Diaphragmatic hernia in a cat
Mak Whittington is a 6-year-old domestic short hair cat who presented on Wednesday 2nd May with acute onset of lethargy, anorexia and shallow breathing.
On examination Mak had some superficial abrasions to his chin and forelegs and two bite wounds to his right hock. Mak also had a very rapid and shallow respiratory rate. On auscultation of the chest he had normal breath sounds present but these were reduced towards the bottom of his chest.
On abdominal palpation his abdomen felt very empty.
X-rays were taken that evening. These showed loops of intestine within his chest indicating that Mak had ruptured his diaphragm muscle (this is the muscle which separates his chest from his abdomen) therefore causing his abdominal contents to herniate into his chest. This condition is called a diaphragmatic hernia.
An acquired diaphragmatic hernia is the result of trauma such as a severe fall or blow to the abdomen. As the abdominal contents such as the stomach and liver are forced against the diaphragm, a tear or rupture of the muscle occurs. Once an opening in the muscle occurs, abdominal contents such as the liver, stomach, or intestines may herniate through the rupture, enter the chest, and put pressure upon the lungs. Also, once ruptured the diaphragm muscle cannot properly expand and contract making it even more difficult breathe.
Mak required surgery to restore his normal respiratory function. This involved voiding his chest of gut contents (in fact most of his gastrointestinal tract was sitting in his chest!) and stitching the diaphragm muscle back together.
Animals rely on negative pressure in the chest in order to inflate their lungs, when we entered his abdomen this negative pressure was lost due to the hole in his diaphragm. Therefore the nurse had to breathe for him throughout surgery. We then had to suck all the air out of his chest cavity once we had stitched up the hole in his diaphragm to restore the negative pressure, allowing Mac to inflate his lungs on his own.
Once surgery was finished we took some more X-rays to make sure Mac’s lungs were fully inflated and that we did not need to suck out any more air.
The surgery was very successful and Mac recovered well. He stayed with us for the following few days to keep him confined, giving him time to heal. He very much enjoyed all the attention he had from our nurses while he was here. Mak is currently doing well at home and is now back to his normal smoochy self!