Congenital Diaphragmatic Hernia in Dogs

The diaphragm’s job is to contract and relax which draws air into the chest cavity for respiration. When a rip or tear occurs, it becomes a problem with your dog’s breathing. When organs move up into the diaphragm area, it puts a lot of pressure on the body, and reactions such as vomiting, bloating and diarrhea are a reaction due to damage dealt to the stomach or bowel area. In traumatic diaphragmatic hernia it can happen rapidly, due to a trauma such as a forceful blow, but in congenital cases it may take some time before any damage is noted.

Congenital Diaphragmatic Hernia is a tear in the diaphragm (a sheet of muscle separating the chest from the abdomen) allowing organs to move into the chest cavity.

The symptoms of the hernia may not be noticed at first; it may take a while to become noticeable, and may only pose a problem later in your dog’s life.

• Muffled heartbeat and heart murmurs (irregular beats)
• Respiration is where your dog will be affected first, followed by other reactions 
• The abdominal area seems abnormal, perhaps suddenly hollow 
• Sudden damage to your dog’s liver or bowels 
• Birth defects may also be present in young puppies
• Rib fractures and organ failure in severe cases 
• Impaired use of the lungs 

Types  

• There are two main types of diaphragmatic hernia in dogs
• The first is congenital diaphragmatic hernia, your dog has this at birth 
• A peritoneal-pericardial diaphragmatic hernia (PPDH) is a common congenital form and is the result of a defect during the development of the diaphragm of your puppy during development within the fetus 
• In Weimaraner’s and Cocker Spaniels, the congenital type of diaphragmatic hernia is a widespread problem 
• Traumatic diaphragmatic hernias are the other main type; it occurs during a traumatic event such as your dog being hit by a car, or suffering a significant blow that causes the diaphragm to tear or be damaged

• The congenital diaphragmatic hernia is uncommon, and is caused by some defective development of your growing puppy during the fetal stage 
• Health professionals are not clear on the exact reason why this happens, but it could be hereditary, viral infections in the womb, or other causes 
• CDH may be found later in life, but over time it can cause additional problems as the abdominal organs can become attached to the chest cavity causing disease 
• With the advent of the abdominal tissue now in the chest cavity, it can cause irritation to the heart muscle causing additional problems in respiration 
• Fluid may leak into the chest cavity from the abdomen, causing complications

If your young puppy is having problems after birth with breathing, it is vital to take the little one to the veterinarian to help diagnose what is happening. Your veterinary specialist will do a thorough physical examination, and will want to know the history of the parents to see if there are any health problems that may have been passed on. The most useful examination is via x-rays and/or ultrasound which can reveal any abnormalities. 

Fluid may be present in the space around the lungs with unusually fast breathing exhibited. Blood, as well as the urine, may be tested. Some puppies are born with only partial diaphragms or abnormal openings due to an abnormality during their development stage in the womb. Depending on the severity of each case, your veterinarian will advise of the treatment needed and the rehabilitation required.

This condition is vital for your pet’s health and if your dog is showing signs of distress, then you should immediately seek the help of a veterinarian. Surgical correction is the only solution to this problem. If your dog is showing signs of exercise intolerance, vomiting, and anorexia, or if heart murmurs and decreased lung sound are displayed, then action must be taken to assist your dog/puppy to better health. Your pet must be stabilised before the hernia can be corrected. A chest ‘tap’ may be needed to drain the fluid that has gathered in the chest area, then once your pet is stable, the surgery can begin. 

The repair work is performed by entering the abdominal cavity along the ventricular midline, and then carefully moving the abdominal organs back into their rightful place. Once that is achieved, the tear in the diaphragm can be achieved. A tube may be needed to remove air and blood that has accumulated. With a congenital diaphragmatic hernia, it is vital to avoid organ entrapment or cause any scarring between the abdomen and the chest to enable effective recovery. The prognosis is always guarded in the first stages of treatment as there are so many variables. Once your dog stabilises and starts recovery, (the heart returns to a normal rhythm) then the prognosis is good. The first twenty-four hours after surgery is the crucial time, but after that your pet can begin recovery.

Your dog/puppy will be required to stay in hospital after the surgery as tubes placed during the procedure to drain the fluid or for feeding may need to stay in place. Pain management is a big part of the recovery process. After a day or two your pet will start feeling better and want to move around more. It is important at this stage to keep your dog confined and encourage rest. The prognosis is excellent for congenital diaphragmatic hernia surgery with a return to normal life and performance possible after the recovery period. Your veterinarian will advise of the home care requirements and medication and will want to see your dog for regular check-ups as he heals.