instud farm medicine anddiagnosing poorperformance and respiratoryconditions. She is a keenfollower of all equestriandisciplines, especiallyhunting and point-to-pointing.
HEALTH & WELFARE
hernia is either anacquired or congenitaldefect in the bodywall. It results in the
protrusion of an organ ortissue through an abnormalopening, creating a softswelling below the abdomenor within the scrotum.Congenital defects occur at threecommon sites, the umbilicus,the scrotum and the inguinalring (the channel in the bodywall through which the testiclesdescend). Umbilical herniasoccur in up to 2% ofThoroughbred foals and arepresent at birth. Scrotal/inguinalhernias are seen in young coltsand may be present at birth ordevelop over the first few daysof life. Acquired hernias in adulthorses normally occur afterabdominal surgery or trauma.The contents of the hernia havean implication on its severity. Anuncomplicated hernia willcontain either non-compromised intestine or nointestine at all, i.e. fat. These arenot life threatening andtreatment is oftenstraightforward. Complicated hernias containcompromised, oftenstrangulated (twisted) intestine.These cases often present withcolic-like signs of discomfort andtoxicity, with the area of thehernia being hot, hard andpainful. These cases areconsidered a surgical emergencyand warrant immediate referralto a surgical facility.
Clinical Signs and DiagnosisHernias are usually apparent onvisual examination of a foal anddetected by palpation of theswelling and the defect of thebody wall. Uncomplicatedhernias are most commonlyencountered with no other signsof disease. Diagnosis by palpation istypically all that is required. Anattempt will be made to reduce(replace the contents of thehernia) into the abdomen.Uncomplicated hernias reduceeasily and carry an excellent
prognosis for treatment.Ultrasound can be used if thehernia is non-reducible todifferentiate the contents of theswelling. External abdominalsoft swellings can also be causedby an abscess, haematoma orseroma (fluid accumulation),and it is important to ascertainthe contents of the swellingprior to treatment. If the foal presents with acomplicated hernia, ultrasoundwill be used to assess thecondition of the intestine insideprior to surgery. Strangulation of
intestine must always beconsidered in a foal with ahernia that develops colic.
TreatmentUncomplicated HerniasSmall congenital umbilical oringuinal hernias are treatedconservatively and are likely tocorrect spontaneously as thefoal grows. These should bemonitored by the owner andveterinary attention sought ifany problems occur. Largerhernias, i.e. umbilical herniasgreater than 5cm in diameter, orhernias that have not resolvedby 7-9 months of age, willnormally not resolve withoutintervention.The most common treatmentfor these umbilical hernias isplacement of a tight rubber ringaround the excess skin of thehernia whilst reducing itscontents back into theabdomen. Most commonly thisis performed while the foal isstanding under sedation, but it
can also be done with the foalon its back under a short generalanaesthetic. Care is taken tomake sure all of the contents arereplaced and no intestine iscaught within the rubber ring. Intime, the hernia dries upthrough lack of blood supplyand drops off. It is normal tohave some localised swelling forthe first few days but the foalshould be in no discomfort. Very large, uncomplicatedhernias may require surgery to
place a synthetic mesh acrossthe defect in the abdominalwall. This will be performedunder general anaesthetic in thehospital and will be advised byyour vet if required.
Complicated HerniasThese are considered a surgicalemergency and admission to anappropriate surgical facility isrequired. The foal will be given ageneral anaesthetic and thecontents of the hernia assessed.If the intestine has beencompromised for a significantperiod of time, it may benecessary to remove a portion ofthat intestine. The defect in theabdominal wall can then berepaired. If the defect is large itmay be necessary to place amesh over the hole in order toprevent any further abdominalcontents pushing through. Inthe case of scrotal or inguinalhernias, it may be necessary toremove the testicle associated inorder to close the ring throughwhich the intestine has entered.
PrognosisThe prognosis for the treatmentof uncomplicated hernias is very
VET PROFILE
AVetWa
tchHERNIAS
Umbilical hernia before treatment
Umbilical hernias are most commonly treated by the placement of a tightrubber ring around the excess skin of the hernia whilst reducing itscontents back into the abdomen.
Surgical removal of a hernial sac and associated skin,followed by closure of the defect with sutures.in horses
By Sarah Moore MRCVS
good and a good cosmetic resultis often achieved. In the case ofcomplicated hernias, theprognosis is variable, dependingon the degree of compromise ofthe intestine involved and if aportion has to be removed.However, if treated quickly withprompt referral for surgery this isalso good.
It may be necessary to remove surgically a portion of the intestine if has beencompromised for a significant period of time
Photos Nick Wingfield Digby
