Diaphragmatic Hernia in Cats
Dr. Cathy Reese
A complete medical history. You will usually be asked specific questions regarding your cat's apcatite, weight loss or gain, urination, defecation and breathing pattern. Your veterinarian will also want to know if your cat has been outside unsupervised, allowing an opportunity for injury.
Diagnostic tests are needed to recognize a diaphragmatic hernia. Tests that your veterinarian may wish to perform include:
A complete physical exam. Your veterinarian will listen to your cat's heart and lungs and palpate (technique of checking parts of the body by touching and feeling them) his abdomen. If there is a diaphragmatic hernia, the heart and lung sounds will be abnormal and the abdomen may feel abnormal. If your cat has collapsed and has pale gums, he may be in shock.
Diagnostic imaging. Radiographs (X-rays) of the chest are often taken whenever an animal has been hit by a car or suffered other types of major trauma. These X-rays can reveal many types of injuries to the chest wall, lungs and heart, including diaphragmatic hernias. As with many diseases, early detection often leads to improved results. On a chest X-ray of a patient with a diaphragmatic hernia, the abdominal organs may be seen in the chest cavity, surrounding the heart and lungs. An ultrasound of the chest and diaphragm is helpful if a diaphragmatic hernia is suspected but abdominal organs were not visualized in the chest on the X-ray.
Blood tests. If an animal has suffered a major trauma, is vomiting, has diarrhea, has collapsed or is in shock, blood tests are important in determining the underlying problem. Blood tests can often hint at the type of injuries that have happened to your cat's abdominal organs, show the levels of the major body electrolytes, indicate if there was major blood loss or reveal if your cat has a blood clotting problem (bleeding disorder). This information is necessary in directing your veterinarian in providing life-saving therapy and determining the appropriateness and need for various medications, blood transfusions or emergency surgery.
Treatments for diaphragmatic hernia may include the following:
Stabilization. If your cat has suffered a major trauma, emergency measures may need to be taken to stabilize him before surgery can be considered to repair the diaphragm. Emergency treatments including intravenous (IV) fluids, blood transfusions, steroids, antibiotics and oxygen are among the most common treatments used in a critical trauma patient. Each patient is different and may require different therapies. Anesthesia for surgery can be more safely administered after your cat is stable, which often takes at least 24 hours. Very rarely, an animal cannot be stabilized and has to have immediate surgery to repair the hernia. Most often this is because the organs are pressing on the lungs to such an extent that the lungs cannot inflate properly, or because the stomach has herniated into the chest and has distended causing difficult breathing and low blood pressure.
Surgery. For surgery your cat will be anesthetized and placed on a ventilator to help him breathe. The hernia is repaired by making an incision in the abdomen, pulling the displaced abdominal organs out of the chest, returning them to their normal positions and closing the defect in the diaphragm. Sometimes the organs that were herniated, such as the liver, spleen or intestines, may have had their blood supply damaged, necessitating partial or total removal. A tube may be placed in the chest cavity to drain air and fluid out of the chest after surgery. Your cat will be monitored closely after surgery for evidence of difficulty breathing or other problems.
Prognosis. Statistics on cats with congenital diaphragmatic hernias show about an 80 to 85 percent survival rate after surgery. Animals with traumatic diaphragmatic hernias have a more guarded prognosis, probably due to injuries to other major organs at the time of the accident. Statistics on these patients range from 52 to 88 percent survival rate.
There is no way to prevent congenital diaphragmatic hernias, which are developmental malformations, from occurring in a particular animal; however, it is recommended that affected animals not be used for breeding purposes because this condition may be hereditary.
Be observant and know what your pet's normal breathing pattern is. Being familiar with what is normal allows you to notice subtle changes and help diagnose problems early.
The symptoms associated with a congenital diaphragmatic hernia are vague and non-specific. If you suspect that your animal might have a diaphragmatic hernia, X-rays may be a helpful screening test.
Traumatic diaphragmatic hernias can be prevented. Protect your cat from potential trauma by keeping him or her out of dangerous situations. This can be done by keeping your cats indoors.
Contact your veterinarian as soon as you notice your cat has any abnormal breathing patterns, vomiting, diarrhea or any of the previously mentioned symptoms that can be associated with a diaphragmatic hernia.