A hernia occurs when one part of the body protrudes through a gap or opening into another part of the body. For example, a hiatal hernia takes place at the opening of the diaphragm where the food pipe joins the stomach. Part of the stomach pushes through the opening, and a hernia is formed. It is most likely to occur before a kitten has reached the first year, and is usually inherited (congenital). However, trauma may bring on an acquired hiatal hernia, and this can occur at any age.
- Weight loss
- Excessive salivation
- Shortness of breath
- Acquired - secondary to trauma or an increased effort to inhale
- Concurrent — the lower esophageal sphincter slides into the thoracic cavity and allows gastric reflux into the esophagus, causing inflammation of the esophagus
X-rays may show soft-tissue density in the region of the esophageal opening (hiatus), but they may not reveal lesions. However, an enlarged esophagus can be detected by X-ray. Contrast exams can show the esophagus as it is joined to the stomach and may reveal any abnormalities that are causing the problems. An exam called the esophagoscopy will use a scope to detect inflammation and might possibly show the end (terminal) of the esophagus sliding into the thorax.
Diagnosis of hiatal hernia is based on examination and observation of one or more of the following manifestations of the condition:
- Foreign body in the esophagus
- Abnormal tissue growth in the esophagus
- Inflammation of the esophagus
- Enlargement of the lower esophagus
- The protrusion of the stomach into the esophagus
- A foreign body in the digestive tract
- Abnormal tissue growth in the stomach
- Inflammation of the stomach
Not all hiatal hernias require treatment. Conservative therapy may be successful in controlling symptoms, and feeding small but frequent portions of a low-fat diet may control symptoms. Your veterinarian can prescribe drugs that will promote digestion and increase the tone of the sphincter in the lower esophagus. Medications such as cimetidine will decrease the acidity of the reflux, and promote healing of the damaged esophageal tissue. However, surgical treatment will be necessary if your surgeon finds that your cat needs the opening (hiatus) to be closed, or to have its stomach attached to the abdominal wall so that it does not protrude further. If your cat develops aspiration pneumonia, antibiotics may be necessary, as well as other kinds of therapeutic breathing treatments.
Living and Management
If your cat requires surgery, you will need to follow through with return visits to your veterinarian for after care treatment. This is also true if you are managing the hiatal hernia from home. Aspiration pneumonia is one of the possible long term complications related to a hiatal hernia, so you will need to be watchful for signs of this. If you do detect symptoms of pneumonia, you will need to take your cat to the veterinarian immediately for treatment, as complications can quickly progress, possibly with a fatal outcome. Even with prompt treatment, some cats may have a recurrence of all of the symptoms, forcing you and your doctor to return to square one so that other causes can be settled upon and a treatment plan put into place.