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New Feline Surgery Study Reveals High Recovery Rates Despite Post-Op Risks
Journal of Feline Medicine and Surgery 2025
Obi Veterinary Education
September 22, 2025
Vinciane Mertz, Marcos Garcia, Fabrice Bernard
Background
Paracostal hernias in cats are uncommon traumatic abdominal wall hernias often associated with high-energy trauma such as vehicular accidents or animal attacks. These hernias occur when abdominal muscles are avulsed from their rib attachments, potentially allowing organs to herniate under the skin. Previous literature primarily includes isolated case reports, and this study addresses the lack of comprehensive data on outcomes, complications, and the prevalence of concurrent diaphragmatic hernias in feline patients undergoing paracostal hernia repair.
Methods
A retrospective analysis was conducted on medical records of 19 cats that underwent surgical repair of paracostal hernias between January 2019 and January 2024 across multiple veterinary centers. Data collected included clinical presentation, diagnostic methods, surgical details, concurrent injuries, postoperative outcomes, and follow-up status. All surgeries used a midline celiotomy approach, and hernia repair was achieved with simple continuous sutures. Descriptive statistical analysis was used to summarize the findings.
Results
Of the 19 cats (median age: 2 years), 63% had concurrent diaphragmatic hernias. Radiography was the most common diagnostic tool, accurately identifying paracostal hernia in 89.5% of cases. The most frequently herniated organ was the small intestine. Postoperative complications occurred in 47.3% of cases, including major complications in 15.7% (3 cats) that resulted in early postoperative mortality—each of these had a diaphragmatic hernia. Minor complications included anorexia, icterus, and wound seroma. Most surviving cats recovered well, with long-term follow-up showing good outcomes in the majority of cases.
Limitations
As a retrospective study, data variability and incomplete records posed limitations. The lack of standardized quality-of-life assessments and the involvement of multiple surgeons could have influenced the outcomes. Owner recall bias may also affect the accuracy of long-term follow-up data. The small sample size limits the generalizability of findings and the ability to perform robust statistical comparisons.
Conclusions
Paracostal hernia repair in cats is associated with a generally favorable prognosis, especially when diaphragmatic hernias are absent. However, the presence of diaphragmatic hernias significantly increases the risk of postoperative complications and early mortality. Given the strong correlation between paracostal and diaphragmatic hernias, the authors recommend thorough intraoperative evaluation of the diaphragm. Despite some postoperative risks, most cats recovered well, supporting early surgical intervention following stabilization.
(a) Ventrodorsal thoracic and cranial abdominal radiograph. The red arrow highlights a discontinuity in the left abdominal wall associated with an area of tissue opacity lateral to the ribs. The diaphragmatic domes are well defined and clear, with no radiographic evidence of a diaphragmatic hernia. (b) Right lateral thoracic and cranial abdominal radiograph. The red arrow shows a discontinuity in the abdominal wall behind the sternum, with an area of dense tissue opacity ventral to the last ribs. The diaphragm is well defined with no evidence of a diaphragmatic hernia
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