Hernias in puppies are not uncommon and they can be present from birth or they may develop later on. If your puppy has a hernia, you may be wondering what caused it, what should be done about it and whether it's something that requires veterinary attention of not. Hernias in puppies may vary in size and some may be more troublesome than others. Following is some information about hernias in puppies by veterinarian Dr. Ivana Crnec.
Hernias in Puppies
Hernias develop when tissues and/organs squeeze through a so-called weak spot or hole in the surrounding muscle or connective tissue. A hernia can be defined as an abnormal exit of a tissue or an organ. Each hernia consists of three important parts: the ring, tear or opening, the sac and the content.
Based on how they develop, there are two types of hernias: congenital and acquired.
Congenital means the puppy is born with the condition. Congenital hernias can occur due to spontaneous problems during the developmental period or due to genetic defects passed on from one or both parents. Acquired hernias, on the other hand, can be acquired through trauma (usually blunt force trauma), disease or aging.
Based on their reducibility, there are two types of hernias: Reducible – meaning that the protrusion can be pushed back under small pressure and non-reducible – meaning that the protrusion cannot be pushed back into its original place. In non-reducible hernias, the herniated content is at least partially adhered to the opening.
Based on their complexity, there are two types of hernias: Non-complicated – meaning that the hernia sac contains no organs (manifests as soft swelling of variable size). The good news is that non-complicated hernias tend to resolve on their own.
Complicated hernias encompass hernias where organs have passed through the opening and have eventually become entrapped. If part of the intestines gets entrapped, it strangulates. Intestinal strangulation or incarceration means that the blood flow to the intestines is cut off. When the blood flow is stopped, tissue damage and death are likely to occur.
Types of Hernias in Puppies
Based on their location, there are six types of hernias in puppies: umbilical hernias, inguinal hernias, diaphragmatic hernias, perineal hernias, hiatal hernias and peritoneo-pericardial hernia. Let's take a closer look into each.
Umbilical hernia: this is the most common type of hernia in puppies. It has congenital origin and it is quite easy to spot – your puppy’s belly button is replaced by a squishy protrusion. Puppies with umbilical hernias, in spite of having bubble-like masses beneath the skin, are usually asymptomatic.
Normally, before birth, to provide nourishment for the developing fetus, the umbilical blood vessels pass through an opening in the abdominal wall. The opening is called umbilical ring. After birth, the umbilical ring is supposed to close. Umbilical hernias occur when the closure of the umbilical ring is incomplete. More often than not, umbilical hernias are clinically insignificant and may spontaneously close as late as 6 months of age.
Inguinal hernia: occurs in the so-called "groin" region or more precisely where the inner fold of the rear leg comes into contact with the belly wall. It is particularly common among young puppies and middle-aged, pregnant dogs.
Statistically speaking, inguinal hernias are more frequently seen in female puppies. Once again, statistically speaking, they usually tend to develop in the left side. Bilateral inguinal hernias are rarely seen. Inguinal hernias develop when the inguinal canal becomes enlarged. The most common contents of inguinal contents include: fat, omentum, intestines, bladder and uterus.
Diaphragmatic hernia: the dog’s heart and lungs are separated from the abdominal organs with a muscle wall called diaphragm. If there is a hole in the diaphragm, abdominal organs may enter the chest cavity and impair the breathing.
Perineal hernia: develops when the pelvic muscles tear thus allowing abdominal organs to enter the area adjacent to the anus. Perineal hernias are more common among unneutered male dogs older than 5 years of age.
Hiatal hernia: develops when part of the stomach enters the chest cavity through the diaphragm’s opening for the esophagus.
Peritoneo-pericardial hernia: occurs when there is an opening between the peritoneum (membrane that lines the abdominal cavity) and the pericardium (sac that surrounds the heart).
Certain dog breeds are genetically predisposed to developing certain types of hernias. For example, Shar-Peis and English Bulldogs are prone to developing hiatal hernias, Weimaraners are prone to developing peritoneopericardial hernias and Airedales, Pekingese dogs and Basenjis are prone to developing umbilical hernias.
Signs of Hernias in Puppies
The clinical signs of hernias in puppies depend on two factors: the hernia's size and the hernia's content. Based on these factors, the clinical signs can vary from small, soft and non-painful swelling to visceral obstruction, followed by shock and eventually death.
Commonly observed clinical signs include:
- Protruding or bubble-like, squishy mass
- Decreased appetite usually without decreased water intake
- Excessive drooling
- Difficulty urinating
- Difficulty breathing
- Shortness of breath
- Irregular heartbeat
- Depression and lethargy
- High fever.
A hernia’s content tends to protrude when the puppy is under increased physical pressure, for example when standing on its hind legs, barking, crying, or simply straining.
At the Vet's Office
Generally speaking, the diagnosis is based on palpation during regular physical examination, radiography and ultrasonography. Radiographic and ultrasonographic imaging is performed to determine the content and type of hernia – which organs are displaced and to what extent.
Unless dealing with incarcerated or strangulated hernia content, hernias are usually fixed at the time of spaying/neutering. On the flip side, incarcerated or strangulated hernias are considered an emergency and require quick medical attention.
The surgical correction includes putting the displaced tissues and organs back in their anatomical place and then repairing the muscle tear by suturing it closed.
The success of the surgical repair is based on several factors: size of the defect, content of the hernia, whether the organs sustained damage while herniated and overall health status of the patient.
To prevent messing with the incision, it is advisable to use Elizabethan collars, for several days after the surgery. Restricted physical activity and pain medications are also indicated in the post-surgery period. In most cases the recovery is smooth and without complications.
Cost of Puppy's Hernia Surgery
Repairing your puppy’s hernia can be quite expensive. Depending on the costs of living in your area and the hernia’s type, the price may vary from $700 for simple, non-complicated hernias to as much as $2.500 for more complex hernias. The average cost is estimated to be $1.600.
Unfortunately, hernias cannot be prevented. However, since spaying/neutering has an impact on preventing certain types of hernias, it is highly advisable to have your puppy spayed/neutered as early as possible. It should also be mentioned that due to the genetic basis of the condition, puppies with congenital hernias should not be bred.
About the Author
Dr. Ivana Crnec is a graduate of the University Sv. Kliment Ohridski’s Faculty of Veterinary Medicine in Bitola, Republic of Macedonia.