Hernia and Treatment/Procedure Options for Pets

April 20, 2019

Hiatal Hernia in Pets

hernia occurs when one part of your body or part of an organ protrudes through a gap or opening into another part of the body. Many types of hernias occur in the abdominal area. Hiatal hernias, also known as diaphragmatic hernias, form at the opening (hiatus) in the diaphragm where the food tube (esophagus) joins the stomach. When the muscle tissue around the hiatus becomes weak, the upper part of the stomach may bulge through the diaphragm into the chest cavity. Hiatal hernia refers to the protrusion of the abdominal contents into the chest cavity through the esophageal hiatus of the diaphragm.


What causes a hiatal hernia?

In most veterinary patients, hiatal hernia appears to be a congenital or birth defect. Trauma can also cause a hiatal hernia. The Bulldog and Chinese Shar Pei seem to have a higher incidence of hiatal hernias than other breeds, although any breed can be affected. Male dogs are thought to be at greater risk for having a hiatal hernia.

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What are the clinical signs of a hiatal hernia?

Many dogs that have small hiatal hernias have no accompanying clinical signs. The symptoms most commonly associated with hiatal hernias include vomiting, regurgitation, excessive salivation, bloody vomiting and difficulty breathing.

How is a hiatal hernia diagnosed?

Diagnosis is based on medical history, clinical signs, and radiographs. Most dogs will require a special radiographic dye study or contrast fluoroscopy for definitive diagnosis. Esophagoscopy and gastroscopy may also be performed. 

How is a hiatal hernia treated?

Conservative medical treatment will usually be recommended when the condition is first diagnosed. Medications to help control esophagitis and its accompanying clinical signs are used at the start of treatment. Acid-blocking medications and/or medications to relax the lower esophageal sphincter may be prescribed. Antibiotics are used as needed to combat any secondary infections, especially if aspiration pneumonia develops. In severe or chronic cases, surgery is recommended.

What is the prognosis for a pet diagnosed with a hiatal hernia?

The prognosis for hiatal hernia is guarded. Many animals will develop secondary conditions such as aspiration pneumonia. Your veterinarian will be able to give you a better prognosis based on your pet’s specific condition and clinical signs. 

Diaphragmatic Hernia

What is a diaphragmatic hernia?

The diaphragm is the muscular partition that separates the abdomen and the chest. Tearing or disruption of this thin muscle is called a diaphragmatic hernia or diaphragmatic rupture.  The terms can be used synonymously. One form of diaphragmatic hernia, a peritoneal-pericardial diaphragmatic hernia(PPDH) is congenital, and is due to defective development of the diaphragm in the fetus.  This condition is most often found in puppies or kittens and should be considered separately from the traumatic type of diaphragmatic hernia. Congenital diaphragmatic hernias are a recognized problem in Weimeraners and cocker spaniels.

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Once a tear in the diaphragm is present, abdominal contents such as the stomach, liver, and intestines are able to enter the chest cavity. This compresses the lungs and prevents them from fully inflating, causing respiratory distress. The abdominal tissues may irritate the heart muscle, which may cause abnormal heart rhythms. Fluid may leak into the chest cavity from the abdomen, further complicating and worsening heart and lung function.

What causes a diaphragmatic hernia or rupture?

The most common cause of a diaphragmatic hernia is blunt force trauma. This type of trauma can occur after a fall from a high place (such as out of a window), an automobile accident or a blow to the abdomen. Congenital diaphragmatic hernias are less commonly seen.

What are the clinical signs of diaphragmatic hernia?

Clinical signs are dependent on the severity of herniation. With small tears or in dogs born with a diaphragmatic hernia, there may be no discernable clinical signs. The pet owner may report non-specific symptoms such as mild breathing difficulties, especially when stressed or exercising, and periods of mild gastrointestinal upset. In severe or acute cases, there is often respiratory distress, an abnormal heart rhythm, muffled heart and lung sounds and other signs of systemic shock. The abdomen may feel empty when palpated.

How is a diaphragmatic hernia diagnosed?

Diagnosis is based on medical history, physical examination findings and radiographs. Blood and urine tests may be performed if the patient is showing signs of shock. In certain cases, ultrasound or special radiographic dye studies will be required for a definitive diagnosis.

What is the treatment for diaphragmatic hernia?

If there is a history of recent trauma, the dog must be stabilized before the hernia can be corrected. Some patients will require emergency thoracocentesis (a chest ‘tap’) to remove any fluid that has accumulated in the chest cavity.

“Once the patient is stable, the hernia must be corrected surgically.”

Once the patient is stable, the hernia must be corrected surgically. In congenital forms, surgical intervention as early as possible is important to prevent organ entrapment or scarring between the abdomen and the chest. Many congenital diaphragmatic hernias are discovered during ovariohysterectomy surgery, and are corrected at that time. 

What is the prognosis?

The prognosis for any patient with diaphragmatic hernia is always initially guarded. It improves once the patient has been stabilized and if the heart rhythm is normal. After surgery, a condition called re-expansion pulmonary edema may occur. Thus, a guarded prognosis must be given for at least twenty-fours after an apparently successful surgery. The prognosis for a young puppy with a congenital diaphragmatic hernia is guarded to good, depending on the specific diaphragmatic defect and the abnormalities found during surgical correction.

If the patient stabilizes with medical treatment, is it possible to avoid surgery?

In trauma cases, adhesions may form between the lungs and any herniated abdominal contents after approximately seven days.

These adhesions will affect the ability of the lungs to inflate properly. The longer the corrective surgery is delayed, the more complicated and dangerous it becomes.  However, each case needs to be assessed individually.

Umbilical Hernia in Pets

What is an umbilical hernia?

An umbilical hernia is a protrusion (outward bulging) of the abdominal lining, abdominal fat or a portion of abdominal organ(s) through the area around the umbilicus (navel or belly button). The umbilicus in dogs and cats is located on their underside just below the ribcage.

What causes an umbilical hernia?

Before birth, the umbilical blood vessels pass through the umbilical ring (an opening in the abdominal muscles) to provide nourishment to the developing fetus. An umbilical hernia is caused by the incomplete closure of the umbilical ring after birth. The hernia generally appears as a soft swelling beneath the skin and it often protrudes when the puppy is standing, barking, crying, or straining. Some hernias are reducible, meaning that the protrusion can be pushed back into the abdomen while others are non-reducible indicating at least partial obstruction or adhesion of the herniated contents to the opening.

An umbilical hernia can vary in size from less than a quarter-inch (1-cm) to more than an inch (2.5-cm) in diameter. Small (less than ¼ inch or 1-cm) hernias may close spontaneously (without treatment) by age 3 to 4 months. Umbilical hernias that do not close may require surgery, especially if a portion of an intestinal organ protrudes through it. Umbilical hernias are usually painless. The exact incidence and cause is unknown. Certain family lines have a higher incidence of umbilical hernias suggesting at least a partial genetic predisposition to the condition.

Is an umbilical hernia dangerous?

Most umbilical hernias pose no health threats.

In rare cases, a portion of the intestines or other tissues can be trapped and become strangulated (blood flow is cut off to the tissue, causing its death). This is an emergency requiring immediate surgery.

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How is an umbilical hernia treated?

If the hernia has not closed by the time of spaying or neutering, surgical repair of the hernia is recommended. The surgery can be performed at the time of spaying and neutering. The fibrous or scar tissues that have formed around the hernia are dissected out or removed, and the defect is closed with sutures.

What is the prognosis for an umbilical hernia?

The prognosis is excellent following surgical correction. Few puppies experience recurrence of the hernia and few complications are reported with the procedure.

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