F Mitchell, T Charlesworth, M Rossanese, F Cinti, J Riggs, R White, W Robinson, S Das
Twenty dogs met the inclusion criteria. Median age at surgery was 8.9 months (3.0 months to 10.2 years) and Cavalier King Charles Spaniels represented 30% (6/20) of cases. Seventeen dogs presented with clinical signs attributable to pleuroperitoneal diaphragmatic hernia, most commonly vomiting (45%, 9/20), tachypnoea (40%, 8/20) and dyspnoea (35%. 7/20), while three hernias were diagnosed incidentally. The stomach was the most frequently herniated organ (65%, 13/20), followed by the spleen (50%, 10/20) and small intestine (45%, 9/20). Hernias were most commonly located in the dorsolateral left crus of the diaphragm (80%, 16/20). Surgical enlargement of the defect to facilitate reduction of herniated viscera was required in 35% (7/20) of cases. Nineteen dogs underwent successful herniorrhaphy; one dog was euthanased intraoperatively because of extensive jejunal necrosis associated with mesenteric volvulus. Post-operative complications occurred in 47% (9/19) dogs, and all dogs survived to discharge. One dog developed hernia recurrence.
OBJECTIVES: To describe the signalment, clinical presentation, diagnostic findings, surgical management and outcomes of dogs undergoing surgical management for pleuroperitoneal diaphragmatic hernia.
MATERIALS AND METHODS: Medical records from seven referral hospitals were retrospectively reviewed to identify dogs diagnosed with pleuroperitoneal diaphragmatic hernia during the study period. Data collected included signalment, clinical presentation, diagnostic imaging findings, surgical findings, post-operative complications and outcome. Complications were classified using the Clavien-Dindo grading system.
RESULTS: Twenty dogs met the inclusion criteria. Median age at surgery was 8.9 months (3.0 months to 10.2 years) and Cavalier King Charles Spaniels represented 30% (6/20) of cases. Seventeen dogs presented with clinical signs attributable to pleuroperitoneal diaphragmatic hernia, most commonly vomiting (45%, 9/20), tachypnoea (40%, 8/20) and dyspnoea (35%. 7/20), while three hernias were diagnosed incidentally. The stomach was the most frequently herniated organ (65%, 13/20), followed by the spleen (50%, 10/20) and small intestine (45%, 9/20). Hernias were most commonly located in the dorsolateral left crus of the diaphragm (80%, 16/20). Surgical enlargement of the defect to facilitate reduction of herniated viscera was required in 35% (7/20) of cases. Nineteen dogs underwent successful herniorrhaphy; one dog was euthanased intraoperatively because of extensive jejunal necrosis associated with mesenteric volvulus. Post-operative complications occurred in 47% (9/19) dogs, and all dogs survived to discharge. One dog developed hernia recurrence.
CLINICAL SIGNIFICANCE: Pleuroperitoneal diaphragmatic hernia may present with acute respiratory and gastrointestinal signs or be identified incidentally during diagnostic imaging or surgery. Surgical correction is associated with favourable outcomes and a low recurrence rate.