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==Introduction==

 

==Description==

'''Inguinal hernias''' occur when abdominal organs move into the inguinal canal where they may become [[Hernia|incarcerated]] or [[Hernia|strangulated]].  The herniated organs may be within the tunica vaginalis (an '''indirect hernia''') or they may be beside the tunica but within the inguinal canal (a '''direct hernia''').  In both cases, a true [[Hernia|hernial sac]] is formed by either the tunica vaginalis or parietal peritoneum, respectively.  '''Scrotal hernias''' occur in male animals when indirectly herniated organs pass along the tunica vaginalis to the level of the scrotum.  Organs in a scrotal hernia are much more likely to become strangulated.  The organs most commonly involved in the hernia are the omentum, small intestine, bladder and uterus and these may become incarcerated or strangulated within the relatively narrow inguinal canal.

'''Inguinal hernias''' occur when abdominal organs move into the inguinal canal where they may become [[Hernia|incarcerated]] or [[Hernia|strangulated]].  The herniated organs may be within the tunica vaginalis (an '''indirect hernia''') or they may be beside the tunica but within the inguinal canal (a '''direct hernia''').  In both cases, a true [[Hernia|hernial sac]] is formed by either the tunica vaginalis or parietal peritoneum, respectively.  '''Scrotal hernias''' occur in male animals when indirectly herniated organs pass along the tunica vaginalis to the level of the scrotum.  Organs in a scrotal hernia are much more likely to become strangulated.  The organs most commonly involved in the hernia are the omentum, small intestine, bladder and uterus and these may become incarcerated or strangulated within the relatively narrow inguinal canal.

==Signalment==

==Signalment==

In small animals, inguinal hernias may be '''congenital''' (often in male entire dogs) or '''acquired''', often in older females.  West Higland white terriers, Pekingese and Cairn terriers are known to be predisposed to congenital hernias but it is not currently known whether the disease is heritable.  In male dogs, both testes have usually descended within a few weeks of birth but, if this descent is delayed, the inguinal canals are held open by the testes.  It is suggested that the widening of the canals increases the chance of another abdominal organ entering the canal and becoming incarcerated there.  These congenital inguinal hernias are therefore often associated with [[Reproductive Male - Pathology|cryptorchidism]] and they may also occur with concurrent [[Umbilical Hernia|umbilical herniation]].   

In small animals, inguinal hernias may be '''congenital''' (often in male entire dogs) or '''acquired''', often in older females.  West Higland white terriers, Pekingese and Cairn terriers are known to be predisposed to congenital hernias but it is not currently known whether the disease is heritable.  In male dogs, both testes have usually descended within a few weeks of birth but, if this descent is delayed, the inguinal canals are held open by the testes.  It is suggested that the widening of the canals increases the chance of another abdominal organ entering the canal and becoming incarcerated there.  These congenital inguinal hernias are therefore often associated with cryptorchidism and they may also occur with concurrent [[Umbilical Hernia|umbilical herniation]].   

Acquired hernias occur with any condition that causes the diameter of the inguinal canal to increase.  In pregnant bitches, it is suggested that hormones cause the inguinal rings to widen allowing abdominal organs (including the gravid uterus) to herniate.  Fat may also be deposited in the canal in obese animals and this is thought to effectively hold the canal open.  Inguinal hernias may occur after blunt abdominal trauma, either due to an increase in intra-abdominal pressure or due to congenital weakness of the muscles forming the inguinal rings.   

Acquired hernias occur with any condition that causes the diameter of the inguinal canal to increase.  In pregnant bitches, it is suggested that hormones cause the inguinal rings to widen allowing abdominal organs (including the gravid uterus) to herniate.  Fat may also be deposited in the canal in obese animals and this is thought to effectively hold the canal open.  Inguinal hernias may occur after blunt abdominal trauma, either due to an increase in intra-abdominal pressure or due to congenital weakness of the muscles forming the inguinal rings.   

===Clinical Signs===

===Clinical Signs===

In small animals, clinical signs are most likely to be noticed if part of the small intestine becomes strangulated, causing:

In small animals, clinical signs are most likely to be noticed if part of the small intestine becomes strangulated, causing:

*'''Vomiting'''

*'''[[Vomiting]]'''

*'''Anorexia''', depression and lethargy

*'''Anorexia''', depression and lethargy

*Septic peritonitis may develop if the intestine ruptures

*Septic peritonitis may develop if the intestine ruptures

The hernia may be palpable in the inguinal region and over the scrotum of male dogs.  The hernia may be externally reducible, especially if the animal is in dorsal recumbency and the hind limbs and caudal abdomen are elevated.

The hernia may be palpable in the inguinal region and over the scrotum of male dogs.  The hernia may be externally reducible, especially if the animal is in dorsal recumbency and the hind limbs and caudal abdomen are elevated.

In horses, entrapment of the small intestine in the hernia may cause obstruction and/or strangulation.  Affected horses show signs of severe colic, including rolling, flank watching, belly kicking, flehmus, bruxism and scraping.  Rectal palpation will reveal the presence of multiple loops of distended small intestine (which feel similar to bicycle inner tubes) and intestine may be palpable within the scrotum.  See [[Surgical Colic in the Horse|here]] for more details.

In horses, entrapment of the small intestine in the hernia may cause obstruction and/or strangulation.  Affected horses show signs of severe colic, including rolling, flank watching, belly kicking, flehmus, bruxism and scraping.  Rectal palpation will reveal the presence of multiple loops of distended small intestine (which feel similar to bicycle inner tubes) and intestine may be palpable within the scrotum.  See [[Colic Diagnosis - Rectal Examination|here]] for more details.

===Laboratory Tests===

===Laboratory Tests===

'''Plain radiographs of the abdomen''' show that the normally distinct border of the caudal ventral abdomen is disrupted by the presence of structures within the inguinal canal.  If the hernia contains small intestine, gas lucencies may be evident within the canal.

'''Plain radiographs of the abdomen''' show that the normally distinct border of the caudal ventral abdomen is disrupted by the presence of structures within the inguinal canal.  If the hernia contains small intestine, gas lucencies may be evident within the canal.

'''Ultrasonography''' may be used to identify the contents of the inguinal canals.  It is important that both canals are scanned and palpated as the contralateral side may be subclinically affected.  This modality is also useful in cases of suspected scrotal herniation to assess testicular blood flow and to ascertain whether the spermatic cord is torsed.  

'''Ultrasonography''' may be used to identify the contents of the inguinal canals.  It is important that both canals are scanned and palpated as the contralateral side may be subclinically affected.  This modality is also useful in cases of suspected scrotal herniation to assess testicular blood flow and to ascertain whether the spermatic cord is torsed.

==Treatment==

==Treatment==

==Prognosis==

==Prognosis==

The prognosis is good after surgical correction of the hernia but is poorer if intestinal strangulation or rupture have occurred.  A mortality rate of 3% has been recorded for surgical management of inguinal hernias <ref> Waters DJ, Roy RG, Stone EA. '''A retrospective study of inguinal hernia in 35 dogs.''' ''Veterinary Surgery''. 1993 Jan-Feb;22(1):44-9.</ref>.

The prognosis is good after surgical correction of the hernia but is poorer if intestinal strangulation or rupture have occurred.  A mortality rate of 3% has been recorded for surgical management of inguinal hernias <ref> Waters DJ, Roy RG, Stone EA. '''A retrospective study of inguinal hernia in 35 dogs.''' ''Veterinary Surgery''. 1993 Jan-Feb;22(1):44-9.</ref>.

==References==

==References==

Fossum, T. W. et. al. (2007) '''Small Animal Surgery (Third Edition)''' ''Mosby Elsevier''

Fossum, T. W. et. al. (2007) '''Small Animal Surgery (Third Edition)''' ''Mosby Elsevier''

[[Category:To_Do_-_James]]

 

[[Category:Cat]][[Category:Dog]][[Category:Horse]]

 

 

[[Category:Peritoneal Cavity Diseases - Cat]][[Category:Reproductive Diseases - Cat]]

[[Category:Expert_Review - Horse]]

[[Category:Reproductive Diseases - Horse]]

[[Category:Reproductive Diseases - Dog]]

[[Category:Peritoneal Cavity Diseases - Dog]]