Feline Hiatal Hernia: Vet Guide 2025 🐱🩺⚠️

Hi attentive cat parents! I’m Dr Duncan Houston BVSc 🩺. A hiatal hernia occurs when part of the stomach (and occasionally esophagus) moves through the esophageal hiatus into the chest. In cats, it’s usually congenital, but trauma or increased abdominal pressure can cause it later. This 2025 guide explains causes, clinical signs, diagnostics, treatment options (medical & surgical), prognosis, and supportive home care—all served with empathy and lots of ❤️ and emojis 😊.

🔍 What Is a Hiatal Hernia?

A hiatal hernia arises when the stomach pushes through the diaphragm’s natural opening (the hiatus) into the chest. Cats often have a Type I sliding hernia—intermittent and positional :contentReference[oaicite:3]{index=3}. It may coexist with reflux and esophagitis :contentReference[oaicite:4]{index=4}.

⚠️ Causes & Risk Factors

• Congenital—most common in kittens <1 yr old, possibly inherited :contentReference[oaicite:5]{index=5}.
• Acquired—secondary to trauma (e.g. hit by car) or increased abdominal effort (coughing, vomiting) :contentReference[oaicite:6]{index=6}.
• Concurrent reflux—acid damages esophagus, worsens hernia :contentReference[oaicite:7]{index=7}.

👂 Clinical Signs

• Regurgitation or vomiting—often after eating :contentReference[oaicite:8]{index=8}.
• Excessive drooling (ptyalism), repeated swallowing, gagging :contentReference[oaicite:9]{index=9}.
• Coughing, respiratory distress from reflux or aspiration :contentReference[oaicite:10]{index=10}.
• Weight loss or decreased appetite over time :contentReference[oaicite:11]{index=11}.
• Some cats remain subclinical unless reflux or megaesophagus develops.

🔬 Diagnosing Hiatal Hernia

• Plain X‑rays: may show soft tissue or gas behind diaphragm, esophageal dilation :contentReference[oaicite:12]{index=12}.
• Barium contrast studies: visualize sliding stomach, reflux into esophagus :contentReference[oaicite:13]{index=13}.
• Fluoroscopy: shows intermittent herniation in real-time :contentReference[oaicite:14]{index=14}.
• Esophagoscopy: directly examines esophageal lining, identifies inflammation or herniation :contentReference[oaicite:15]{index=15}.
• Thoracic ultrasound: may aid but less common.

🏥 Treatment Options

1. Medical Management

Suitable for many sliding hiatal hernias—especially Type I:

• Feed small, frequent meals; elevate bowls/head during feeding :contentReference[oaicite:16]{index=16}.
• Low-fat diets to enhance stomach emptying.
• Medications:
• Proton pump inhibitors or H₂ blockers to reduce acid :contentReference[oaicite:17]{index=17}.
• Prokinetics like metoclopramide or cisapride to boost motility :contentReference[oaicite:18]{index=18}.
• Manage reflux/esophagitis per scope findings.
• Monitor for megaesophagus or aspiration pneumonia—treat with antibiotics if present :contentReference[oaicite:19]{index=19}.

2. Surgical Correction

Indicated for persistent or severe cases (Type II–IV, paraesophageal):

• Procedures may include hiatal plication (phrenoplasty), esophagopexy, and left-sided gastropexy :contentReference[oaicite:20]{index=20}.
• Goals: reduce herniated contents, tighten hiatus, secure stomach to prevent recurrence.
• Post-op care: hospitalization, monitoring reflux symptoms, pain meds, gradual refeeding.
• Prognosis: good in uncomplicated sliding hernias; guarded if megaesophagus or pneumonia present.

📈 Prognosis & Follow-Up

• Sliding hiatal hernias respond well to medical therapy; many cats stable long-term :contentReference[oaicite:21]{index=21}.
• Surgical repair has high success when complications addressed :contentReference[oaicite:22]{index=22}.
• Regular rechecks—X-rays, scope checks, monitoring weight and symptoms.
• Untreated reflux may cause strictures, aspiration pneumonia, weight loss.

🏡 Home Care Tips

• Use **Ask A Vet app** 📱 to log regurgitation, vomiting, appetite, drooling, and medication schedule.
• Elevate bowls; offer small frequent meals of low-fat diet.
• Keep calm after meals—avoid strenuous activity.
• Watch breathing; seek vet help if coughing, wheezing, or distress starts.
• Monitor weight; contact vet if loss resumes.

📝 Key Takeaways

• Hiatal hernia in cats occurs when stomach intermittently slides into the chest.
• Signs include regurgitation, drooling, coughing, and weight loss.
• Diagnosis via imaging and scope; barium studies helpful.
• Medical management works for Type I; surgical repair for severe cases.
• Home support and early detection improve outcomes.

📞 When to Contact Ask A Vet

If your cat regurgitates frequently, drools, vomits blood, coughs persistently, or loses weight—use the **Ask A Vet app** 💬 immediately for expert guidance on care and next steps.

✨ Final Thoughts

Feline hiatal hernia can be a chronic challenge—but with prompt diagnosis, targeted treatment (medical or surgical), and nurturing home care, most cats live comfortable, happy lives. Tools like Ask A Vet, structured feeding, and monitoring give your kitty every chance at wellness ❤️🐾.