INGUINAL HERNIA

Inguinal hernias generally develop in stallions after breeding a mare, trauma, or a hard workout. Hernias appear to be most common in Tennessee Walking Horses, American Saddlebreds, and Standardbreds. In most cases, the hernia results in acute colic. The intestine descends through the vaginal ring in most cases and lies next to the testis and epididymis. Physical examination reveals a swollen testis that is firm and cool to the touch. If the hernia has occurred within hours, the intestine may be palpated in the inguinal canal. In this situation, an attempt may be made to reduce the hernia by pulling down on the testis to tighten the boundaries of the inguinal canal and then forcing the intestine up toward the vaginal ring. Once the incarcerated intestine, which frequently includes the ileum, has become edematous, it is not possible to reduce the hernia manually. Rectal examination will reveal distended loops of small intestine, with one of the loops tracing to the vaginal ring on the affected side. There will be gastric reflux, and the horse’s condition will deteriorate rapidly. Peritoneal fluid generally reflects the degree of ischemia.

Surgery involves a ventral midline celiotomy and inguinal approach to reduce the hernia. Often, the testicle on the affected side must be removed, and the affected intestine resected. The prognosis for survival seems to be breed-dependent, with Standardbred horses having a good prognosis and Tennessee Walking Horses having a fair to poor prognosis. Presumably, this reflects the fact that many Tennessee Walking Horse stallions with inguinal hernias show little evidence of pain.

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