Hiatal hernia in the dog and cat: A retrospective study of 16 cases

Abstract

Sixteen cases of hiatal hernia were diagnosed in cats and dogs at the University of Tennessee between 1978 and 1989. Three cases were found as incidental findings during thoracic or abdominal radiography and another two cases were found during post mortem examination. The remaining 11 cases were evaluated clinically and radiographically. The results of conservative or surgical therapy were reviewed. Not all animals with a hiatal hernia were symptomatic. Five animals with signs underwent surgery and another three had surgical intervention but were asymptomatic. Medical management was successful in controlling the signs in two animals showing signs consistent with reflux oesophagitis. One dog with 'shortened oesophagus syndrome' was treated inappropriately with conventional surgical techniques used in veterinary medicine for hiatal hernia. This study clearly emphasises the need to evaluate carefully each dog or cat with hiatal hernia before choosing the best therapeutic plan.

Hiatal hernia controversies ‐ a review of pathophysiology and treatment options

“…4,5 The underlying aetiology and pathophysiology are incompletely understood, and even terminology of the types of HH has been unclear. 6,7,8 Whilst progress is being made in our understanding, 1,2,[9][10][11][12] there has been no detailed discussion of pathophysiology in the veterinary literature. Understanding pathophysiology is important in decision making for medical and surgical therapy.…”

“…While changes have recently been advocated in both medical and surgical treatments, 2,11,13 controversy still exists over when to employ medical and/or surgical treatment and which procedure to use. [1][2][3]9,14 The aim of this article is to review the aetiology and pathophysiology of HH in animals, with the inclusion of relevant information from the human literature. A discussion of currently available medical and surgical treatments follows, with indications for each.…”

Combined surgical and endoscopic approach for the reduction of a congenital hiatal hernia in a cat: a case report

“…Congenital hiatal hernia, as other congenital malformations (Pisoni et al 2012;Tremolada et al 2013) is an uncommon abnormality in dogs and rare in cats, but various reports are available in the literature (Gaskell et al 1974;Teunissen et al 1978;Peterson 1983;Ellison et al 1987;Miles et al 1988;Prymak et al 1989;Bright et al 1990;Williams 1990;Brinkley 1990;White 1993;Callan et al 1993;Auger and Riley1997;Hardie et al 1998;Lorinson and Bright 1998;Sivacolundhu et al 2002;Rahal et al 2003;Kirkby et al 2005;Owen et al 2005;Ardnt et al 2006;Baig et al 2006;Keeley et al 2008;DeSandre-Robinson et al 2011), most of which are congenital, such as, apparently, the case described in the present report. Despite the several cases reported, the pathogenesis is not completely understood and, similarly, the therapeutic protocol has not been standardised.…”

“…Hiatal plication is necessary to reduce an excessively wide opening in the diaphragm for passage of the oesophagus; oesophagopexy is essential to avoid sliding of the oesophagus; gastropexy helps in maintaining the stomach in a correct position; the antireflux procedures prevent gastro-oesophageal reflux from increasing the pressure of the LES (Sivacolundhu et al 2002). Different techniques have been proposed to avoid gastro-oesophageal reflux (Leonardi et al 1977), but the Nissen fundoplication is the most frequent technique performed (Bright et al 1990;Sivacolundhu et al 2002). In the case reported here the Nissen fundoplication could be indicated but, with reference to the literature, we decided not to perform it (Callan et al 1993;White 1993;Lorinson and Bright 1998;Sivacolundhu et al 2002), to avoid the severe complications reported: dysphagia, inability to belch, "gas bloat" and recurrence of stomach herniation with possible strangulation (Gaskell et al 1974;Callan et al 1993).…”

“…Plane radiographs can also not be diagnostic if the gastric protrusion is not permanent (Hunt and Johnson 2003). Different surgical techniques are described to resolve HH: antireflux procedures, hiatal plication, oesophagopexy and incisional left-side or tube gastropexy (Ellison et al 1987;Prymak et al 1989;Bright et al 1990;Williams 1990;Callan et al 1993;White 1993;Lorinson and Bright;. No specific guidelines about treatment protocols are present in the literature, particularly about which type of surgical procedure gives greater success in relation to the different types of HH.…”