How to manage umbilical masses in cattle

Oct 01, 2005

Umbilical masses in calves are a common problem presented to veterinarians. Proper management of these masses first requires a correct diagnosis. The differentials for umbilical masses include hernias and infections/abscesses. Although some hernias can spontaneously resolve, most umbilical problems require surgery.

Uncomplicated hernias

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Uncomplicated umbilical hernias usually can be diagnosed on physical examination. They are easily reducible, non-painful and have no evidence of infection present. These hernias can be hereditary but also can be secondary to mild umbilical infections that go unnoticed. Small, uncomplicated hernias can resolve without treatment. Larger hernias usually need some intervention for resolution. Many non-surgical methods exist to keep the contents of the hernia reduced while the ring is trying to close. If the ring doesn't show signs of closing in a few weeks, surgical reduction is indicated.

Complicated hernias

Complicated hernias are non-reducible and/or infected and can contain strangulated bowel. These hernias are generally painful, and the calves might show systemic signs of depression and/or colic. Complicated hernias can be difficult to distinguish from infections of the external umbilicus. Ultrasonography can be helpful in distinguishing these conditions. If bowel is strangulated, surgical intervention is indicated immediately. Surgery also can be indicated to remove infected tissue as outlined in the following sections.

Infection of external umbilical structures

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Infections of the umbilicus external to the body wall are common. There will be swelling and possibly drainage in the area. Ultrasonography and/or needle aspiration can be helpful in determining if an abscess is present. Careful palpation is necessary to rule out a hernia before abscesses are lanced. These calves might not show systemic signs. If systemic signs are seen, infection of internal structures should be suspected. Lancing, draining and flushing external abscesses along with systemic antimicrobials can work, but many times deep seeded infections and cellulitis make surgery necessary.

Infection of internal umbilical structures

Umbilical remnants include one umbilical vein that travels to the liver, the urachus that goes to the bladder and two umbilical arteries that travel alongside the bladder to the aorta. Any or all of these structures can be infected. In most cases, external swelling and possibly drainage is present as previously described. The urachus can be patent, but this condition is not as common in calves as in foals.

A defect in the body wall can be present. These calves are generally systemically ill (intermittent fevers, unthrifty looking, poor growth rates). Deep palpation of the abdomen can reveal enlarged internal umbilical structures.

Ultrasonography also might show enlarged remnants. Even if internal infection cannot be proven, systemically ill calves with external infections usually have it. It is tempting to place these calves on systemic antimicrobials until they feel better, then perform surgery. But the majority of calves will not improve without surgery.

Delaying surgery delays growth rates and increases the chance of the infection spreading to other parts of the body such as the joints, heart valves, lungs, etc. Therefore, surgery is indicated as soon as these infections are diagnosed.

Umbilical surgery

Simple hernias can be corrected under heavy sedation and local anesthesia. Simple hernias should be repaired when the calf has matured enough to have a well developed fibrous ring but is still small enough that the rumen does not put undue pressure on the closure. More complicated repairs should be done under general anesthesia. The entire abdomen should be clipped and prepared because the extent of internal involvement and length of incision needed is hard to determine until the abdomen is entered.