Congenital Diaphragmatic Hernia In Dogs

In veterinary medicine, Hernia is best defined as a defect in the structure that identifies the borders of a body cavity and this ’defect’ may lead to the limited or complete spilling out of the contents of one area into the other.

A congenital Diaphragmatic Hernia (CDH) is the abnormal development of the pleuroperitoneal membrane of the diaphragm in the fetus which allows the abdominal contents to protrude ("herniate") through the diaphragm. The diaphragm is a thin, muscular and membranous structure that separates the chest and abdomen. When there are abnormalities in diaphragm development and consequent herniation, the lungs will be not developed properly but this mostly affects only one lung (90% on the left).

Abdominal contents that herniate through the diaphragm can vary. The stomach, small intestine, splenic, pancreas, and mesentery can become locked or incarcerated which can lead to obstruction and is a life-threatening problem. Therefore, vets recommend closing all hernias after diagnosis.

In Ultrasound findings of Diaphragmatic hernias, echogenic hernia means containing mainly solid organs, such as the stomach, liver, or spleen. Meanwhile, a hernia containing fluid-filled bowel loops with or without reverberation due to luminal bowel gas appears hypoechoic.

• Breathing difficulties
• Tachypnea (rapid breathing).
• Cyanosis (blue discoloration of the skin).
• Abnormal heart rhythm
• Less full abdomen.
• Muffled lung and heart sounds.
• The abdominal area seems abnormal, perhaps suddenly hollow.
• Always lying down / Malaise / Depression.
• Lack of appetite
• Sudden damage to your dog’s liver or bowels.
• Pain

Surgical Treatment:

Surgery for most pets with diaphragmatic hernias is typically corrected by a surgical procedure. A ventral midline approach is used and the hernial sac is opened. After inspection, sac contents are replaced in the abdominal cavity and the sac is trimmed at the margins. The hernia ring is sealed with suture material after organ replacement. An abdominal wrap bandage is provided for support.

If the opening is minuscule, some vets do not recommend surgical treatment. However, most defects will widen in due course with abdominal pressures like excess weight, whelping, pregnancy, exercise, or trauma.

Hernias become a medical emergency if the intestine becomes trapped or incarcerated, and cannot be moved back cutting off its own blood supply. Incarcerated hernias are not a medical emergency but still, they should be treated to prevent strangulation.

Strangulation happens when incarcerated organs become ischemic due to compromised blood supply and become necrotic. This is a life-threatening condition and it is a surgical emergency.

Diaphragmatic Hernias don't go away on their own. Many dog owners are able to holdup surgery for months or even years. For some dogs with a small hernia, it may never need surgery.

When the herniation is small and the dogs don't have any symptoms, or if the symptoms don’t bother the dogs so much, you and your vet may simply continue to watch for symptoms to occur.

Or else, if you are too busy to wait and watch for the symptoms to occur, you can straightaway opt for surgery.

• Check with your vet if the breed has a history of a hernia.
• There is no real way to prevent a hernia. Some of the breeds inherit the condition and others acquire it through other health issues. Congenital hernias can be prevented by not breeding pets susceptible to inguinal hernias.
• Pregnancy and obesity are also predisposing factors, it is better to take care of these things in your pets.

Weimaraner, Cocker Spaniel

1. Causes:

• Congenital
• Surgical procedures on the abdomen or chest.
• Traumatic hernias due to blunt injuries, and accidents.
• Falls that damage the diaphragm region.

2. Types:

Congenital Diaphragmatic Hernias:

For instance, a peritoneal-pericardial diaphragmatic hernia (PPDH) is a common congenital form involving the peritoneal and pericardial spaces.

Acquired Inguinal Hernia:

• Traumatic Diaphragmatic Hernias: This happens because of a traumatic event such as falls that causes a significant blow to the dog or being hit by a car causing the diaphragm to be damaged or torn.
• Frequently seen in female dogs.
• Other Causes: Old age, chronic cough, pregnancy, increased abdominal pressure to other connective tissue problems.

3. Morbidity:

Congenital diaphragmatic hernias are more common in young dogs.

4. Mortality:

• Death from CDH is uncommon.
• Incarcerated hernia or strangulated hernia can cause death.

5. Diagnosis:

• X-rays and/or ultrasound.
• Special radiographic dye studies.

6. Prognosis:

Prognosis depends on the size of herniated organs or other complications associated with hernia. In general, the prognosis is generally good with earlier diagnosis and surgery.

As of now, the only main negative prognostic indicator for diaphragmatic hernia in dogs has been identified as ‘strangulated hernia’. This is life-threatening and has to be addressed immediately.

If you see a dog has a strange bulge in its abdomen area, take your dog to your veterinarian for an examination.

• Less full abdomen.
• Muffled lung and heart sounds.
• The abdominal area seems abnormal, perhaps suddenly hollow.

• Nutritionally balanced, wholesome diet.
• Avoid DRY FOOD and go for a fresh diet.
• When opting for Commercial foods, they should have high-quality, natural ingredients, with no artificial additives.
• The raw diet, Semi-Homemade Food (commercial homemade diet with a dehydrated formula), or home-cooked meals.
• Protein (required levels of bioavailable protein).
• Fiber-rich foods: Apples, pears, oatmeal, and other foods.

In general, diaphragmatic hernias are associated with a guarded prognosis.

With proper treatment, the outlook is good for dogs that even have had a strangulated hernia. The most important thing is to check for re-expansion pulmonary edema soon after the surgery.

You may also be able to prevent your dog’s hernia becomes strangulated by being proactive. Seek treatment immediately if you suspect their hernia symptoms are getting bigger.