What is Umbilical Cord Hernia?
Factors that may prevent this is the cord being stretched abruptly due to maternal or foal movement, or abnormal umbilical cord thickness. In some cases, human intervention may be the cause of umbilical herniation. It is interesting to note that on farms with calm and competent staff, incidences of herniation occurring are lower than elsewhere.
As complications may arise if hernias are left unassessed or untreated, it is vital that you contact your veterinarian for a consultation if your foal appears to have an umbilical hernia.
An umbilical hernia in horses is seen in less than 2% of horses. This condition occurs following the failure of the abdominal wall to close causing intestinal protrusion into the umbilicus. The umbilicus is the area that the umbilical cord enters the foal in utero, providing nutrients and oxygen and removing waste products from the fetus. Following birth, the umbilical cord detaches, this should lead to the closure.
Symptoms of Umbilical Cord Hernia in Horses
Umbilical hernias often occur in the first week of life, though they may occur in up to the first six weeks. Although in other forms of hernia symptoms may be seen such as colic, usually there are very few symptoms shown and no discomfort.
Symptoms that may be seen are swelling of the abdominal area, small unsightly lumps and a ring felt under the umbilicus. If infection or abscess occurs, localized heat, swelling, fever or purulent discharge may be seen.
- Discharge in the umbilical area
A hernia is a protrusion of an organ or tissue through an opening into an abnormal cavity. There are a range of types of hernia that may develop in horses. These include various herniations of the intestine such as:
- Inguinal hernia – This is when the intestine slips through the inguinal canal into the tissue between the hind legs
- Scrotal hernia - This is when the intestine slips through the inguinal canal into the scrotum of the horse
The two above forms of herniation may cause colic or pain in the horse due to obstruction or strangulation of the intestine.
- Umbilical Hernia - This is when the intestine slips through and protrudes from the umbilicus
Causes of Umbilical Cord Hernia in Horses
In utero, the umbilicus is the structure whereby the umbilical cord enters the fetus. This transports nutrients and oxygen to the fetus from the mother, while removing waste products from the blood system. Following birth, the umbilicus should close; when a defect occurs that causes the body wall to remain open an umbilical hernia may develop. This can occur from birth or over the first week of life.
It is thought that the behavior of the mare following foaling may lead to the formation of hernias in foals. A mare that is able to deliver their foal in a quiet, undisturbed environment will often remain recumbent until the foal becomes active and the umbilical cord is separated. In mares that are placed under stress or become agitated during foaling, the mare may jump up or move excessively causing damage to the umbilical ring that increase the risk of umbilical hernias developing. Therefore, providing mares with a safe, quiet place to foal may reduce the incidences in foals.
Diagnosis of Umbilical Cord Hernia in Horses
Your veterinarian will likely make the diagnosis through a careful clinical examination and looking at your horse’s history. Further diagnostic tests are generally unnecessary, however if infection is suspected your vet may recommend an ultrasonography to evaluate the umbilical area for the presence infection or an abscess. Blood tests may also be recommended.
Treatment of Umbilical Cord Hernia in Horses
There are a variety of treatment options if your horse has an umbilical hernia. In cases of small hernias that are unlikely to cause problems later in life, treatment may be conservative. Often these hernias will self-resolve by 12-14 months of age. To support this, your veterinarian may recommend daily reduction of the hernia by pushing the hernia sack back to the abdomen.
If your foal has a large hernia, or a hernia that is unable to be reduced back into the abdomen, surgical intervention may be considered to remove the risk of strangulation of infection of the intestine. Treatment methods include:
- The clamping of the skin and margins of the defect to close the skin together, with care taken not to involve the intestine
- The injection of blistering agents on the edges of the defect to encourage the formation of scar tissue to aid closing of the defect
- The closed surgical approach repairs the hernia with sutures, without opening the abdominal cavity
- The open surgical approach which opens the cavity and surgically repairs the defect
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Recovery of Umbilical Cord Hernia in Horses
The prognosis for a simple hernia repair with no infection or abscessing is good. If your horse has required surgery barn rest and reduced exercise may be required for 4 weeks following surgery. It is vital that the surgical site is carefully monitored for signs of infection or re-herniation.