Kitten with diaphragmatic hernia - lethargic

kerfuffle

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16th Sept 2015(public holiday where I'm from!):

- found a 2 month old female kitten around 11am. fed it half a 3oz can of wet food. noticed right eye was clouded but appears healed, slight eye gunk.

-  found at 2pm sitting on belly on concrete floor under the sun and breathing rapidly. placed it in a box, shifting a lot, not putting weight on right hind leg and lower lip was pulled down exposing gums. suspect was kicked(and shock). did not get up to poop, pooped a lot.

- could not find a vet. breathing slowed down but still faster than normal.

- brought to a vet at 4pm, was performing surgery and to come back at  6pm.

- brought it to above vet at 6pm. treated cut lip, gave antibiotic and dewormed. described rapid breathing but said was normal. ignored it lying down a lot...

- ate some food and drank.

- watery poop(at least 5 times throughout the day). normal urine.

17th-20th sept:

- brought to usual vet. described yesterday's event. x ray revealed diaphragmatic hernia(left lung collapsed, stomach and liver in chest cavity, large intestines moved to middle, right femoral fracture). suggested surgery or leave it as is as bodily functions normal. cut lip and eye was healing, so not a major concern. nothing prescribed.

- noticed tiny patches of red skin on abdomen after vet visit, growing larger day by day.

- exploring my home. putting some weight on right hind leg.

- in total ate about 3-4 teaspoonfuls of wet food a day. drank water.

- normal urine.

- 17th-19th: poop starting to solidify. (2 times)

- 20th: tiny streaks of blood in poop (1 time)

- 21th(2am): patches of blood in poop (1 time)

21th sept:

- ate 1/2 or 1 teaspoonful during the night(between 3am-10am).

- brought to usual vet(10am, waited until 12pm...). described bloody poop and red skin on abdomen(which by now is a large patch). Said has trapped gas in body and bruising is starting to show few days after accident, which is normal(is it?) for accidents. lost 50g of weight. prescribed metrogel syrup(0.2ml, 2 times a day) and to feed royal canin gastro intestinal wet food(had choice of i/d as well, but royal canin was cheaper). 

- lethargic. First time curling up to sleep! (previously it would just lie on its side.)

- brought it to work

- (after vet visit onwards)ate about 2 teaspoonfuls of wet food. (had to force feed the intestinal type during work and when we came back home, ate normal wet food on its own and ignored the intestinal type which was right beside...)

- gave 0.2ml(prescribed amount) of metrogel syrup around 7pm

- urine darker yellow (was out the whole day and only peed when it had its toilet)

- poop super watery with a semi-solid lump near the end of pooping. (only when it had its toilet)

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Should I force feed it more? It ate on its own that one time today but I don't think it's enough. But I think it knows how much its stomach can take right now... Today's event probably stressed it out as well, and holding in its poop and pee...maybe that's why it's lethargic? It's 2 months old. How much should a kitten this age eat? And what about when it's sick? 

Also, should I go ahead with the surgery? It's a 50/50. I asked if she were older if the chance would be better. Short answer is no. Long answer is that it would complicate the surgery when she's older as her internal organs would fuse with her muscle lining(or something like that). Spaying won't be an issue if the DH is left alone when she's older.
 

red top rescue

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If she were mine, I would go ahead with the surgery.  If she makes it, then she has a chance to heal and grow up into a normal cat.  If she doesn't make it, you spare her a lot of suffering.  With the hernia and fractured femur, she was obviously either hit by a car or abused -- in any case, she is obviously in pain with a collapsed lung and her intestines in her chest cavity.  If the vet thinks she can be repaired, then by all means try. She may have damage to her intestines too and they can check for that when they are inside.  If they discover something that cannot be fixed, at least you can choose to let her go while she is already asleep. She is a fighter or she would not have made it this far.

Oh, and PS - WELCOME TO THE CAT SITE!  Do let us know how this comes out.  We care.
 
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kerfuffle

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She's not displaying any signs of pain other than a slight limp in her walk. Her breathing is practically normal now but she breathes a little harder when she purrs. Overall she appears normal, the other patrons at the vet thought that her eye was the problem but they couldn't see the underlying problem without being told. She'll be indoor only, along with my 1 1/2 year old cat who's slowly warming up to her. They sat within a foot of each other for awhile and my older cat hissed and ran off. The kitten has never made any attempt to fight.)

I left a heaped tablespoon of food(mixed 2:1 gastrointestinal to normal wet food) during the night and this morning it's all gone. I put another heap in and she straight away ate and almost finished it. I think the ordeal yesterday just wore her out. She pooped again and its back to mushy poop, no blood. (Probably discharging the damaged parts in the body?)
 

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I don't think this is a problem that can be ignored or left for any time. My Persil had the same thing (probably genetic in her case) at 4 months old, and from lethargy she developed rapid breathing and panting and eventually stopped eating. Xray showed all her organs were up in her chest and her diaphragm had completely ruptured. One vet wanted to put her down, but I found another who would operate though he gave her only a 20% chance. We went ahead and she pulled through. Since then she has lived a completely normal life and she is now 11 years old. So I would go with t he surgery as soon as possible - a cat cannot live long with this condition.
 
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kerfuffle

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I kinda forgot this in my worry: Thanks for the welcome :)

Sorry for the lack of update as well. But just a few days after picking up this kitten, my senior cat at my parents' developed CKD but unfortunately did not make it... I grew up with her. It's a sad loss but she was already in stage 3 when I noticed(I go back occasionally). Life goes on...

The kitten has had a successful surgery but one of the vet who operated on her(there were 2) told me that they actually lost her at one point but managed to resuscitate her. The reason why the surgery was delayed was so that they can spay her at the same time which helps with not having to open her up a second time when she matures in a few more months. I was told that this is the youngest age(3 months) they've spayed at. The previous one was at 4 months old, which was also with another major surgery at the same time. 

She was in awful mood for a whole day after the surgery, I guess it's from adjusting to how her internal organs are no longer in their formerly "normal" place. It's now the 4th day since her surgery and she's adjusted well, she's started playing with a toy I left in her crate. She's practically like a normal cat now, eating well and pooping normally too except her belly is now bigger than her rib cage whereas previously it's the other way around.
 

red top rescue

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I am SO happy to hear she had surgery and is okay now.  When people just disappear from the site for a month, we often assume that means bad news, and it's wonderful to hear that things turned out OK.  This will be useful to others who may find the thread in the future, to see that you and @JennyR did have kittens with diaphragmatic hernias and had successful surgeries.  Thanks for the update.  Also, I'm sorry for your loss of your senior cat at your parents house.  If you would like to write a tribute to her, please go to the "Crossing the Bridge" forum and write something and post her picture.  I'm glad you only had one loss to deal with and not two, and the kitten you rescued is going to recover. 
 

carinajosefine

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So glad to hear she had the surgery, and is doing well! My dog also had this surgey, and I did not know till after, how serious the conditon was. When I told about it on a group for canine epilepsy quite a few people came forward telling about how their dog either died from waiting too long, or barely made it due to realising too late what was going on. From what I understand its not a surgery that should be put off. My dogs heart also stopped on the operating table. Thankfully I didnt know this untill the worst was over. He recovered quite fast, considering.

Im so sorry about the loss of your senior cat :(
 

jennyr

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I am sorry for your loss, but so glad about the kitten. People need to know about this condition - it is often not diagnosed till too late, and then vets often refuse to do the surgery. Not all vets even consider it as a genetic condition - when I first got the diagnosis I was accused of kicking or throwing my cat and causing the problem, and I got the impression that they wanted to put her down almost to punish me. Fortunately I was in the university vet hospital and there was one vet there who realised my distress and offered to operate. Persil has had a great life since, with no problems now for over 9 years.
 

carinajosefine

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I am sorry for your loss, but so glad about the kitten. People need to know about this condition - it is often not diagnosed till too late, and then vets often refuse to do the surgery. Not all vets even consider it as a genetic condition - when I first got the diagnosis I was accused of kicking or throwing my cat and causing the problem, and I got the impression that they wanted to put her down almost to punish me. Fortunately I was in the university vet hospital and there was one vet there who realised my distress and offered to operate. Persil has had a great life since, with no problems now for over 9 years.
Oh can in really be a genetic condition? When my dog had this, they were so stubborn saying he must of been hit by a car or had something else hard hit him. I swear he hadnt, he never leaves my sight, and he is never out alone. No one had been meat to him either. It left me so confused and I felt accused of hiding information from them. I never knew it could be a genetic thing, allthough it crossed my mind, as he was born with other types of hernias. Thanks a lot for this!
 

jennyr

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Yes, it is rare, but it happens. The animal is born with a hole in the diaphragm that gradually gets larger as it grows. Then it ruptures, either through stress like a fall or just because the hole gets too large and it tears. I felt awful when they accused me of hurting my cat, I knew she had never been mistreated. And when you are already going through the trauma of possibly losing your pet, the last thing you need is to be told it is your fault.
 
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