Luna – Diaphragmatic rupture

Luna is a 2.5-year-old cat who initially presented to our out-of-hours team in the evening as she was struggling to breathe. Initial bloods were unremarkable and radiographs were consistent with a ruptured diaphragm. Luna was stabilised overnight with pain relief and oxygen and referred to Samantha Lane in the surgical referral team for further investigations.

Luna was very unstable and full clinical examination was limited due to her deteriorating breathing effort and pattern. Due to this, a decision was made to proceed to surgery as soon as possible. Luna was anaesthetised and once her abdomen had been clipped a large amount of bruising around her ribs was present consistent with trauma. On surgical exploration, a combination of circumferential and radial tears were noted and the right side of the liver was in the thorax. The liver was gently returned to the abdomen and no abnormalities of the liver were noted. The lungs were visible through the diaphragmatic rupture and were inflating well.

The diaphragm was sutured back to a normal position and remaining air was drained from the thorax via a catheter placed into the thorax as the final sutures were tied. As the hernia was closed, ongoing pneumothorax formation was not expected so a thoracic tube was not placed in this case.

Luna was recovered from her anaesthetic under close supervision and strong pain relief was given in the post-operative period. The following day, Luna was much more comfortable and her breathing had returned to normal. She was discharged from the hospital and has recovered well at home.

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