• 1. Noden DM, deLahunta A. Malformations of the diaphragm. In: Noden DM, deLahunta A, eds. The embryology of domestic animals. Developmental mechanisms and malformations. Baltimore: Williams & Wilkins, 1985; 288290.

    • Search Google Scholar
    • Export Citation
  • 2. Evans SM, Biery DN. Congenital peritoneopericardial diaphragmatic hernia in the dog and cat: a literature review and 17 additional case histories. J Vet Radiol 1980; 21: 108116.

    • Search Google Scholar
    • Export Citation
  • 3. Bolton GR, Ettinger S, Roush JC. Congenital peritoneopericardial diaphragmatic hernia in a dog. J Am Vet Med Assoc 1969; 155: 723730.

    • Search Google Scholar
    • Export Citation
  • 4. Neiger R. Peritoneopericardial diaphragmatic hernia in cats. Compend Contin Educ Pract Vet 1996; 18: 461479.

  • 5. Wallace J, Mullen HS, Lesser MB. A technique for surgical correction of peritoneal pericardial diaphragmatic hernia in dogs and cats. J Am Anim Hosp Assoc 1992; 28: 503510.

    • Search Google Scholar
    • Export Citation
  • 6. Reimer SB, Kyles AE, Filipowicz DE, et al. Long-term outcome of cats treated conservatively or surgically for peritoneopericardial diaphragmatic hernia: 66 cases (1987–2002). J Am Vet Med Assoc 2004; 224: 728732.

    • Search Google Scholar
    • Export Citation
  • 7. Tobias AH. Pericardial disorders. In: Ettinger SJ, ed. Textbook of veterinary internal medicine. Vol 2. 6th ed. Philadelphia: Saunders, 2005; 11041107.

    • Search Google Scholar
    • Export Citation
  • 8. Eyster GE, Evan AT, Blanchard GL, et al. Congenital pericardial diaphragmatic hernia and multiple cardiac defects in a litter of collies. J Am Vet Med Assoc 1977; 170: 516520.

    • Search Google Scholar
    • Export Citation
  • 9. Detweiler DK, Brodey RS, Flickinger GL. Diagnosis and surgical correction of peritoneopericardial diaphragmatic hernia in a dog. J Am Vet Med Assoc 1960; 137: 177182.

    • Search Google Scholar
    • Export Citation
  • 10. Schmiedt CW, Washabaugh KF, Rao DB, et al. Chylothorax associated with a congenital peritoneopericardial diaphragmatic hernia in a dog. J Am Anim Hosp Assoc 2009; 45: 134137.

    • Search Google Scholar
    • Export Citation
  • 11. Banz AC, Gottfried SD. Peritoneopericardial diaphragmatic hernia: a retrospective study of 31 cats and 8 dogs. J Am Anim Hosp Assoc 2010; 46: 398404.

    • Search Google Scholar
    • Export Citation
  • 12. Clinton JM. A case of congenital periocardioperitoneal diaphragmatic communication in a dog. J Am Vet Radiol Soc 1967; 8: 5760.

  • 13. Baker GJ, Williams CSF. Diaphragmatic pericardial hernia in the dog. Vet Rec 1966; 78: 578583.

  • 14. Schulman AJ, Lusk R, Lippincott CL, et al. Congenital peritoneopericardial diaphragmatic hernia in a dog. J Am Anim Hosp Assoc 1985; 21: 655662.

    • Search Google Scholar
    • Export Citation
  • 15. Hay WH, Woodfield JA, Moon MA. Clinical, echocardiographic, and radiographic findings of peritoneopericardial diaphragmatic hernia in two dogs and a cat. J Am Vet Med Assoc 1989; 195: 12451248.

    • Search Google Scholar
    • Export Citation
  • 16. Bellah JR, Whitton DL, Ellison GW et al. The surgical correction of concomitant cranioventral abdominal wall, caudal sternal, diaphragmatic, and pericardial defects in dogs. J Am Vet Med Assoc 1989; 195: 17221726.

    • Search Google Scholar
    • Export Citation
  • 17. Berry CR, Koblik PD, Ticer JW. Dorsal peritoneopericardial mesothelial remnant as an aid to the diagnosis of feline congenital peritoneopericardial diaphragmatic hernia. J Vet Radiol 1990; 31: 239245.

    • Search Google Scholar
    • Export Citation
  • 18. Lamb CR, Mason GD, Wallace MK. Ultrasonographic diagnosis of peritoneopericardial diaphragmatic hernia in a Persian cat. Vet Rec 1989; 125: 186.

    • Search Google Scholar
    • Export Citation
  • 19. Barrett RB, Kittrell JE. Diaphragmatic hernia in a cat. J Am Vet Radiol Soc 1966; 7: 2125.

  • 20. Bistner S, Butler WB. Peritoneal-pericardial diaphragmatic hernia. J Am Vet Med Assoc 1967; 151: 235236.

  • 21. Smith L, Lippert KM. Peritoneopericardial diaphragmatic hernia. Ann Surg 1958; 148: 798804.

  • 22. Bjorck GR, Tigerschiold A. Peritoneo-pericardial diaphragmatic hernia in a dog. J Small Anim Pract 1970; 11: 585590.

  • 23. Wilson GP, Newton CD, Burt JK. A review of 116 diaphragmatic hernias in dogs and cats. J Am Vet Med Assoc 1971; 159: 11421145.

  • 24. Rendano VT, Parker RB. Polycystic kidneys and peritoneopericardial diaphragmatic hernia in the cat: a case report. J Small Anim Pract 1976; 17: 479485.

    • Search Google Scholar
    • Export Citation
  • 25. Leighton RL. Peritoneopericardial hernia in a dog. Vet Med Small Anim Clin 1977; 72: 18431847.

  • 26. Atkins CE. Suspect congenital peritoneopericardial diaphragmatic hernia in an adult cat. J Am Vet Med Assoc 1974; 165: 175176.

  • 27. Saperstein G, Harris S, Leipold HW. Congenital defects in domestic cats. Feline Pract 1976; 6(4):1843.

  • 28. Reed CA. Pericardio-peritoneal hernia in mammals with description of a case in the domestic cat. Anat Rec 1951; 110: 113119.

  • 29. Willard MD, Aronson E. Peritoneopericardial diaphragmatic hernia in a cat. J Am Vet Med Assoc 1981; 178: 481483.

  • 30. Schuh JC. Hepatic nodular myelolipomatosis (myelolipomas) associated with a peritoneo-pericardial diaphragmatic hernia in a cat. J Comp Pathol 1987; 97: 231235.

    • Search Google Scholar
    • Export Citation
  • 31. Cowan WD, Feeney DA, Walter PA. What is your diagnosis? Peritoneopericardial diaphragmatic hernia. J Am Vet Med Assoc 1989; 194: 13311332.

    • Search Google Scholar
    • Export Citation
  • 32. Sisson D, Thomas WP, Reed J, et al. Intrapericardial cysts in the dog. J Vet Intern Med 1993; 7: 364369.

  • 33. Liptak JM, Bissett SA, Allan GS, et al. Hepatic cysts incarcerated in a peritoneopericardial diaphragmatic hernia. J Feline Med Surg 2002; 4: 123125.

    • Search Google Scholar
    • Export Citation
  • 34. Chalkley J, Salinardi BJ, Bulmer BJ. What is your diagnosis? Peritoneopericardial diaphragmatic hernia (PPDH). J Am Vet Med Assoc 2006; 228: 695696.

    • Search Google Scholar
    • Export Citation
  • 35. Statz GD, Moore KE, Murtaugh RJ. Surgical repair of a peritoneopericardial diaphragmatic hernia in a pregnant dog. J Vet Emerg Crit Care 2007; 17: 7785.

    • Search Google Scholar
    • Export Citation
  • 36. Koffas H, Fuentes VL, Boswood A, et al. Double chambered right ventricle in 9 cats. J Vet Intern Med 2007; 21: 7680.

  • 37. Less RD, Bright JM, Orton EC. Intrapericardial cyst causing cardiac tamponade in a cat. J Am Anim Hosp Assoc 2000; 36: 115119.

  • 38. Lunney J. Congenital peritoneal pericardial diaphragmatic hernia and portocaval shunt in a cat. J Am Anim Hosp Assoc 1992; 28: 163165.

    • Search Google Scholar
    • Export Citation
  • 39. Rexing JF, Coolman BR. A peritoneopericardial diaphragmatic hernia in a cat. Vet Med 2004; 99: 314318.

  • 40. Teague HD, Cook M, Brunell WK, et al. Surgical repair of a diaphragmatic pericardial hernia in a dog. Canine Pract 1978; 5(5):6365.

    • Search Google Scholar
    • Export Citation
  • 41. Levine SH. Diaphragmatic hernia. Vet Clin North Am Small Anim Pract 1987; 17: 411430.

  • 42. McPhail MC. Medical and surgical treatment of pyothorax. Vet Clin North Am Small Anim Pract 2007; 37: 975988.

  • 43. Moores AL, Halfacree JZ, Baines SJ, et al. Indications, outcomes and complications following lateral thoractomy in dogs and cats. J Small Anim Pract 2007; 48: 695698.

    • Search Google Scholar
    • Export Citation
  • 44. Valtolina C, Adamantos S. Evaluation of small-bore wire-guided chest drains for management of pleural space disease. J Small Anim Pract 2009; 50: 290297.

    • Search Google Scholar
    • Export Citation
  • 45. Ball CG, Lord J, Laupland KB, et al. Chest tube complications: how well are we training our residents? Can J Surg 2007; 50: 450458.

    • Search Google Scholar
    • Export Citation
  • 46. Chan L, Reilly KM, Henderson C, et al. Complication rates of tube thoracostomy. Am J Emerg Med 1997; 15: 368370.

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Surgical and nonsurgical treatment of peritoneopericardial diaphragmatic hernia in dogs and cats: 58 cases (1999–2008)

Colby G. Burns DVM, MS, DACVS1, Mary Sarah Bergh DVM, MS, DACVS, DACVSMR2, and Mary A. McLoughlin DVM, MS, DACVS3
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  • 1 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 2 Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.
  • | 3 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

Abstract

Objective—To determine clinical findings and outcomes for cats and dogs with peritoneopericardial diaphragmatic hernia (PPDH) treated surgically or nonsurgically.

Design—Retrospective case series.

Animals—28 dogs and 30 cats.

Procedures—Medical records for cats and dogs evaluated at 1 of 2 veterinary teaching hospitals were reviewed, and data regarding clinical signs, diagnostic and surgical findings, and outcome were evaluated.

Results—Prevalence of PPDH in the 2 hospitals during the study period was 0.025% (0.062% and 0.015% for cats and dogs, respectively); PPDH was an incidental finding for 13 (46.4%) dogs and 15 (50.0%) cats. Other congenital abnormalities were identified in 16 (571%) dogs and 7 (23.3%) cats (most commonly umbilical hernias, abdominal wall hernias cranial to the umbilicus, or sternal anomalies). Thirty-four (58.6%) animals underwent surgical repair of PPDH; 27 (79.4%) of these animals had a primary diagnosis of PPDH. Detection of clinical signs of PPDH (primary diagnosis) and intestines in the pericardial sac were significantly associated with surgical treatment. Short-term mortality rate for surgically treated animals was 8.8% (3/34). Clinical signs associated with PPDH resolved in 29 (85.3%) of surgically treated animals. No significant differences were detected between dogs and cats or between surgically and nonsurgically treated animals regarding long-term survival rate.

Conclusions and Clinical Relevance—Results of this study indicated animals with clinical signs of PPDH were more likely to undergo surgery than were animals without such signs. Herniorrhaphy was typically effective for resolution of clinical signs. Long-term survival rates were similar regardless of treatment method. Surgical or nonsurgical treatment of PPDH may be appropriate for animals with or without clinical signs, respectively.

Contributor Notes

Dr. Burns's present address is Tampa Bay Veterinary Specialists and Emergency Care Center, 1501 S Belcher Rd, Largo, FL 33771.

Dr. Bergh's present address is Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.

Presented as a podium presentation at the Resident's Forum at the American College of Veterinary Surgeons Annual Symposium, Washington, DC, October 2009.

The authors thank Rebecca Sandee for technical assistance.

Address correspondence to Dr. Burns (cburnsdvm@gmail.com).