Disorder - Hernia, hiatal

Organ Systems Involved
Musculoskeletal

Alternative Names
Oesophageal hiatal hernia; Sliding hiatal hernia; Axial hernia; Paraoesophageal hernia

Presenting Signs

Hiatal hernia is a rare disease in cats, caused by an abnormality in the diaphragm (the sheet-like muscle that separates the abdomen and chest cavity). Hiatal hernias occur when abdominal organs protrude through the oesophageal hiatus, the opening in the diaphragm for the oesophagus, into the chest cavity. This happens particularly with the oesophagus and part of the stomach. Often the condition has no symptoms and is only recognised as an incidental finding in chest X-rays. If symptoms are present they are usually related to the reflux of gastric acid into the oesophagus from the stomach. This happens because the muscle that closes off the stomach (lower oesophageal sphincter) is ineffective. The most common presenting signs that occur are vomiting, regurgitation, diarrhoea, reduced appetite and weight loss. The cat may also have difficulty swallowing, increased salivation and may swallow air. Coughing and respiratory distress may also be present. These presenting signs can occur constantly or intermittently.

Cats at Risk

Obese cats may be at risk.

Treatment

Surgical and medical. Medical: diet change from dry food to a canned, low-fat food fed in small volumes three to four times a day in an upright position to reduce reflux of gastric acid. Medications that decrease gastric acid secretion and increase gastric emptying time are also used.
Surgical: decreasing the size of the oesophageal hiatus and attaching the stomach and/or oesophagus to the body wall to prevent it from moving into the chest cavity.

PubMed References
Hernia, hiatal

Contributor
Anna Pedersen