Diaphragmatic hernia, a condition in which organs from the abdomen protrude into the chest cavity through a tear in the diaphragm, is a common disorder in cats. This retrospective study aims to shed light on the various aspects of diaphragmatic hernia in cats and provide valuable insights into this condition.
Understanding the Study
In previous studies, it was observed that male cats were more commonly affected by diaphragmatic hernia. However, Gibson et al. challenged this notion and found no significant correlation between sex and the occurrence of this condition in cats. Recent studies have not reported any predisposition based on sex, age, or breed, but in this study, it was noted that most cases occurred in young cats.
The study highlighted that diaphragmatic hernia is a congenital disorder that can manifest in cats aged two and older, with intermittent and diverse symptoms. The median age of cats at the time of presentation was found to be 48 months. While there is no specific sex predisposition, Domestic Long Hair and Himalayan cats may be at a slightly higher risk.
Motor vehicle accidents were identified as the most common cause of diaphragmatic hernia in small animals, aligning with previous studies. High-rise syndrome was also reported as a significant contributing factor. Dyspnea, characterized by difficulty breathing, emerged as the most frequently observed clinical syndrome in this study, consistent with other research findings.
The Contents of Hernia and its Location
The contents of the hernia largely depend on the anatomical position of the structures and the location of the rupture. Liver was the most commonly found organ within the thoracic cavity, along with other herniated organs such as small intestines, stomach, omentum, and even the uterus in pregnant cats. This further emphasizes the impact of the rupture location on the hernia’s contents.
The location of diaphragmatic hernia was found to be influenced by the position of the animal during trauma and the site of the viscera. As seen in multiple studies, right-sided hernias were predominant in this report. While the liver was initially believed to act as a protective barrier on the right side of the diaphragm, preventing hernia, recent findings have challenged this notion. It has been suggested that the liver’s presence may increase the potential for trauma due to a higher likelihood of liver herniation.
The intestines and stomach, on the other hand, seem to play a protective role by absorbing the shock during trauma. Interestingly, the removal of herniated abdominal organs rarely posed difficulties. In some cases, a combination of median sternotomy with celiotomy was utilized to enhance visualization and ensure precise dissection.
Survival Rate and Concurrent Abnormalities
Mortality rates in cats with diaphragmatic hernia do not seem to differ significantly whether they have concurrent injuries or not. However, specific studies have shown higher mortality rates in patients with concomitant injuries. In this study, four out of five cases with concurrent injuries unfortunately resulted in death.
It is worth noting that abnormalities often coexist with diaphragmatic hernia. In dogs, cardiac abnormalities, sternal deformities, and defects in the diaphragm and peri-cardial region are commonly observed alongside this condition. However, in this particular study, no concurrent abnormalities were found in the cats with diaphragmatic hernia.
The survival rate after surgical treatment was reported to range between 54.00% and 90.00% in previous studies. In this study, the survival rate was determined to be 71.00%. It was observed that prolonging the surgical intervention for at least one day to allow for patient stabilization proved to be beneficial. However, a recent study suggested that early surgery did not contribute to a higher mortality rate.
The rate of mortality was found to be higher in older cats or those with severe respiratory disorders and concurrent injuries following hernia repair.
To ensure the best outcome, the study suggests that patient stabilization is crucial before undergoing herniorrhaphy, a surgical procedure to repair the hernia. The location of the hernia, the number of organs inserted into the thorax, concurrent disorders, and perioperative care were all identified as factors that influence the survival rate.
As cat owners, it’s essential to be aware of the potential risks associated with diaphragmatic hernia. Early detection and prompt medical intervention can significantly improve the chances of a successful outcome. Remember, vigilance and proactive care are key in safeguarding the well-being of our feline companions.
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