Inguinal hernia in Cats (Felis) | Vetlexicon
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Inguinal hernia

ISSN 2398-2950

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Introduction

  • Mostly in females, occasional inguinoscrotal hernia in the males.
  • Usually acquired in middle-age, particularly after pregnancy, may also occur after trauma causing abdominal compression.
  • Cause: pathologically enlarged inguinal canal, delineated by the external abdominal oblique muscle externally and the rectus and internal abdominal oblique muscles internally.
  • Signs: presents as a fluctuating mass in the inguinal (or scrotal) region that can often be gently reduced in the uncomplicated case.
  • Diagnosis: history, signs, radiography, ultrasonography.
  • Treatment: repaired by partial closure of the opening in the aponeurosis of the external abdominal oblique muscle with permanent sutures. Intestinal and bladder involvement are indications for immediate surgical repair. Gravid uteri may be managed until full term, at which point Caesarean section can be undertaken through the hernia to allow repair at that time.
  • Prognosis: complications include gravid uterine herniation, strangulation of intestine and incarceration of the bladder.
Print off the owner factsheet Hernias in cats (umbilical and inguinal) to give to your client.

Presenting signs

  • Fluctuating mass in the inguinal region which can often be gently reduced in the uncomplicated case.
  • Inguinal hernia containing uterus, bladder or intestine.
  • Scrotal hernia.

Acute presentation

  • Signs associated with strangulation of intestine or incarceration of the bladder.

Age predisposition

  • Middle age.

Pathogenesis

Etiology

  • Usually an acquired problem in the middle-aged female, particularly after pregnancy, but may also be encountered after a traumatic incident causing abdominal compression.

Predisposing factors

General

  • Pregnancy.
  • Entirety.

Pathophysiology

  • Usually an acquired problem in the middle-aged female, particularly after pregnancy, but may also be encountered after a traumatic incident causing abdominal compression.
  • Herniation occurs through a pathologically-enlarged inguinal canal which is normally delineated by the external abdominal oblique muscle externally and the rectus and internal abdominal oblique muscles internally.
  • Herniation occurs through a pathologically-enlarged inguinal canal which is normally delineated by the external abdominal oblique muscle externally and the rectus and internal abdominal oblique muscles internally.
  • Herniation (may)   →   strangulation or incarceration of abdominal organs, eg small intestine, bladder, gravid uterus.

Diagnosis

Presenting problems

Clinical signs

  • Hernia presents as a fluctuating mass in the inguinal (or scrotal) region and can often be gently reduced in the uncomplicated case.

Diagnostic investigation

Radiography

Treatment

Standard treatment

Surgery

  • Easier to repair a fresh injury; in chronic and scar tissue, may be difficult to identify/suture tissues.
  • The hernia is repaired by partial closure of the opening in the aponeurosis of the external abdominal oblique muscle with permanent synthetic absorbable sutures. Rarely, a prosthetic mesh is required.
  • The external inguinal canal may be approached medially from the mid-line.
  • The peritoneal sac is dissected free and inverted through the enlarged canal before part closure of the overlying muscle.
  • In some cases the contents are adhered to the sac and may necessitate the sac being opened to allow reduction of the content.
  • Concurrent castration Castration in affected males.

Monitoring

Complications

  • Complications of inguinal herniation include gravid uterine herniation, strangulation of intestine and incarceration of the bladder.
  • Intestinal and bladder involvement are indications for immediate surgical repair.
  • In the case of the bladder it is normally possible to decompress it by urethral catheterization Urethra: catheterization or cystocentesis Cystocentesis .
  • Strangulated intestine may require resection before reduction.
  • Gravid uteri may be managed until full term, at which point Caesarean section Cesarean section can be undertaken through the hernia to allow repair at that time.
  • Pyometra herniation can be managed by ovariohysterectomy Ovariohysterectomy through a surgically enlarged hernia/inguinal canal.

Prevention

Prophylaxis

Outcomes

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Waldron D R, Hedlund C S, Pechman R (1986) Abdominal hernias in dogs and cats - a review of 24 cases. JAAHA 22 (6), 817-823 VetMedResource.
  • Wright J G (1963) The surgery of the inguinal canal in animals. Vet Rec 75, 1352-1356.