When a dog has suffered a traumatic process such as a run over, a fall or a blow strong enough to cause a defect in the diaphragm that allows the passage of abdominal viscera into the thoracic cavity, it occurs a diaphragmatic hernia. This disorder can also be congenital. In these cases, the puppy is born with the hernia and it should be resolved as soon as possible, although sometimes it takes time for the hernia to become apparent to the caregivers.
Keep reading this article on our site to find out exactly what is a diaphragmatic hernia in dogs, its causes, symptoms and treatment to know more about this process that our dogs can suffer.
What is a diaphragmatic hernia?
A diaphragmatic hernia occurs when there is a failure of the diaphragm, which is the musculotendinous separation between the abdominal and thoracic cavities, which limits and separates the organs while intervening in the animal's breathing. This failure consists of a hole that allows the passage between the two cavities, therefore, it brings as a consequence the passage of abdominal organs to the thoracic cavity.
There are two types of diaphragmatic hernia in dogs: congenital and traumatic.
Congenital diaphragmatic hernia
Dogs are born with hernias due to improper or defective development of the diaphragm during embryogenesis. Said hernia, in turn, can be:
- Peritoneopericardial hernia: when abdominal contents enter the pericardial sac of the heart.
- Pleuroperitoneal hernia: when the contents enter the pleural space of the lung.
- Hiatal hernia: when the distal esophagus and part of the stomach pass through the esophageal hiatus of the diaphragm and enter the chest cavity.
Traumatic diaphragmatic hernia
This hernia occurs when a traumatic external event, such as a car accident, a fall from a great height or a crush, causes a tear on the diaphragm.
Depending on the severity of the diaphragm rupture damage, the process will be more or less serious, allowing the passage of more abdominal content that will hinder the dog's vital functions, such as breathing.
Diaphragmatic hernia symptoms in dogs
The clinical signs presented by a dog with diaphragmatic hernia are mainly respiratory due to the compression exerted by the abdominal viscera on the lungs, making it difficult your correct inspiration. It should also be considered that congenital hernias may not be evident until the dog reaches an age, with less acute and frequently intermittent symptoms. Acute cases are those of traumatic hernias, where the dog usually shows tachycardia, tachypnea, cyanosis (bluish discoloration of the mucous membranes) andoliguria (decreased urine output).
Therefore, the symptoms of a dog with diaphragmatic hernia are:
- Dyspnea or shortness of breath.
- Anaphylactic shock.
- Chest wall dysfunction.
- Air in chest cavity.
- Reduction in lung distention.
- Pulmonary edema.
- Cardiovascular system dysfunction.
- Cardiac arrhythmias.
- Tachypnea.
- Muted breath sounds.
- Lethargy.
- Thoracic rumbling.
- Impact of the apex of the heart enlarged on one side of the thorax due to the mobilization of the apex of the heart by the herniated abdominal viscera.
- Fluid or viscera in the pleural space.
- Palpitation of the abdomen.
- Vomiting.
- Gastric dilatation.
- Oliguria.
Diaphragmatic hernia diagnosis in dogs
The first thing to do in the diagnosis of a diaphragmatic hernia is to perform X-rays, especially of the chest to assess the damage. In 97% of dogs, an incomplete diaphragm silhouette is observed, and in 61%, gas-filled intestinal loops are found in the thoracic cavity. Content may be observed in the pleural space, which may be a hydrothorax due to pleural effusion in recent cases or a hemothorax with hemorrhage in more chronic cases.
To assess respiratory capacity, arterial blood gas analysis and noninvasive pulse oximetry are used to determine imbalances between ventilation/ perfusion with alveolar-arterial oxygen difference. Likewise, ultrasound allows the identification of abdominal structures in the thoracic cavity and can sometimes even determine the location of the diaphragm defect.
To confirm the presence or absence of hernia in dogs, contrast techniques such as barium administration or pneumoperitoneography and peritoneography may be used positive contrast with iodinated contrast. This is only used if the dog can tolerate it and if imaging tests have been unclear.
The gold test for the diagnosis of diaphragmatic hernia in dogs is computed tomography, but due to its high price it is not usually considered.
Treatment of canine diaphragmatic hernia
Correction of diaphragmatic hernia in dogs is achieved with one surgery Around 15% of dogs die before surgery, being the treatment of the shock before the operation key for his survival. Those who are operated on immediately, that is, during the first day of the trauma, have a high mortality rate, around 33%. If it is possible to wait because its cardiorespiratory function allows it, it will be better to wait a little longer until the animal is stabilized and the anesthetic risk is reduced.
What is diaphragmatic hernia surgery in dogs?
The surgical operation to resolve the hernia consists of a celiotomy or ventral midline incision to visualize the abdominal cavity and the access to the entire diaphragm. Subsequently, the strangulated viscera must be rescued from the thoracic cavity to restore their blood supply as soon as possible. The herniated viscera must also be replaced in the abdominal cavity. Sometimes, if the irrigation has been very pronounced and they are very affected, the necrotic portion must be removed. Finally, the diaphragm and skin lesion is closed in layers.
After surgery, drugs should be prescribed, especially to treat pain, such as opioids, and the dog must be in a safe and quiet place and be well fed and hydrated.
Forecast
Death from diaphragmatic hernia in dogs is due to hypoventilation due to compression of the viscera in the lungs, shock, arrhythmias, and multi-organ failure. However, the majority of dogs that undergo diaphragm reconstruction survive and fully recover their quality of life prior to the development of the hernia.
