What Is a Hiatal Hernia?
The diaphragm is the sheet of muscle that separates the chest from the belly. The esophagus passes through a small opening in it, called the hiatus, to reach the stomach. A hiatal hernia occurs when part of the stomach, and sometimes the lower esophagus, slides up through that opening into the chest. In many pets the hernia slides in and out, so symptoms can come and go.
Strong breed link
Flat-faced breeds like English and French Bulldogs, Pugs and Boston Terriers are most at risk, because the hard work of breathing through narrow airways pulls the stomach toward the chest. See brachycephalic airway syndrome.
Causes
- Congenital: a hiatus that is too wide from birth, often seen in young dogs and in Shar Peis
- Breathing effort: chronic upper airway obstruction in brachycephalic breeds
- Trauma: a fall or car accident that damages the diaphragm
- Other conditions: tetanus or severe chronic coughing and vomiting
Signs to Watch For
- Regurgitation, which is effortless bringing up of undigested food, unlike active vomiting
- Drooling, lip licking and frequent swallowing from acid reflux
- Gagging, coughing or noisy breathing
- Weight loss or poor growth in young dogs
- Coughing and fever, which can mean aspiration pneumonia from inhaled food
Diagnosis
Because sliding hernias move, plain chest X-rays do not always catch them. Vets often use a contrast study, where the pet swallows barium and is X-rayed or filmed with fluoroscopy, to watch the stomach slide forward. Endoscopy can show inflammation of the esophagus. Vets also rule out look-alike causes of regurgitation such as megaesophagus.
Treatment
- Medical management first: antacids, drugs that help the stomach empty, and medications that protect the esophagus
- Feeding changes: small, frequent, low-fat meals and keeping the pet upright for a while after eating
- Airway surgery: in flat-faced dogs, widening the nostrils and shortening the soft palate often improves the hernia too
- Hernia surgery: tightening the hiatus and anchoring the stomach for pets that do not respond to medication
- Weight control: extra belly fat increases pressure on the stomach
When to go now
Repeated regurgitation with coughing, fast breathing or fever needs same-day care, because aspiration pneumonia can become serious quickly.
Frequently Asked Questions
Can a dog live a normal life with a hiatal hernia?
Many do, especially mild sliding hernias managed with diet and medication or corrected with airway surgery.
Do cats get hiatal hernias?
Yes, but less often than dogs; flat-faced breeds like Persians can be affected.
Is a hiatal hernia the same as bloat?
No. Bloat is a twisting of the stomach in the belly, while a hiatal hernia is the stomach moving up into the chest.
If your pet regurgitates food often, keep a short video of the episodes for your vet. Find a veterinary clinic near you for an exam.