Diaphragmatic hernia in horses in Israel: A case series

Diaphragmatic hernia (DH) is possibly more frequent in the horse than typically reported in the literature. Since DH is not as rare as perceived, reporting on its occurrence is critical in order to increase awareness of this problem. DH typically presents as an emergency situation, whose prompt treatment influences the prognosis. Thus, it should be included in the differential diagnosis of horses presenting with signs of colic or of respiratory distress, or with a combination of the two. The aims of this study were to determine the prevalence of DH cases at the Veterinary Teaching Hospital of the Koret School of Veterinary Medicine and to describe the clinical signs, case management and outcome of these cases. The equine medical records of our hospital for January 2008 – August 2012 were reviewed. The information retrieved included chief complaints, mode of diagnosis, physical characteristics of the hernia, organs found in the thorax, treatment, results and, where relevant and pathology report. The number of DHs was compared to the hospital’s caseload and colic surgeries during the reference period. Four horses were presented with DH in the reference period constituting 0.46% of all surgeries and 1.29% of all colic surgeries in the reference period, and 0.14% of the annual referral figure. Three of the four cases showed signs of colic with respiratory symptoms, whereas the fourth presented only acute respiratory distress. The survival rate was 25%, one patient being successfully treated. The prevalence of DH was found to be more frequent at the KVSM-VTH than previously reported. Early diagnosis and a suitable surgical approach proved essential to the successful surgical repair of DH, but the overall survival rate remained low.