I met Hugo, a very handsome, long-haired kitty, in April of 2018. His owner had recently adopted him from a woman who could no longer care for him. Hugo’s human dad was concerned about his breathing and some digestive issues but he was eating and otherwise acting normally.
When I examined Hugo, it seemed that he was exerting his breaths from his belly rather than from his chest. Although Hugo is not a purebred Maine Coon, he is a large framed cat, and with big cats, I always worry about their hearts since Maine Coons and other large sized cats are especially prone to heart disease. Hugo was breathing as if his heart was not working well. In cases of significant heart disease, the chest is prone to fill up with fluid, and because there is a compromise of lung space, the cat will be forced to breath with intense effort which ends up looking like they are breathing from their bellies.
When I actually listened to Hugo’s chest, however, his heart sounded completely normal. A cat with heart disease doesn’t have to have a heart murmur or irregular rhythm to have significant disease, but I thought that if Hugo were at the point of possible fluid buildup in his chest, his heart would present with abnormalities that I would pick up on my auscultation.
I had to be prepared for another scenario going on, since I was not convinced about Hugo’s having heart disease. His owners allowed me to take radiographs of Hugo’s chest. After I saw them, I was surprised that Hugo had been acting as normally as he had been. On the radiographs, it appeared that Hugo had much of his intestinal contents in his chest. This is known to happen when a diaphragmatic hernia occurs, which is a hole in the diaphragm wall which normally separates the chest and abdominal cavities and does not allow abdominal contents to slide into the chest. In Hugo’s case, however, an opening in the diaphragm allowed his organs to slide over.
Diaphragmatic hernias can occur in usually only two ways; A cat can have an extreme trauma, such as being hit by a car where the intense impact can cause a rip in the diaphragm, allowing the abdominal contents through. The other option is a congenital defect whereby the cat is born with an opening in the diaphragm which is underdeveloped. It was interesting to me that there was no mention of this on Hugo’s past history. Did the prior owner and the veterinarian not see this? We will never likely know, but now since we diagnosed the problem, let’s fix it!
I referred Hugo to a board certified surgeon for this delicate surgical procedure because there can be complications and compounding and other problems with this surgery. I wanted him to be in a place where the doctors could be ready for anything. The surgeon would have to repair the hole in the diaphragm and put the abdominal contents back into the belly. Unfortunately, we don’t know how long this situation had been going on, and when the chest is full of organs that shouldn’t really be there, they can shrink down the sizes of the lung lobes to accomodate for all this extra organ tissue. This can cause respiratory difficulties during anesthesia as well as present long term respiratory complications.
The Happy Ending
Luckily, Hugo made it through with flying colors. He recovered uneventfully and I have seen him since the surgery for other concerns. He is breathing much more normally now and his owners couldn’t be happier as they anticipate a nice long, comfortable and healthy life for Hugo!