A male domestic kitten of 3 months old and 1.12 kg body weight (BW) was referred to a veterinary hospital with the complaint of a belly-button-like protrusion through the umbilicus (Figure 1A and B). Clinical history included periodic pain and discomfort, lack of appetite, and weakness. Physical examination revealed a ruptured umbilical hernia with mild evisceration. No other complications were detected, and the clinical and hematobiochemical parameters showed no considerable alterations. Initially, the kitten was provided with 25 ml of intravenous (IV) 5% dextrose in normal saline (0.9% NaCl). With the informed consent of the owner, herniorrhaphy was considered to treat the case. To perform surgery, premedication was done with atropine sulfate @ 0.04 mg/kg BW followed by sedation with xylazine hydrochloride (HCl) @ 1.1 mg/kg BW via intramuscular (IM) routes. Anesthetic induction was done with IM ketamine HCl @ 15.5 mg/kg BW. Under general anesthesia and aseptic conditions, the protruded and eviscerated mass (button-like) was carefully manipulated. This involved cleaning with normal saline, gentle decompressing, and unwinding (Figure 2A) which finally revealed a small, normal, and free omental flap (Figure 2B) without any adhesion. Then the eviscerated portion of the omentum was reduced back to the cavity (3A), and the abnormal umbilical opening (i.e., hernial ring) was repaired by herniorrhaphy that involved the closure of the ring with horizontal mayo-mattress sutures using polyglactin 910 of size 1-0. Next, muscles and skin were routinely closed (Figure 3B). In the immediate postoperative period, the kitten again received the same amount of the aforementioned IV fluid therapy. The other routine medications included IM ceftriaxone @ 25 mg/kg BW, ketoprofen @ 2.2 mg/kg BW, and pheniramine maleate @ 1 mg/kg BW along with a regular antiseptic dressing of the surgical site. After 12 days of surgery, the external sutures were removed, and the cat was found apparently healthy.

Figure 1. Physical examination of the affected kitten. (A) Manual palpation of the umbilical region. (B) A belly-button-like protrusion through the umbilicus.

Figure 2. Gentle manipulation of the protruded and eviscerated mass. (A) Cleaning with normal saline following the unwinding of the segment. (B) A small and vital omental flap.

Figure 3. Reduction of omental herniation and closure of the wound. (A) Visible hernial ring after replacing the contents to the abdomen. (B) Final skin sutures following ring and muscle closures.

Herniation and evisceration through the umbilicus are not frequently reported in cats. In an umbilical hernia, the abdominal content protrudes through the umbilicus due to an abnormal opening in the cavity wall and rests underneath the skin [1]. Hernias are usually congenital or acquired in origin [2]. The omentum is a flat adipose tissue layer and a fold of the visceral peritoneum, which can get herniated through the umbilicus, as seen in this case. Spontaneous rupture of umbilical hernia and evisceration due to ascites are previously reported in other studies [3, 4]. However, the present case was not assumed to be associated with ascites. The possible reasons for this defect might be a prior anomaly in umbilical cicatrization, any neglected umbilical affection(s), traumatic injury causing weakness of the abdominal wall around the umbilicus, straining for defecation, and the conditions that increase intraabdominal pressure and ventrally force the contents. In these cases, early reporting and treatment are important to prevent further complications and ensure prompt recovery.

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