title: Diaphragmatic hernia in horses: 44 cases (1986-2006).
abstract: OBJECTIVE
  To present a case series of horses diagnosed with diaphragmatic hernia, and to determine the significance of (1) historical information, examination findings, and laboratory data; and (2) exploratory laparotomy or necropsy findings on short- and long-term outcome.
  
  
  METHODS
  University Referral Hospital.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Forty-four horses/foals admitted between 1986 and 2006 with a diagnosis of diaphragmatic hernia made either at exploratory laparotomy or necropsy.
  
  
  METHODS
  None.
  
  
  RESULTS
  Information from the medical records included history, clinical examination findings at presentation, and findings of exploratory laparotomy or necropsy. Logistic regression or the Fisher exact test was used to determine factors associated with survival. Outcome was defined as survival to discharge (short-term survival), and long-term survival was defined as horses alive at least 1-year post surgery. Of the 44 horses, 18 died or were euthanized before surgery. Twenty-six were taken to surgery, 17 were euthanized. Nine horses recovered from anesthesia, 7 of which survived to hospital discharge. Of these, 5 were alive at long-term follow-up. Survival was significantly associated with the age of the horse (≤2 y old) at presentation, presence of normal peritoneal fluid at presentation, amount of compromised viscera at surgery (<50% small intestine), and the size (<10 cm) and location (ventral) of the diaphragmatic tear.
  
  
  CONCLUSIONS
  This study confirms that size and location of the lesion do play a significant role in prognosis. And, although the prognosis for horses with diaphragmatic hernia is poor, if horses have operable lesions there is a fair prognosis for long-term survival.
authors.affiliation: Department of Clinical Studies, New Bolton Center, Kennett Square, PA 19348, andthe Marion duPont Scott Equine Medical Center, Leesburg, VA 20176.
authors.forename: Samantha K
authors.initials: SK
authors.lastname: Hart
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Brown
mesh_terms: D000818:Animals; D004630:Emergencies / Q000662:veterinary; D005260:Female; D006548:Hernia, Diaphragmatic / Q000401:mortality / Q000662:veterinary*; D006734:Horse Diseases / Q000401:mortality* / Q000601:surgery; D006736:Horses; D007813:Laparotomy / Q000662:veterinary; D008297:Male; D012189:Retrospective Studies; D016019:Survival Analysis; D014768:Virginia
keywords: colic; diaphragm; equine; respiratory; trauma