Scrotal hernia, like inguinal hernia, is sometimes congenital, and especially in weakly foals, in which case it may either gradually disappear as the animal acquires strength or assume a chronic state.
It has been observed in many instances to increase in volume during the first few months of the foal's life and then to diminish gradually, the alteration being more or less coincident with weaning, and the substitution of food less disposed to distend the abdomen than summer grass. If the abnormality is not naturally remedied during the first eighteen months of the horse's life it may be regarded as established or chronic.
Animals affected with congenital scrotal hernia may continue to work for years, and even to the end of their lives, without suffering any untoward result, but in those cases where it occurs in aged horses the liability to strangulation of the imprisoned gut is greatly increased.
This description of hernia is not always detected at birth, but may become noticeable a few days or weeks afterwards.
As an acquired disease it is most frequently seen in aged stallions, when as a result of progressive relaxation and enlargement of the internal abdominal ring and the inguinal canal the entrance of the bowel into the scrotum is facilitated.
It is in this latter form of disease that trouble is to be feared, much more so than where the malady occurs early in life and exists as a chronic congenital disorder.
The presence of scrotal hernia is marked by an increase in the size of the scrotum on the affected side, but inasmuch as the volume, of this sac may be augmented by other causes than that of hernia, a careful manipulation of the part and nice discrimination will be required in order to arrive at a correct diagnosis. The presence of a portion of bowel in the purse will be indicated (i) if the enlargement varies in size from time to time, or wholly disappears and returns again; (ii) if the swelling is springy and elastic to the touch, like confined air, or if it is soft and pits to pressure of the finger, or if these conditions are alternately present at different times; (iii) if pressure applied to the scrotum produces a gurgling sound, and at the same time a reduction in the size of the scrotum; (iv) if when the patient is made to cough by compressing the throat the enlargement increases.
Any opinion formed from external manipulation must be confirmed by passing the hand into the rectum and examining the internal abdominal ring as directed for inguinal hernia.
In some cases of this disease the hernia will in part or altogether disappear, and especially after a roll or a long period of fasting, but only to return again. If the escaped gut becomes inordinately distended with food compression and strangulation may result, where symptoms indicative of suffering, such as were described in speaking of inguinal hernia, will be manifested.
Here again in the matter of treatment taxis must precede surgical interference. An attempt must be made to relieve the bowel through the medium of the rectum and by manipulation of the hernia as advised-in the preceding article. For this purpose the horse is cast, chloroformed, and placed on his back, and underpacked in the manner described for inguinal hernia.
Should this fail, then it will be necessary to liberate the gut by dividing the point of constriction. This having been done the animal must be castrated by the covered operation, and after free irrigation of the parts with antiseptic dressing he is allowed to rise. If symptoms of acute pain follow the operation, a bold dose of opium may be administered and hot cloths applied to the region of the scrotum.
In the matter of feeding and general management the patient should be dealt with as prescribed in inguinal hernia.