HERNIORRHAPHY AND SURGICAL OUTCOMES OF DIAPHRAGMATIC HERNIA IN CATS
DOI:
https://doi.org/10.26873/SVR-1295-2022Abstract
Abstract: The aim of this study was to evaluate the surgical outcome and mortality of diaphragmatic hernia in cats and present herniorrhaphy results. Diagnostic and surgical data from 25 cats with diaphragmatic hernias were analyzed retrospectively. The cats were between the ages of 2 months and 4 years, included 9 cases of males (5/9 neutered) and 16 cases of females (9/16 spayed). acute cases were 12/25 and chronic cases were 13/25. Diaphragmatic rupture locations were defined according to the points that are determined based on a clockwise scale. Location was classified as multiple in 10 (40 %), ventral in 7 (28 %), right in 5 (20 %), and left in 3 (12 %) cases. The three most frequently herniated organs were small intestine (20, 80 %), liver (16, 64 %), and omentum (15, 60 %). Postoperative survival rates were 83.3 % for acute cases and 69.2 % for chronic. Full recovery was achieved in 19 (76 %) of the cats. Results suggest that the location and size of diaphragm ruptures, the organs herniated, and the presence of concurrent pathologies directly affect mortality. Mortality is higher in cases with concurrent injuries, large diaphragmatic ruptures, and excessively herniated organs.
Key words: prognosis; feline diseases; hernia; rupture; survival
HERNIORAFIJA IN KIRURŠKI IZIDI DIAFRAGMALNE KILE PRI MAČKAH
Izvleček: Namen te študije je bil ovrednotiti kirurški izid in smrtnost diafragmalne kile pri mačkah ter predstaviti rezultate herniorafije. Retrospektivno smo analizirali diagnostične in kirurške podatke pri 25 mačkah z diafragmalno kilo. Mačke so bile stare od 2 mesecev do 4 let, med njimi je bilo 9 samcev (5/9 kastriranih) in 16 samic (9/16 steriliziranih). Akutnih primerov je bilo 12/25 in kroničnih 13/25. Mesta pretrganja diafragme so bila opredeljena glede na točke, določene na podlagi lestvice v smeri urinega kazalca. Pretrganje je bilo določeno kot večmestno v 10 (40 %) primerih, ventralno v 7 (28 %), desno v 5 (20 %) in levo v 3 (12 %) primerih. Trije najpogosteje vrinjeni organi so bili tanko črevo (20, 80 %), jetra (16, 64 %) in omentum (15, 60 %). Preživetje po operaciji je bilo pri akutnih primerih 83,3 %, pri kroničnih pa 69,2 %. Popolno okrevanje je bilo doseženo pri 19 (76 %) mačkah. Rezultati kažejo, da na umrljivost neposredno vplivajo mesto in velikost raztrganine diafragme, vrinjeni organi in prisotnost sočasnih patologij. Smrtnost je večja pri sočasnih poškodbah, velikih raztrganinah diafragme in prekomernem vrinjenju organov.
Ključne besede: prognoza; bolezni mačk; kila; raztrganina; preživetje
References
→ 1. Ozer K, Guzel O, Devecioglu Y, Aksoy O. Diaphragmatic hernia in cats: 44 cases. Med Wet 2007; 63: 1564–7.
→ 2. Yaygıngül R, Bozkan Z, Şen BZ, Kurt BK, Belge A. Traumatic diaphragmatic hernia in cats: a retrospective study of 15 cases (2016–2017). Kocatepe Vet J 2019; 12(2): 205–12. doi: 10.30607/ kvj.493594
→ 3. Legallet C, Mankin KT, Selmic LE. Prognostic indicators for perioperative survival after diaphragmatic herniorrhaphy in cats and dogs: 96 cases (2001–2013). BMC Vet Res 2016; 13(1): e16. doi: 10.1186/s12917-016-0926-y
→ 4. Hyun C. Radiographic diagnosis of diaphragmatic hernia: review of 60 cases in dogs and cats. J Vet Sci 2004; 5: 157–62.
→ 5. Bradley K. Practical contrast radiography 2: Gastrointestinal studies. In Pract 2005; 27: 412–7.
→ 6. Besalti O, Pekcan Z, Caliskan M, Aykut GZ. A retrospective study on traumatic diaphragmatic hernias in cats. Ankara Univ Vet Fak Derg 2011; 58: 175–9.
→ 7. Schmiedt CW, Tobias KM, Stevenson MM. Traumatic diaphragmatic hernia in cats: 34 cases (1991–2001). J Am Vet Med Assoc 2003; 222: 1237–40. doi: 10.2460/javma.2003.222.1237
→ 8. Boudrieau JR, Muir MW. Pathophysiology of traumatic diaphragmatic hernia in dogs. Compend Contin Educ Pract Vet 1987; 9: 379–85.
→ 9. Wilson GPT, Hayes HMJ. Diaphragmatic hernia in the dog and cat: a 25-year overview. Semin Vet Med Surg 1986; 1: 318–26.
→ 10. Worth AJ, Machon GR. Traumatic diaphragmatic herniation: pathophysiology and management. Compend Contin Educ Pract Vet 2005; 27: 178–91.
→ 11. Stokhof AA. Diagnosis and treatment of acquired diaphragmatic hernia by thoracotomy in 49 dogs and 72 cats. Vet Q 1986; 8: 177–83.
→ 12. Bellenger JR, Hunt GB, Goldsmid, ES, Pearson BMR. Outcomes of thoracic surgery in dogs and cats. Aust Vet J 1996; 74: 25-30. doi: 10.1111/j.1751-0813.1996.tb13729.x
→ 13. Minihan AC, Berg J, Evans KL. Chronic diaphragmatic hernia in 34 dogs and 16 cats. J Am Anim Hosp Assoc 2004; 40: 51–3. doi: 10.5326/0400051
→ 14. White DJ, Tisdall LP, Norris JM, Malik R. Diaphragmatic hernia in a cat mimicking a pulmonar mass. J Feline Med Surg 2003; 5: 197–201. doi: 10.1016/S1098-612X(02)00069-4
→ 15. Stickle LR. Positive-contrast celiography (peritoneography) for the diagnosis of diaphragmatic hernia in dogs and cats. J Am Vet Med Assoc 1984; 185: 295–8.
→ 16. Eugster S, Schawalder P, Gaschen F, Boerlin P. A prospective study of postoperative surgical site infections in dogs and cats. Vet Surg 2004; 33: 542–50.
→ 17. Nelson LL. Surgical site infections in small animal surgery. Vet Clin North Am Small Anim Pract 2011; 41: 1041–56.
→ 18. Nicholson M, Beal M, Shofer F, Brown DC. Epidemiologic evaluation of postoperative wound infection in clean-contaminated wounds: a retrospective study of 239 dogs and cats. Vet Surg 2002; 31: 577–81.
→ 19. Findji L. Antibiotics in surgical patients. Clinician’s Brief 2014; (May): 19–22. https://www.cliniciansbrief.com/article/antibiotics-surgical-patients (01. 11. 2020)
→ 20. Walker GR, Hall LW. Rupture of the diaphragm: Report of 32 cases in dogs and cats. Vet Rec 1965; 77: 830–7.
→ 21. Hunt BG, Johnson AK. Diaphragmatic, pericardial, and hiatal hernia. In: Slatter DH, ed. Textbook of small animal surgery. Philadelphia : Elsevier, 2002: 471–87.
→ 22. Burns CG, Bergh MS, McLoughlin AM. Surgical and nonsurgical treatment of peritoneopericardial diaphragmatic hernia in dogs and cats: 58 cases (1999–2008). J Am Vet Med Assoc 2013; 242: 643–50. doi: 10.2460/javma.242.5.643
→ 23. Chan L, Reilly KM, Henderson C, Khan F, Salluzzo FR. Complication rates of tube thoracostomy. Am J Emerg Med 1997; 15: 368–70. doi: 10.1016/S0735-6757(97)90127–3
→ 24. McPhail CM. Medical and surgical treatment of pyothorax. Vet Clin North Am Small Anim Pract 2007; 37: 975–988. doi: 10.1016/j.cvsm.2007.05.012
→ 25. Lee JH, Yang WJ, Kang EH, et al. Diaphragmatic hernia in dogs: 4 cases. J Vet Clin 2009; 26: 62–8.
→ 26. Pratschke K. Management of hernias and ruptures in small animals. In Pract 2002; 24: 570–81.
→ 27. McClaran JK. Diaphragmatic and peritoneopericardial diaphragmatic hernias. Monnet E, ed. In: Small animal soft tissue surgery. Philadelphia : Saunders, 2012: 278–85.
→ 28. Kladakis S. Choosing sutures in small animal surgery. J Dairy Vet Anim Res 2014; 1(3): 68–71. doi: 10.15406/jdvar.2014.01.00015
→ 29. Wilson GP, Newton CD, Burt JK. A review of 116 diaphragmatic hernias in dogs and cats. J Am Vet Med Assoc 1971; 159: 1142–5.
→ 30. Marlof A, Kraft S, Lowry J, Pelsue D, Veir J. Radiographic diagnosis right kidney herniation in a cat. Vet Radiol Ultrasound 2002; 43: 237–40. doi: 10.1111/j.1740-8261.2002.tb00996.x
Kraje BJ, Kraje AC, Rohrbach BW, Anderson AK, Steven ML, Macintire DK. Intrathoracic and concurrent orthpedic injury associated with traumatic rib fracture in cats: 75 cases (1980–1998). J Am Vet Med Assoc 2000; 216: 51–4. doi: 10.2460/javma. 2000.216.51
→ 32. Gibson GTW, Brisson AB, Sears W. Perioperative survival rates after surgery for diaphragmatic hernia in dogs and cats: 92 cases (1990– 2002). J Am Vet Med Assoc 2005; 227: 105–9. doi: 10.2460/javma.2005.227.105
→ 33. Sullivan M, Reid J. Management of 60 cases of diaphragmatic rupture. J Small Anim Pract 1990; 31: 425–30. doi: 10.1111/j.1748-5827.1990.tb00 503.x
→ 34. Brody RS, Sauer MR. Clinico-pathologic conference. J Am Vet Med Assoc 1964; 145: 1213–22.
