Inguinal Hernias By Michael Bell Two categories have been developed to describe true hernias in the inguinal region,

these being indirect and direct hernias. Where an abdominal organ enters the inguinal ring an indirect hernia exists, whereas a direct hernia occurs where organs pass through the inguinal rings. Because of this anatomical difference direct hernias are usually large and where most do not result in strangulation of the herniating organ. Overall inguinal hernias occur less frequently than umbilical hernias and results form a defect in the inguinal ring through which abdominal contents protrude. Inguinal hernias in males are normally direct hernias, whereas those in females can be either indirect or direct. Congenital inguinal hernias in dogs are quite rare and often consist with umbilical hernias, whereas acquired inguinal hernias are rather common and most often involve middle-aged intact bitches. How are inguinal hernias caused? Factors potentially involved in inguinal hernia formation can be grouped into three major areas: (i) Anatomical enlargement of the inguinal ring area which, unlike in humans remains open, is the main cause of inguinal hernias in dogs. Congenial inguinal hernias may disappear spontaneously at 12 weeks of age due to the reduction in size of the inguinal rings. Traumatic inguinal hernias in dogs may be due to a preexisting anatomical weakness in the area. (ii) Hormonal evidence suggest sex hormones play an important role in the cause of inguinal hernias as most inguinal hernias appear in bitches in oestrem or that are pregnant. Inguinal hernias have not been reported in desexed females. Because of this ostrogen production is considered to play a part in inguinal hernia development. It is thought sex hormones may change the strength and character of the corrective tissue thus weakening or enlarging the inguinal ring. (iii) Metabolic altered nutritional and metabolic status of a dog may cause weakening of the abdominal wall. Obesity increases intra-abdominal pressure which may in turn force abdominal fat through the inguinal cord furthermore accumulation of fat around the round ligament may dilate the inguinal coral area. What are the signs of inguinal hernias? Dogs with inguinal hernias usually present with a painless mass with a soft doughy consistency. This can occur on one or both sides, although in dogs most cases have only one side affected with the hernia more commonly occurring on the left side. How can inguinal hernias be diagnosed? Careful history taking is helpful in diagnosing inguinal hernias. Where a dog is showing signs of vomiting, belly pain and depression the possibility of intestine being trapped in an inguinal hernia must be considered. Also a prior breeding or vaginal discharge

associated with an inguinal mass may indicate involvement. However the history is not of great assistance when only fat protrudes through the inguinal rings. Diagnosis can be confirmed by reducing a mass in the inguinal region. Where there is a mass in the inguinal area that cannot be reduced the area should be surgically explored as the contents could include abdominal organs, mammary tumour or lymph node just to mention a few. Surgery will identify whether or not this non-reducible mass is actually a hernia. What should be done where an inguinal hernia is detected? Where a hernia is detected it should be surgically repaired as soon as possible. Usually surgery is quite successful although patients often are reluctant to walk for several days after surgery presumably because the walking causes stretching and/or inflammation on the repaired area.