Zack, a 9 week old Pomerian 500gm pup was presented with sudden shortness of breath and vomiting. There was no history of eating a foreign body.
Tapping a finger on the chest wall gave a dull sound instead of a nice hollow sound.
Zack's colour was slightly blue and he had great difficulty getting his breath. He was placed on oxygen and a quick chest x-ray showed loss of detail- the heart and lungs were not visible and in their place was a solid mass with gas shadows. We suspected a diaphragmatic hernia.
The diaphragm is a flat muscle sheet that keeps the contents of the abdomen (liver, intestines, stomach etc.) out of the chest where the lungs and heart reside. When breathing, the diagram moves backwards and forwards and helps the lungs breath.
In Zack's case, his diaphragm had been torn and the liver and small intestines were in the chest cavity squashing the lungs and heart. These hernias often happen after massive trauma e.g. hit by car, falling from a height, being trodden on.
We anaesthetised Zack after placing him on a drip and one of our nurses did the breathing for him by gently filling and squeezing the re-breathing bag.
We kept the chest drain in place and removed 10mls of fluid twice a day for the first 2 days. On day 3, there was no fluid so the drain was removed.
Zack made a great recovery and at stitches out 10 days later, he was barking and trying to jump up on our legs to say hello.