Jun 12 2013

A Puppy Asks: Why Can’t I Breathe?

This is Lucas, a six month old Cavalier King Charles Spaniel.  Isn’t he cute!

lucas

However, Lucas has recently been vomiting a lot, and his breathing has  become more and more labored.  Now that we mention it, he has always been very quiet and well behaved for a puppy.  So, we take x-rays to try to figure out the vomiting and breathing trouble, and this is what they look like.

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Let me orient you a little so you know what you are looking at.  Little Lucas is on his back, and the x-rays are shooting through his chest cavity.  His lungs appear black on the x-ray and should be mostly symmetrical left compared to right side of the chest.  His spine is the little row of dots going down the middle of the picture, and his heart is supposed to be an oval shape in the middle of the chest.  His diaphragm, liver, and abdominal contents are supposed to stay at the bottom of the x-ray.

Lucas has a problem though.  His diaphragm has a hole in it.  He was born this way.  On the x-ray, you can see a big dark oval that is his stomach filled with gas to the right of his chest. There is white material around this big balloon, further obscuring the heart and lungs on the right side of the x-ray (which is actually Lucas’ left side, but that is neither here nor there…).  All of that white material is more abdominal contents that shouldn’t be in the chest either.

What happened is that as Lucas’ diaphragm was being formed, a hole never closed.  His stomach, spleen, and intestines slid into this tiny hole and got stuck.  He was still able to breathe, but his lungs were terribly squisted.  His stomach and intestines worked, but his food sometimes got stuck or his stomach filled with gas, causing him to vomit.  Uncorrected, this would have continued to get worse and he would have had a bad, short life.

Soooo, we took him to surgery and fixed it!  The short story is that we went into the belly, found the hole in the diaphragm, and pulled all the stomach, spleen, and intestines in the chest back through the hole.  Then we sutured the hole closed and closed up the skin incision.  After the surgery, the lungs didn’t quite know what to do with all that space, so we had to watch the puppy to make sure he could breathe.  His stomach also had a little trouble straightening out, so-to-speak, but a pro-motility agent got things moving the right way!

Lucas is now healthy and happy with all his body parts in the right place.  He is much more playful, and is very glad to be able to breathe and eat and drink like a normal puppy. This doesn’t happen too often, and it is a first for us, but we are just glad that we could make this cute little puppy’s life better.

– Doc Cleland

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