Ruptured Diaphragm in Dogs

[Anastasia]

My 7 month old puppy suffered an bad injury today and the vets think has ruptured her diaphragm after looking at her x-rays. I have done google searches on this and it makes me even more worried (well sick if I am being honest). So I wondered if anyone has any experience with this, the surgery and prognosis.

 

[FinnishLapphund]

I'm sorry to hear about your puppy, it must be a very worrying situation for you and I hope your puppy is doing as well as possible. I have been hoping somebody else would have something to say about it and perhaps you already have found more information elsewhere by now.

Besides, I haven't had any experience of a ruptured diaphragm myself, so I can't really offer any input on that. But as far as I can understand, it sometimes have some resemblance to hernias and I had one litter of kittens many years ago, where it sadly turned out that one of them had an inguinal hernia. However we chose to not try anything, without followed the vets advice and euthanised him, they said that they could operate if I really wanted to, but that the chances for the operation to be successful in his case was very small and that even if the operation was successful, there was still a big risk for later complications.

But note, everything I've read both in my books and on the internet, states that there is a clear difference in the chances for an operation to be successful, between if it is something they're born with or whether it is the result of an injury. Because if it is something they're born with, the organs maybe have changed somehow and tissue surrounding the area might have become thicker, to adjust to the situation and then it is much more difficult to "repair". So if your puppy's condition is due to an injury, I would try to be cautiously optimistic.

{{{{{Hugs}}}}}.

P.s. Did your Google search find this http://www.emmathevet.co.uk/pettalk.asp?id=42

(From the above link, in case the link stops working)
The horseplay that went too far- An article about diaphragmatic rupture


Lulu is not only a well- known singer from the sixties but also a robust, and some would say feisty, Yorkshire terrier. Lulu went everywhere with her owners which included the twice daily trip to the stables to see her good friends Dusty and Rolo, a rather beautiful cob and an equally feisty Shetland pony. This relationship had been going for years without incident until the day that the two biggest egos in the two smallest bodies clashed!

Lulu had gone darting playfully into the paddock as was normal for her but on this day Rolo was feeling a little mischievous too. One well- timed buck saw a very shocked Yorkie sailing rather unceremoniously through the air to land some metres away. You can understand the instant horror that filled her owner. Lulu was instantly up and around and having yelped loudly as it happened seemed remarkably well, although shaken. Her owner felt her all over gently for broken bones but there appeared to be nothing obvious except some tenderness on her side, which was frankly to be expected.

Lulu’s owner kept a close eye on her while she finished her chores at the stable and apart from a little dented pride she appeared to have had a lucky escape. It wasn’t until two days later that her owner noticed that Lulu seemed a little more breathless than usual and had apparently ‘lost her bark’. It was at this point that she came to see us.

My initial clinical examination revealed little on top the slightly laboured breathing except some bruising. I commented to her owner that I also thought she looked a little sucked in at the middle. Once it was pointed out her owner agreed that she did look thinner than usual. With her history we simply had to investigate whether she had a ruptured diaphragm and the easiest way to do this is with an x-ray. The diaphragm is a large sheet of muscle in between your chest cavity and your abdomen. It moves to aid breathing and it helps maintain the vacuum necessary in the chest to allow air to be sucked in. When you get a high impact blunt trauma to the body the rise in internal pressure can rupture the diaphragm and allow the contents of the abdomen to move into the chest.

Lulu’s x-ray showed that the clear line between the two cavities was gone and there were all sorts of bits and bobs in her chest. The presence of these organs were squashing her lungs and making it more difficult to breathe. Our only option was surgery to put everything back in its rightful place.

We needed to get ourselves properly prepared because Lulu would need to be ventilated by a nurse throughout the surgery. In these cases as soon as you enter the abdomen air can rush into the chest and this makes it impossible for the lungs to expand.

Julie started the ventilation as I entered the abdomen and I started to have a look round to see what was where. I found with gentle traction that most of the liver, all of the stomach and some small intestines had been pushed into the chest. It was quite incredible. I pulled the organs gently back into the abdomen and got my first glimpse inside her chest. I was watching her lungs inflate with each squeeze of the bag and I could actually see her heart beating. This kind of thing just blows my mind!

Once all was where it should be I needed to repair the diaphragm tear and make sure the chest was air tight once again. The tears can be anywhere in the muscular sheet and in Lulu’s case her had pulled clean away from one side of her rib cage. This made my job a little trickier because there was hardly any tissue to stitch the main section to. I decided to use her ribs as an anchor point. I started at the top of the tear, which was actually her sternum because she was upside down on the table. When I ran out of tissue I looped each stitch round her rib until I got to a place where there was muscle to use. Once I was happy with the repair it was time to test it out and see if Lulu’s lungs would start to work on their own again if we stopped ventilating. We all subconsciously took a deep breath in as Julie stopped bagging her. As Lulu took her first unaided breath there was a communal out rush of air from the onlookers!

Although we had repaired the damage the surgery lets air into the chest which can make breathing as hard as the organs we have removed. This must be gradually sucked out from the outside to allow the lungs to expand gradually. In days gone by surgeons would forcibly inflate the lungs after the surgery but this was found to be potentially damaging and sometimes fatal in some cases so a more gentle approach is used now.

I placed a chest drain in Lulu’s side and we pulled off the first lot of air until we felt resistance. The drain was bandaged to her side as she started to wake up and we repeated the process of drawing off air every couple of hours until there was none coming out any more.

Animals on the whole are incredibly resilient creatures. I am always in awe of the way they seem to bounce back from major injury. They don’t have any stigmas and they don’t look for sympathy or attention (well, some do!) and their response to these things can be quite humbling. Lulu didn’t let me down either. The next morning she was standing on her back legs at the kennel door, wagging her tail and looking longingly for some breakfast. With her chest drain removed she went off home later that day. Her post- op instructions; stitches out in ten days and in future; stick to playmates of your own size!

So it can end well. Fingers crossed it will end well for your puppy too.

 

[MurphysMinder]

Can't offer any advice but I really hope your pup makes a full recovery.