The Animal Medical Center’s emergency room staff often talks about medical versus surgical emergencies. A medical emergency is one treated with medications, where a surgical emergency needs an urgent surgery to resolve the crisis. Glen, a 12 year old male terrier arrived at AMC as a surgical emergency on a Friday night. Glen had a hernia on the left side of his rectum which had been present for some time, but it began to enlarge, causing him to have trouble urinating and defecating. Glen’s regular veterinarian diagnosed entrapment of the bladder and intestine within the hernia with an x-ray and sent the little guy to the AMC emergency room.
According to the Merck/Merial Manual for Pet Health, a hernia is the protrusion of a body part through the lining that normally encloses it. Hernias occur commonly in pets. If your puppy has an “outie” belly button, I would bet the “outie” is a small umbilical (belly button) hernia. In an umbilical hernia, a small bit of abdominal fat protrudes though the body wall because the body wall did not completely close after birth.
Herina Types in Pets
A hernia requires two components: 1) A weakness or defect in the lining which normally encloses various body parts and 2) an organ or tissue which protrudes through the defect. In the case of an umbilical hernia, the defect in the lining is present at birth, also called congenital. Another type of congenital hernia is a peritoneal pericardial diaphragmatic hernia. In this congenital disorder, the diaphragm does not properly form and there is an abnormal communication between the heart sac and the abdomen. In dogs and cats with this disorder, the liver, stomach and intestines lie in abnormally close contact with the heart. Longhaired cats and Weimaraners appear to be predisposed to peritoneal pericardial diaphragmatic hernia.
Trauma can result in a hernia. In the case of a diaphragmatic hernia, the diaphragm ruptures from a traumatic event like the force of being hit by a car. Once the diaphragm ruptures, abdominal contents move into the chest cavity and pets with a diaphragmatic hernia may have respiratory difficulty.
Perineal and hiatal hernias occur more often in older dogs. Portions of the stomach slide up into the chest in hiatal hernias. In perineal hernias, the muscles around the rear end weaken, allowing the bladder and intestines to slip out of the abdominal cavity and under the skin of the rear end. Perineal hernias may occur after an episode of straining due to diarrhea, constipation or because of an enlarged prostate. This is the type of hernia that sent Glen to the ER. A progressive weakness in the muscle surrounding the esophagus allows the stomach to slip in and out of the chest cavity in a sliding hiatal hernia.
A body wall hernia is a rare complication of an abdominal surgery where the sutures give way before healing as occurred and again, the abdominal contents end up under the skin.
Anytime an important organ is trapped inside a hernia, it becomes an emergency. Glen’s hernia was classified as an emergency because the entrapment of the bladder and intestine prevented normal urination and defecation. A diaphragmatic hernia which is compromising respiration requires an emergency surgery to move the abdominal organs back into place, allowing the lungs room to expand. A body wall hernia after an abdominal surgery can also be a surgical emergency where the abdominal incision is repaired. Fortunately most hernias do not require an emergency correction, but if your pet has a hernia, you should follow your veterinarian’s guidance on when to seek emergency care.