Abigail’s close shave
Hernias may be something we associate with older guys lifting heavy objects, but at the pet hospital on Pitama Rd, Palmerston North, we saw an epidemic of different types of hernias last week.
Abigail was sleeping quietly on the nice warm drive when Dad came home unexpectedly.
You guessed it. A bit sleepy and a bit slow to move – bump. It was too late.
Surprisingly, Abigail was quite bright and walked inside afterwards, but she was a bit quiet as she lay under the bed. Rachel made the right decision and gave us a call to get her checked.
Car accidents can be deceiving when it comes to the severity of internal damage. A patient may initially appear OK but within hours that can change as a result of internal bleeding, muscle damage or internal organ damage not immediately apparent.
We strongly recommend any car accident patient be fully examined as soon as possible and be admitted in to the hospital for 12 hours for close observation.
Abigail’s heart sounds were displaced to the right side – the wrong side – and her abdomen felt empty. We admitted Abigail, placed her on IV fluids, gave her pain relief, treatment for shock and took several chest X-rays. As we suspected, a major problem showed up on the X-ray. Abigail had a diaphragmatic hernia.
The diaphragm is a thin sheet of muscle that separates your chest from your abdomen. Its function is to contract and relax, helping draw air in and out of the lungs. There also needs to be a division between the chest and abdomen, because the inside of the chest is a vacuum or negative pressure, which makes it easier for the lungs to inflate. The inside of the abdomen next door is at near normal pressure.
A diaphragmatic hernia is where there is a tear in the diaphragm sheet and some of the organs, like the intestines and spleen, have gone through the hole in to the chest cavity. Sounds horrible, I know.
Amazingly, the patient is still able to breathe because the soft organs and fat seal the hole they came through. The tear occurs because there has been a massive compression of the abdomen and this has forced the weakest point to give way, forcing the organs forward in to the chest.
Isn’t it amazing these cats – I have only seen one case in a dog – appear reasonably normal and wander around outwardly OK. Cats are amazing survivors.
It is important to stabilise the patient for 12 to 24 hours if surgery is not required immediately, so Abigail rested quietly with us for a night.
On Sunday morning we were ready to get Abigail anaesthetised and fixed up.
Surgery of this kind is a team effort and not without risk, because as soon as we open the abdomen and replace the organs in their correct place, the vacuum is lost in the chest and we have to breathe for the patient.
The nurses are great and two extras arrived to help on their day off. Two hours later and Abigail was gradually waking up on a heated bed, with a large zipper along her belly and lots of pain relief to help her.
The next 24 hours were crucial and we sorted a roster to watch her closely. Abigail is a strong little girl and within that time she was up and wanting food. A close call and all credit goes to Rachel for getting us to check her friend.
Over the weekend we saw several other types of hernias, including the standard umbilical hernia and the more uncommon inguinal – inner thigh – hernia, the equivalent of the older bloke lifting hernia.
Some puppies and kittens are born with umbilical hernias, where the muscle walls haven’t quite closed properly in the midline of their belly around their navel.
If the defect is large enough it can be a serious problem because, potentially, loops of bowel could fall through and then twist or swell and therefore block the bowel. We correct umbilical hernias as infants if necessary or if they are small they can be repaired at the time of speying.
So remember to bend those knees and avoid a hernia.
Have a fun week, from everyone at Anderson’s Vet Hospitals.
Car accidents can be deceiving when it comes to the severity of internal damage.