The doctors at Equine Medical Service were requested to evaluate and diagnose 5 hour old foal, post foaling. On routine exam the foal was diagnosed with an umbilical hernia. The foal was monitored for a week and was found to also have an infected umbilical stump. The umbilical stump was removed and the hernia repaired in the same operation. The foal was placed on antibiotic therapy and recovered uneventfully.
Many foals are born with an umbilical hernia. With this type of hernia, the opening in the abdominal wall surrounding the umbilical cord is larger than normal, allowing the abdominal contents to bulge through. Most umbilical hernias close on their own after the first few weeks of age, as the abdominal wall matures. The most significant problem that can occur with an umbilical hernia is that a portion of the intestine can become trapped in the hernial sac. When this occurs, the foal may act colicky and the umbilical area appears swollen and cannot be reduced with finger pressure.
Visually inspect the hernial sac each time you visit the foal. You can push the sac contents up into the abdominal cavity. This can help in resolving the hernia. Use care when doing this procedure in newborn foals, as they are more prone to infection and injury in the umbilical area. Also, push the hernial sac very gently, this can be uncomfortable and can lead to unwanted behaviors like kicking.
If an umbilical hernia is still present at 3 months of age or is large enough to contain intestines, repair should be considered. After 3 months of age, the hernia is unlikely to close unaided. The abdominal wall at 3 months is also strong enough to withstand repair. If the hernia opening is greater than 2 fingers in diameter (5 cm), surgical closure under general anesthesia will be necessary.