Ruptured inguinal hernia in new-born colt foals: a review of 14 cases

Over a six year period, 14 new-born colt foals were treated surgically because of ruptured inguinal hernia. In all cases, the prolapsed intestines, which were jejunal loops, were situated subcutaneously and protruded through a rent in the parietal vaginal tunic at the level of the inguinal canal. After herniorrhaphy and unilateral castration, the prolapsed loops were replaced into the abdomen, and the superficial inguinal ring closed. Seven foals survived.     

Extensive umbilical herniation of the large colon in a foal

A 5‐month‐old Warmblood cross colt was presented with focal swelling of the ventral abdomen extending from the umbilicus to the scrotum in the absence of colic signs. Palpation and ultrasound examination revealed the presence of incarcerated large intestine within the subcutaneous space adjacent to the caudal ventral abdomen and prepuce. Surgery was performed and revealed that the umbilical hernia sac had ruptured, and confirmed that the left dorsal and ventral colon were present in the subcutaneous space. The mild degree of vascular compromise of the large colon did not necessitate resection and so it was replaced within the abdomen. The abdominal wall defect was closed and the subcutaneous dead space was reduced by using a walking suture pattern. Herniation of the large colon through the umbilicus with dissection through the subcutaneous tissues of the ventral abdominal wall and prepuce has not been previously reported in foals. Ultrasonography permits differentiation of herniated small intestine from large intestine.     

Laparoscopic inguinal herniorrhaphy with barbed suture in a ram

A 7-month-old Hampshire ram, with no history of trauma or breeding, was referred for treatment of acute, unilateral scrotal swelling. Physical examination revealed a moderately sized, soft, left-sided, non-reducible swelling of the proximal scrotum and mild swelling of the scrotal neck. Ultrasound evaluation of the scrotum revealed morphologically normal testicles and a mild accumulation of free fluid in the left vaginal tunic. Unilateral, laparoscopic inguinal herniorrhaphy under general anesthesia was performed. The herniated omentum was reduced and barbed suture was used to imbricate the internal inguinal ring and the vaginal ring. No recurrence of herniation was reported 5 months after surgery.Key clinical message:Laparoscopic inguinal herniorrhaphy with barbed suture can be a safe and effective means of scrotal hernia resolution in a ram. When performed by a competent surgeon experienced in laparoscopy, this treatment for inguinal and scrotal herniation may minimize post-operative pain, provide a rapid return to function, and preserve normal testicular and scrotal anatomy.     

Intracorporeal suture closure of the internal inguinal and vaginal rings in foals and horses

Objective— To report a technique for repair or prevention of inguinal hernia in horses using intracorporeal suture closure of the internal inguinal and vaginal rings.
Study Design— Case series.
Animals— Foals (n=6) and geldings (n=2).
Methods— After selection of a peri-umbilical telescope portal, instrument portals were made unilaterally or bilaterally, as needed. Herniated viscera was reduced, castration (foals) or spermatic cord remnant transection at the internal inguinal ring (adults) performed, and then simple interrupted intracorporeal sutures of synthetic absorbable suture material were used to close the internal inguinal and vaginal rings.
Results— There was no recurrence of inguinal hernia. Postoperative morbidity was minimal and cosmetic outcome was comparable to that achieved with conventional, open techniques.
Conclusion— Laparoscopic, primary closure of the internal inguinal ring by use of intracorporeal sutures provides a secure barrier to herniation and costs considerably less than using endoscopic staples.
Clinical Relevance— Laparoscopic suture closure of the internal inguinal and vaginal rings provides safe and effective repair of inguinal hernia in horses.     

Direct preputial hernia associated with a ventral abdominal wall defect in a two‐year‐old gelding

The case of a 2‐year‐old gelding with acute onset of preputial swelling and prolapse is presented. After initiating conservative management using a penile repulsion device, the horse repeatedly displayed signs of mild abdominal discomfort with sudden deterioration to an episode of violent colic after 5 days of hospitalisation. Ultrasonographic examination of the preputial swelling at that time demonstrated the presence of small intestine between the internal and external laminae of the prepuce and led to the diagnosis of a direct preputial hernia. The contents of the hernia were readily reduced through a defect in the ventral abdominal wall after the anaesthetised horse was placed in dorsal recumbency. The historical information, clinical progression and surgical findings were supportive of an acquired ventral abdominal wall defect. To the authors' knowledge, this is the first reported case of a direct preputial hernia associated with an acquired ventral abdominal wall defect.     

Normal and cryptorchid castration

Surgical exploration of the horse that has presumably had a normal castration or a previously successful cryptorchid surgery remains a distinct challenge. No hard and fast rules dictate a proper course of action for each case. If a horse was anesthetized for routine castration, discovered to have only one scrotal testis, had a brief exploratory on the nondescended side and was recovered, trauma to the inguinal region would probably be sufficiently minimal that an inguinal approach could be used at subsequent exploratory surgery. If the inguinal canal was extensively manipulated and the tail of the epididymis was inadvertently removed, however, one of the alternate approaches would be advisable. Where previous history is unknown, external and rectal palpation, hormonal assays, and careful evaluation of the scrotal/inguinal scars under anesthesia are advisable prior to proceeding with a specific course of action. As previously cited, "one hopes for the best but prepares for the worst." Where inguinal canals are being explored in the supposedly previously castrated horse that still has aggressive male behavior, the surgeon is searching for vaginal process and contents or the stump of the spermatic cord. If the stump is identified to suggest complete previous castration, the stump should contain cremaster muscle, parietal vaginal tunic, testicular vessels, and ductus deferens. If a second nonvascular tubular structure is found but no testicular vessels are found, the tail of the epididymis was inadvertently removed and assumed to be hypoplastic testis. This determination can be difficult to make on gross observation of the stump. Again, a thorough case workup helps one plan in advance for what should be found at surgery.     

Diaphragmatic Hernia Repair in Three Young Horses

Objective- This clinical report describes surgical correction of diaphragmatic hernia in three young horses.
Study Design- Retrospective investigation of medical records and subsequent racing performance.
Animals- Three young horses with diaphragmatic hernia.
Results- Three young horses with signs of abdominal pain had diaphragmatic hernia causing small intestinal strangulation. The strangulated small intestine was resected and an end-to-end jejuno-jejunal (two horses) or a side-to-side jejuno-cecal anastomosis (one horse) was performed. Diaphragmatic hernias were closed with a continuous suture pattern. All horses recovered and raced. No difference in race records was found between the subject horses and their siblings. One subject horse died of colic at 5 years of age, but the cause of the colic was undetermined. The remaining two horses are in use as broodmares and have produced multiple foals without recurrence of signs of diaphragmatic hernia
Conclusions- Diaphragmatic hernias can be repaired in horses. These horses can achieve race records similar to their siblings and can produce foals without recurrence of signs of diaphragmatic hernia.     

Results and complications of a novel technique for primary castration with an inguinal approach in horses

Reasons for performing study: Complications associated with equine castration can have medical and financial consequences. This retrospective study investigated a novel method of castration via an inguinal approach in mature stallions and compared the incidence of complications with other methods. Hypothesis: Castration via an inguinal approach has a low complication rate at the site of surgery compared with other castration techniques. Methods: Mature stallions (n = 238) were castrated under general anaesthesia in dorsal recumbency using an inguinal approach. The vaginal process was incised, the spermatic cord ligated twice and the testis removed. After suturing, the vaginal process and one or 2 layers of fascia, the subcutis and cutis were closed in a simple continuous pattern. Results: Five of 238 (2.1%) horses had post operative haemorrhage and a haematoma in the scrotal region, which required additional treatment. All horses made a full recovery. Five of 238 (2.1%) of the horses had a post operative respiratory infection, which resolved with antibiotic therapy. Sixteen of 238 (8.8%) had transient signs of colic shortly after surgery. Conclusion: This technique of castration with an inguinal approach had a low incidence of complications at the site of surgery compared with other methods. An inguinal approach and leaving the vaginal tunic in situ may cause less soft tissue trauma than a scrotal approach.     

Inguinal herniation in foals. Literature review and a case report

A literature review is given concerning the occurrence, clinical signs and possible treatment of the different types of inguinal herniation in foals. A six-week old filly with a reducible inguinal hernia is described in detail.     

Ultrasonographic diagnosis of uterine entrapment in an inguinal hernia

An elderly female West Highland white terrier was presented with a history of recent enlargement of an inguinal swelling with concomitant lethargy and inappetence. The radiographic and ultrasonographic findings were suggestive of a pyometra incarcerated within an inguinal hernia. Following routine ovariohysterectomy and hernia repair, the bitch made an uneventful recovery.     

SIMULTANEOUS PRESENCE OF A DIRECT AND AN INDIRECT INGUINAL HERNIA IN A STALLION

SUMMARY: The case history, clinical findings, surgical procedure and post mortem results are described of a horse showing signs of colic which at surgery had both a direct and an indirect left inguinal hernia. The etiology of inguinal hernias in the horse and the surgical management of the direct inguinal hernia are discussed.     

Meconium impaction in newborn foals

Meconium impactions are one of the most common causes of colic in neonatal foals. It is recommended that foals be administered a sodium phosphate or warm soapy water enema within the first 3 hours after birth either routinely or if they have not yet passed meconium. Administration of an acetylcysteine retention enema is recommended for foals with refractory cases of meconium impaction.     

Surgical Repair of an Inguinal Herniation of the Urinary Bladder in an Intact Female Domestic Rabbit (Oryctolagus cuniculus)

A 4-month-old intact female domestic rabbit (Oryctolagus cuniculus) was evaluated for a recent onset of lethargy, anorexia, foul-smelling red urine, diarrhea, and a soft subcutaneous swelling in the inguinal region. Physical examination confirmed the presence of a flocculent subcutaneous swelling in the ventral pelvic region. Whole body radiographs showed an approximately 5 × 3.5 × 3.5 cm structure of mineral opacity within the subcutaneous tissues ventral to the pelvic girdle. Cytology of fluid aspirated from the mass and an excretory urogram supported the diagnosis of a herniation of the urinary bladder through the right caudoventral abdominal body wall. The hernia was successfully repaired with an inguinal herniorrhaphy and replacement of the bladder within the abdominal cavity. The etiology of this herniation could not be definitively determined but was likely congenital or non-traumatically acquired in origin. This is the first published report describing the surgical repair of an inguinal herniation and incarceration of the urinary bladder in an intact female rabbit.     

Testicular neoplasia in the retained testicles of an intersex male dog

This case describes the presentation and management of an 8 yr old phenotypically female intersex male dog presented for evaluation of a mass in the right inguinal region. The right inguinal space was surgically explored, and a large irregular mass resembling a fully developed testicle was identified in the right vaginal tunic. A second mass resembling an atrophied, but anatomically mature testicle, was identified in the left tunic. The larger mass was identified as a Sertoli cell tumor that had replaced all normal testicular tissue. The smaller mass was identified as a testicle that contained a small intratubular seminoma. The patient was diagnosed as having a phenotypic female sex, chromosomal male sex, and a gonadal male sex. Hormone assays completed before and after the gonadectomy and mass removal document an elevation of circulating progesterone presurgically that returned to baseline by 1 mo postsurgically. The source of the progesterone was identified to be the Leydig cells of the atrophied testicle.     

Acquired incarcerated inguinal hernia: a review of 13 horses

The case records of 13 horses with acquired incarcerated inguinal hernia in January-August 1983, were reviewed. Nine cases were in stallions. The remaining four involved eventration 5-48 hours following castration. Ages ranged from 1-17 years. Horses showed a variable degree of colic. Bowel was felt to pass through the internal inguinal ring on rectal examination in most cases. The physical features of the scrotum varied considerably. Resection of ischemic jejunum and/or ileum was necessary in three horses. Two horses were euthanized at surgery (one with bilateral ischemic jejunum, one with bowel perforation), and a further horse on day 16 postsurgery following development of multiple adhesions. All stallions were castrated. Follow-up for 6-24 months (mean 12.7) disclosed that all ten discharged horses were alive and healthy (recovery rate 77%).     

Evaluation of common vaginal tunic ligation during field castration in draught colts

The objective of this study was to determine if ligation of the common vaginal tunic could prevent or reduce the incidence of omental herniation and eventration in draught colts undergoing routine field castration. It was found that common vaginal tunic ligation, while not completely preventing omental herniation and evisceration, significantly reduced the incidence of these complications and should be considered in those males deemed at increased risk of significant post castration complications.     

Diagnosis and treatment of peritonitis caused by a larval cestode Mesocestoides spp., in a dog.

Infection of the peritoneal cavity with cestode larvae, presumptively diagnosed as tetrathyridia of the genus Mesocestoides, was found by exploratory celiotomy in a dog with clinical signs consisting of episodic anorexia, vomiting, and depression. Lymphopenia and hypoalbuminemia were associated clinicopathologic abnormalities. Dystrophic calcification and midline duodenal displacement were found on abdominal radiographs. Therapy with mebendazole was instituted after recurrence of the initial episodic clinical signs postoperatively. Daily use of mebendazole for intermittent periods of up to 3 months led to remission of gastrointestinal signs for 30 months. However, 17 months after the initial diagnosis, infection of the vaginal tunic of the testicle with similar cestode larvae necessitated castration and removal of the vaginal tunic to the inguinal ring. Mebendazole therapy was reinstituted and continued for 31/2 months postoperatively. The dog was free of clinical signs of infection during and for the 16 months since this period of treatment.     

RADIOGRAPHIC DIAGNOSIS OF GASTROINTESTINAL DISORDERS IN THE FOAL

Abdominal discomfort in the foal presents a diagnostic challenge, because the small size of the foal precludes rectal palpation. Standing lateral horizontal beam abdominal radiographs using conventional techniques were evaluated as a diagnostic aid to identify the presence and location of gastrointestinal disorders in foals presented with colic. Forty foals were radiographed prior to surgery (20 foals), necropsy (7 foals), or clinical diagnosis (13 foals). Clinical, surgical, or necropsy findings were then correlated to radiographic findings. Gastrointestinal disease was accurately identified on radiographs as the source of colic in 25 of 26 foals that had surgical or postmortem confirmation. The site of disease, whether gastric, small intestinal, large intestinal, or a combination, was accurately determined from radiographs. Standing lateral abdominal radiographs were determined to be a valuable diagnostic aid in the foal presented with colic.     

Salmonella typhimurium abscess as a postoperative complication in a horse with colic.

An 11-year-old, 430-kg fox-trotter stallion was referred for evaluation of colic. A right-sided inguinal hernia was diagnosed. At exploratory laparotomy, the ileum was found to be herniated through the right inguinal canal. Compromised small intestine was resected, jejunocecal anastomosis was performed, and the horse was castrated. Three days after surgery, the stallion would not bear weight on the left hind limb. The musculature of the left thigh region became swollen. Aspiration of the left thigh region yielded serosanguineous fluid from which Salmonella typhimurium was isolated. Ultrasonography of the left thigh revealed multiple hypoechoic areas suggestive of abscess. The left medial thigh region was surgically incised, and a large abscess was drained. Bacteriologic culture of feces yielded S typhimurium. The owner elected to have the horse euthanatized.     

Equine proliferative enteropathy: a cause of weight loss, colic, diarrhoea and hypoproteinaemia in foals on three breeding farms in Canada

Proliferative enteropathy (PE) is a transmissible enteric disease caused by Lawsonia intracellularis. An outbreak of equine PE was diagnosed in foals from 3 breeding farms. Most foals had been weaned prior to the appearance of clinical signs, which included depression, rapid and marked weight loss, subcutaneous oedema, diarrhoea and colic. Poor body condition with a rough haircoat and a potbellied appearance were common findings in affected foals. Respiratory tract infection, dermatitis and intestinal parasitism were also found in some foals. Haematological and plasma biochemical abnormalities included hypoproteinaemia, transient leucocytosis, anaemia and increased serum creatinine kinase concentration. Postmortem diagnosis of PE was confirmed on 4 foals based on the presence of characteristic intracellular bacteria within the apical cytoplasm of proliferating crypt epithelial cells of the intestinal mucosa, using silver stains, and by results of PCR analysis and immunohistochemistry. Antemortem diagnosis of equine PE was based on the clinical signs, hypoproteinaemia and the exclusion of common enteric infections. Faecal PCR analysis was positive for the presence of L. intracellularis in 6 of 18 foals tested while the serum of all 7 foals with PE serologically evaluated had antibodies against L. intracellularis. Most foals were treated with erythromycin estolate alone or combined with rifampin for a minimum of 21 days. Additional symptomatic treatments were administered when indicated. All but one foal treated with erythromycin survived the infection. This study indicates that equine PE should be included in the differential diagnosis of outbreaks of rapid weight loss, diarrhoea, colic and hypoproteinaemia in weanling foals.