Most of what we refer to as hernias in the Shih Tzu breed are delayed closures, which are highly prevalent. Even champion show dogs and responsible breeders may produce entire litters where every puppy has delayed closures. While we strive to avoid producing hernias or delayed closures, they can still occur even when neither parent displays them. Unlike true hernias, delayed closures have the potential to reduce and even close on their own. It's worth noting that delayed closures are far more common than actual hernias. We use the term "hernias" because veterinarians widely recognize it, and it's challenging to distinguish between a hernia and a delayed closure in very young puppies. Hernias manifest as outie belly buttons, and in most cases, they are purely cosmetic flaws that dogs can live with throughout their lives, especially if they are delayed closures. They feel like small, soft, and small bumps in the belly button area that can be easily pressed in. Humans also have belly buttons where our umbilical cords were once attached to our mothers. For most of us, the spot where the umbilical cord was attached heals and becomes our belly buttons. Humans typically don't undergo any "repair" or "closure" of the belly button. Similarly, an umbilical hernia or delayed closure in dogs is akin to human outie belly buttons. An umbilical hernia often reduces as the puppy grows and resembles an outie belly button. On the other hand, a delayed closure usually reduces significantly and ends up resembling an innie belly button. Some veterinarians may refer to a delayed closure as a reducible hernia. It's challenging to differentiate between an umbilical hernia and a delayed closure unless the hernia is notably large. However, we have observed subtle differences between delayed closures and reducible hernias compared to other hernias. Hernias that may close or reduce size tend to be soft and temporarily recede into the belly button area when pressure is applied. Delayed closures are highly prevalent in the Shih Tzu breed and are typically caused by either the mother dog or ourselves cutting the umbilical cord too short. In contrast to true hernias, delayed closures and reducible hernias are not believed to be inherited but result from "trauma" to the umbilical cord during whelping. Shih Tzu, a flat-faced breed, often encounters difficulties with cutting cords too short due to their facial structure and an uneven bite. In reality, most of what we commonly call hernias are small bubbles of fatty tissue gradually closing. These fatty pockets can be found in the belly button area (most common for umbilical hernias) or in the groin area (for inguinal hernias).
Reducible Umbilical Hernias ( can be delayed closures): Reducible umbilical hernias typically become noticeable between 2-6 weeks of age, although occasionally, they may appear later. While they are not considered significant health issues, they are mentioned here due to their prevalence. It's important to note that most types of hernias are purely cosmetic and will not impact your dog's quality of life. Many pet owners opt to have hernias or delayed closures "repaired" during the spay or neuter procedure. Repairing a small umbilical hernia is generally straightforward for most veterinarians and only requires a few additional stitches. The cost of hernia repair may vary depending on location and the veterinarian, but our previous clients have reported fees ranging from no cost to $100. On average, most vets charge an additional $25-$100. If you receive a quote exceeding $150, it is advisable to contact other veterinarians to find one who is more comfortable with the procedure and therefore charges less. It's worth noting that hernias are very common in various breeds and should raise concerns if a veterinarian appears unfamiliar with them. However, you should seek medical attention if a hernia is exceptionally large and firm, although such cases are extremely rare (we have not encountered one ourselves). For all other hernia cases, a repair can wait until the time of spay/neuter. Inguinal Hernias:
Please be aware that it is only possible to determine if your puppy has a true inguinal hernia once they reach at least five months of age. Dogs with true inguinal hernias should not be bred, but in most cases, what may appear to be inguinal hernias are fatty pockets. An inguinal hernia occurs when abdominal organs, fat, or tissue protrude through the inguinal ring. These hernias feel like small bulges in the groin area and can be bilateral or unilateral. They are typically soft and can be pushed back in. However, it is important to seek veterinary attention if the inguinal hernias are hard, very large, or do not retract. Otherwise, they can be repaired during the spay or neuter procedure. Some small inguinal hernias may close independently, while fatty pockets will generally close naturally. Fatty pockets are quite common, especially in chubby puppies, and tend to resolve as the puppies grow older. We have observed that veterinarians, in general, are less familiar with inguinal hernias compared to umbilical hernias. While you should expect an additional cost for repairing an inguinal hernia, some price quotes we have heard are exorbitant. Therefore, I recommend shopping around and consulting different veterinarians. Obtain price quotes and inquire about their experience with inguinal hernias. Some vets may need more expertise or confidence to perform the repair. Although inguinal hernias should be relatively easy to repair than umbilical hernias, their relative rarity makes it more difficult to find a knowledgeable vet who offers reasonable prices for the procedure. If the inguinal hernia does not close, it is not advisable to breed a female with this issue. It can be hereditary and pose risks to both the female and the puppies during whelping. There are several types of hernias, and if you would like to learn more, I recommend referring to the following articles, which are excellent resources:
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