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Umbilical Hernia 1003

Advanced or Confirmatory Testing • Mouthwash for local pain relief: mix equal Drug Interactions
• Case-specific advanced diagnostics parts viscous lidocaine 2% and sucraflate Immunosuppressive drugs should be avoided
VetBooks.ir ○ If neoplastic disease suspected: thoracic affected areas up to q 6h. There are many Possible Complications Diseases and Disorders
○ If dental disease suspected: dental radio-
suspension 1 g/10 mL; apply 2-5 mL to
in FeLV/FIV-infected cats.
graphs, teeth extraction
alternative “magic mouthwash” formulations,
radiographs for metastasis
lead to hepatic lipidosis
and dose. The toxic dose of lidocaine is
○ If infectious disease suspected: serol- but caution should be used with ingredients Persistent inappetence to anorexia in cats may
ogy, polymerase chain reaction (PCR) ≈6 mg/kg.
assay • Fluid therapy (IV or SQ) and hospitalization PROGNOSIS & OUTCOME
○ If immune-mediated disease suspected: if patient is anorexic, dehydrated, ill
antinuclear antibody titer • Nutritional support (see below) • Depends on underlying cause
○ If metabolic disease suspected, consult • Many of the idiopathic causes tend to be
individual disease chapters. Chronic Treatment recurrent and respond poorly to therapy.
• Tissue biopsy and histopathology • For CUPS and LPGS: dental extractions and
• Cultures are rarely helpful. meticulous dental hygiene are necessary. PEARLS & CONSIDERATIONS
• For immune-mediated disease: immunosup-
TREATMENT pressive therapy Comments
• For identified infectious disease: appropriate Identifying a definitive underlying condition is
Treatment Overview antimicrobial, antiviral, or antifungal therapy crucial for appropriate management.
Focus should be on addressing underlying • For uremic ulcers: address chronic kidney
disease process. It is important to be mindful of disease (p. 169). Technician Tips
nutritional support throughout the therapeutic • Oral bovine lactoferrin was reported to Imparting the importance of dental hygiene
period. have an antiinflammatory effect on chronic and demonstrating at-home dental cleaning are
stomatitis in FIV-infected cats. important in many of these cases.
Acute General Treatment
• Address and treat underlying disease. Nutrition/Diet SUGGESTED READING
• Broad-spectrum antibiotic if secondary • Entice with highly palatable, aromatic foods. Arzi B, et al: Oral manifestations of systemic disorders
infection present: amoxicillin, clindamycin, Baby food or blended food may be helpful. in dogs and cats. J Vet Clin Sci 1:112-124. 2008.
or doxycycline is a good first choice. • Severe cases with prolonged anorexia may
• Pain control: buprenorphine 0.01-0.02 mg/ require placement of a nasogastric or AUTHOR: Megan van Eeden, DVM
EDITOR: Leah A. Cohn, DVM, PhD, DACVIM
kg PO q 8-12h esophagostomy tube.

Umbilical Hernia Client Education
Sheet

BASIC INFORMATION ASSOCIATED DISORDERS • Gastroschisis
• Cryptorchidism ○ Grossly similar to omphalocele, although
Definition • Fucosidosis, an inherited, autosomal recessive paramedian in location; almost always
Congenital midline defect of closure of the body neurovisceral lysosomal storage disease results in neonatal death
wall at the umbilicus with various amounts of • Ectodermal dysplasia
herniated contents • Pentalogy of Cantrell HISTORY, CHIEF COMPLAINT
○ Sternal cleft • Typically an incidental finding on physical
Epidemiology ○ Cardiac defects exam during routine puppy/kitten evalua-
SPECIES, AGE, SEX ○ Peritoneopericardial diaphragmatic hernia tion. The owner may report a soft swelling
• Most common abdominal hernia in small ○ Ectopic cordis syndrome on midline that may change in size. It is
animals usually nonpainful and may or may not be
• Dogs and cats of either sex; from birth Clinical Presentation reducible.
but sometimes not identified until DISEASE FORMS/SUBTYPES • Systemic signs of illness may be present if
adulthood • Uncomplicated abdominal viscera are strangulated.
○ Single umbilical hernia without organ
GENETICS, BREED PREDISPOSITION incarceration or other anatomic PHYSICAL EXAM FINDINGS
• Breed predisposition in dogs: Airedale abnormalities • Soft, nonpainful swelling along midline at
terriers, basenjis, Pekingese, pointers, and • Complicated the site of the umbilicus
Weimaraners ○ Concurrent anatomic abnormalities ○ May or may not be reducible
• Breed predisposition in cats: Cornish rex ○ Strangulated or incarcerated abdominal ○ Other clinical signs may be present,
• Umbilical hernias thought to be heritable, viscera depending on what contents are within
likely through polygenic inheritance • Omphalocele the hernia.
○ Large midline umbilical and skin defect • Acute abdominal visceral herniation
RISK FACTORS that allows abdominal viscera to protrude ○ Firm, painful mass, and possible abdomi-
• Excessive traction on umbilicus at birth from the body nal pain
• Larger hernias more likely to result in organ ○ Most affected animals are euthanized or • Make sure to check for two descended
entrapment, incarceration, or strangulation die before attempted surgical correction testicles in the male dog/cat.

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