UMBILICAL HERNIA 557 



by the symptoms shown by the patient and the local examina- 

 tion of the hernia. Marked symptoms of pain, vomiting, 

 and local inflammation indicate strangulation. During the 

 secondary stages of its development the hernial sac becomes 

 cold, doughy, and non-sensitive to the touch. Fecal fistulae 

 (intestinal fistulse) occur in some cases from a sloughing of 

 a portion of the intestine. 



Forms.— The following are the most common hernias found 

 in small animals: (a) Umbilical, (b) ventral, (c) inguinal, 

 (d) femoral, (e) diaphragmatic, and (/) perineal. 



Umbilical Hernia.— Etiology.— This form occurs either 

 congenitally (usual) or a short time after birth. The hernial 

 ring is formed by an improper closure of the umbilicus, or the 

 fibrous organization being of insufficient strength allowing 

 the abdominal contents to pass through. Occasionally 

 umbilical hernia occurs accidentally in which case the peri- 

 toneum forms the inner portion of the hernial sac. 



The hernial contents may consist of omentum, small or 

 large intestines, or both. In most cases in puppies the sac- 

 contains only omentum. 



Symptoms.— The presence of an enlargement at the umbili- 

 cus which may be soft or firm, depending on the contents and 

 local conditions. In most cases the contents can be readily 

 returned to the abdominal cavity. Occasionally adhesions 

 are present which prevent this. Strangulation is very rare 

 in this hernia. 



Treatment.— In puppies many cases disappear sponta- 

 neously. Several methods of procedure in treatment have 

 been recommended: 



(a) Pressure bandage, or adhesive tape, applied over the 

 part for a few days has proved satisfactory in many cases. 

 This method keeps the contents in the cavity, allowing time 

 for fibrous tissue organization to close the ring. 



(b) Operation.— When adhesions are present or the ring is 

 of considerable size, it is advisable to perform herniotomy. 

 The animal is anesthetized, placed in a dorsal position on the 

 table, the hair removed from the area and painted with 

 tincture of iodin. An incision is made through the skin of 

 sufficient length, dissecting the hernial contents from the 



