Download 4 month old, Feline, Persian Senna was brought in

Senna
4 month old, Feline, Persian
Senna was brought in to Nine Mile Veterinary Hospital to see veterinary
surgeon Jonathan. Senna’s breathing was gradually becoming faster and
more effort was being required to breathe. A blood sample was taken to
test for an airway infection and to check that Senna did not have a problem
with his blood that would make it harder for him to transport oxygen from
his lungs to the rest of his body. Fortunately these came back normal.
Following this result investigations were continued and chest x-rays were
performed. Other common conditions in cats that can cause breathing
problems include cat flu, fluid within the chest (pleural effusion), asthma,
heart disease and cancer. However Senna’s x-rays surprised us all!
Very large outline of heart
Gas filled intestines in the position
where the liver should be
The above x-ray shows that Senna’s heart appears to be massively
increased in size! However, on further inspection there is a loss in the
definition of the outline of the diaphragm. The diaphragm is the large
muscle that separates the chest cavity from the abdominal cavity. These
findings are very suggestive of a rare congenital (‘birth deformity’)
condition called a peritoneo-pericardial diaphragmatic hernia (PPDH). The
peritoneum is a thin clear membrane that lines the inside of the abdominal
cavity, almost like a layer of Clingfilm. The pericardium is a similar
‘Clingfilm-like’ membrane that lies over the outside of the heart. In a
normal cat these two Clingfilm membranes are separated by the diaphragm
muscle. But in Senna, a fault had occurred with the development of his
diaphragm when he was in his mother’s womb, leaving him with a large
hole in the middle of his diaphragm. This meant there was a connection
between his pericardium and his peritoneum so there was nothing
separating his abdominal organs and the sac that contains his heart!
An ultrasound scan revealed why Senna’s heart appeared to be so big. Not
only was his heart inside the pericardium sac but his liver was also in there
as well! So as well as his heart and lungs being inside his chest cavity… his
liver was there too. This therefore meant there was less room for his lungs
to expand and explained why he was having difficulty breathing.
Image from Wikipedia.com
Normal anatomy of the cat shows the heart and liver are separated by the diaphragm.
Surgery was required to repair the defect in his diaphragm. Senna was
anaesthetized and the surgery was performed by veterinary surgeons
Nicola and James. An incision was made into Senna’s abdomen allowing
them to see through the hole in the diaphragm into the pericardial sac
where the liver was sat, next to the beating heart.
Hole in the diaphragm – looking through at the heart.
The liver was gently pulled back through the hole into the abdominal cavity
taking care not to damage the heart in the process. The abdominal organs
where then rearranged to allow the liver to sit back into it’s normal
position. The defect in the diaphragm was then sutured closed to separate
the chest and abdominal cavities.
Hole in diaphragm sutured closed.
After the surgery a follow up x-ray was taken to confirm everything was
back where it should be. Compare this x-ray to the previous one and notice
what the normal size of the heart should be!
Actual size of Senna’s heart
Skin staples
Following surgery Senna was closely monitored all night to ensure he did
not have any problems with his breathing. Thankfully Senna made a
brilliant recovery from the surgery and even wanted to play with his toys
the next day! His breathing has returned to normal and he is able to live a
normal, happy life playing with his brother Freddy.