Long-term outcome of medical and surgical treatment of hiatal hernias in dogs and cats: 27 cases (1978-1996)

Abstract

Objective - To determine long-term outcome of medical and surgical treatment of hiatal hernia (HH) in dogs and cats. Design - Retrospective case series. Animals - 22 dogs and 5 cats. Procedure - Medical records of dogs and cats with HH were reviewed. Outcomes of treatment were obtained from reexamination or owner questionnaires. Results - The most common breeds affected were English Bulldog and domestic shorthair cat. Mean age of all dogs and cats was 4 years. Hiatal hernia was diagnosed by use of contrast radiography of the esophagus (n = 19), fluoroscopy (7), or esophagoscopy (1). Eight of 15 dogs and cats treated medically for 30 days had complete resolution of signs. Of the 7 in this group that did not respond, 1 died on the 10th day of medical treatment and the remaining 6 were treated surgically. Eight of 10 dogs that underwent hiatal plication, esophagopexy, and gastropexy responded favorably. Four of 7 dogs that underwent fundoplication did well. However, 3 of these dogs did not have clinical signs. Fundoplication was successful in only 1 of 4 dogs with clinical signs. Clinical Implications - Dogs and cats with clinical signs of reflux esophagitis associated with HH should undergo conservative treatment for 30 days. Most will be managed successfully by use of drugs, dietary alterations, or both. Those that do not respond to conservative treatment will likely require surgery. The best prognosis after surgery appears to be associated with the esophagopexy technique.