Keaton R S Morgan1, Ameet Singh1, Michelle A Giuffrida2, Ingrid M Balsa2, Galina Hayes3, Margaret L Chu3, Christopher B Thomson4, Shiori Arai4, Daniel D Smeak5, Eric Monnet5, Laura E Selmic6, Megan Cray7, Janet A Grimes8, Taylor Morris1, J Brad Case9, Jeffrey J Biskup10, Jason Haas10, Kelley Thieman-Mankin11, Milan Milovancev12, Mathieu Gatineau13. 1. Department of Clinical Studies, Ontario Veterinary College, Guelph, Ontario, Canada. 2. Department of Surgical and Radiological Sciences, University of California-Davis, Davis, California. 3. Department of Clinical Sciences, Cornell University, Ithaca, New York. 4. Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, Minnesota. 5. Veterinary Teaching Hospital, Colorado State University, Fort Collins, Colorado. 6. Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio. 7. Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois. 8. Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia. 9. Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida. 10. The College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee. 11. Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas. 12. Department of Clinical Sciences, Oregon State University, Corvallis, Oregon. 13. DMV Veterinary Centre, Surgical Department, Montreal, Quebec, Canada.
Abstract
OBJECTIVE: To compare demographics and disease characteristics in dogs in which peritoneopericardial diaphragmatic hernia (PPDH) had been diagnosed and report outcomes after surgical treatment (ST) or conservative treatment (CT). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: One hundred twenty-eight dogs (91 ST, 37 CT) in which PPDH had been diagnosed. METHODS: Medical records were reviewed for demographics, perioperative findings, and outcomes. Follow-up was obtained via telephone interview and email correspondence with owners and referring veterinarians. Baseline variables were compared between treatment groups. RESULTS: Dogs treated surgically were younger (P < .001), more likely to be sexually intact (P = .002), more likely to have clinical signs from PPDH vs an incidental diagnosis (P < .001), and more likely to have other congenital abnormalities (P = .003) compared with dogs treated conservatively. Ninety-seven percent of ST dogs were discharged from hospitals. Intraoperative and postoperative complications were reported in 22% and 41% of dogs, respectively, although most complications were classified as low grade (75% and 83%, respectively). Follow-up was available in 87 dogs, at a median of 1062 days. Hernia recurrence was not reported in any surgically treated dog. The deaths of nine dogs (five ST, four CT) could be attributed to PPDH, and long median survival times were observed in both the ST and CT groups (8.2 and 5 years, respectively). CONCLUSION: Preoperative characteristics differed between dogs treated conservatively vs surgically. Surgical treatment was associated with low operative mortality, and both ST and CT dogs had good long-term survival. CLINICAL SIGNIFICANCE: A diagnosis of PPDH can confer a good long-term prognosis for both ST and CT dogs.
OBJECTIVE: To compare demographics and disease characteristics in dogs in which peritoneopericardial diaphragmatic hernia (PPDH) had been diagnosed and report outcomes after surgical treatment (ST) or conservative treatment (CT). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: One hundred twenty-eight dogs (91 ST, 37 CT) in which PPDH had been diagnosed. METHODS: Medical records were reviewed for demographics, perioperative findings, and outcomes. Follow-up was obtained via telephone interview and email correspondence with owners and referring veterinarians. Baseline variables were compared between treatment groups. RESULTS:Dogs treated surgically were younger (P < .001), more likely to be sexually intact (P = .002), more likely to have clinical signs from PPDH vs an incidental diagnosis (P < .001), and more likely to have other congenital abnormalities (P = .003) compared with dogs treated conservatively. Ninety-seven percent of ST dogs were discharged from hospitals. Intraoperative and postoperative complications were reported in 22% and 41% of dogs, respectively, although most complications were classified as low grade (75% and 83%, respectively). Follow-up was available in 87 dogs, at a median of 1062 days. Hernia recurrence was not reported in any surgically treated dog. The deaths of nine dogs (five ST, four CT) could be attributed to PPDH, and long median survival times were observed in both the ST and CT groups (8.2 and 5 years, respectively). CONCLUSION: Preoperative characteristics differed between dogs treated conservatively vs surgically. Surgical treatment was associated with low operative mortality, and both ST and CT dogs had good long-term survival. CLINICAL SIGNIFICANCE: A diagnosis of PPDH can confer a good long-term prognosis for both ST and CT dogs.