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DATE: 8 JAN 2025
PATIENT:
Domestic short-haired cat, F, 5 years. Resident in Myanmar.
HISTORY:
6 months ago, the cat was hit by a car. Difficulty in breathing for
the past 6 months. Vets were consulted.
VET: Dr Thet
Hmue Kyaw, BVSc (Yesin).
1. Signs.
Eating,drinking,urination and defaecation are normal.
2.
Auscultation. Lung sounds normal but dyspnoea (difficulty in
breathing).
3. Abdominal palpation. Stomach and liver not
palpable.
4. X-rays. Stomach and small
intestines, liver and spleen are present in the thoracic cavity
(chest), indicating a diaphragmatic hernia.
5.
Diagnosis: Acquired diaphragmatic hernai.
6. Treatment: Surgery by
specialists. Specialists fees are costly while the surgical and
anaesthetic risks are very high. Low chances of survival.
7.
Advice to owner: Complications of surgery include death on the
operating table and heart failure when the above-mentioned organs are
separated from the lungs and heart as scarred tissues stick them
together. Scarred tissues have had formed for the past 6 months.
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.
8.
Conclusion. The owner took the cat home.
6 months of Difficult Breathing (dyspnoea) in a
5-year-old female cat in Myanmar.
A BE KIND TO PETS Veterinary
Educational Video is created by:
Dr Sing Kong Yuen, BVMS (Glasgow)
on 11 Jan 2025 to educate owners and vet students.
UPDATE AT:
https://2010vets.blogspot.com/2025/01/4429-case-study-acquired-diaphragmatic.html
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The hernia must be corrected surgically. This surgery is often done in referral centers by surgical and anesthesia specialists.
In congenital forms, surgical intervention as early as possible is important to prevent organ entrapment or scarring between the intestines and the chest cavity.
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.
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FROM MERCK MANUAL
The diaphragm is a layer of muscle that extends across the base of the chest and separates the chest from the abdomen.A diaphragmatic hernia is a medical condition in which a break in the diaphragm allows protrusion of abdominal organs into the chest..
The break may be caused by trauma e.g. car accident, fall from high-rise or congenital (present at birth).
Clinical signs depend on severity, varies from laboured breathing to weight loss.
During an examination, the veterinarian may note the absence of normal lung sounds and/or the presence of digestive system sounds in the chest.
Careful physical examination by the veterinarian, including listening to and tapping the chest and abdomen, usually suggests the presence of chest disease. A definitive diagnosis is most frequently made from x‑rays, which can reveal changes in the shape of the diaphragm and the displacement of abdominal organs. Specialized x‑rays that use dyes to highlight the digestive organs are sometimes necessary to make the diagnosis.
Surgical repair of the hernia is the only treatment. Animals with long term hernias must be observed closely after surgery because life-threatening fluid accumulation can develop in the lungs.
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KEY POINTS
Diaphragmatic hernia can be acute (eg, traumatic) or chronic (usually congenital).
Clinical signs can range from nonexistent (eg, incidental finding) to severe respiratory distress.
Thoracic radiographs are usually diagnostic, and surgical repair is the EY POdefinitive treatment.
Re-expansion pulmonary edema is more common after chronic diaphragmatic hernia repair.
