Breed: domestic shorthair
Age: 5-8 years
Our 8-year-old neutered male cat has a history of various health issues: breathlessness on exertion as an adoloscent (which he outgrew); lifelong periodic diarrhea (investigated and determined to be irritable bowel/food allergies and well managed with low-dose prednisone and a special diet); and hyperthyroidism
(managed with medication). Recently, his vet heard unusual lung sounds during a regular physical,and a chest x-ray revealed a large mass, apparently in his left lung. He was referred to a specialist who made a tentative diagnosis of lung cancer, and Osiris underwent a number of tests and a surgery. The result was that he turned out to have a diaphragmatic hernia (likely congenital), and the mass was actually outside his lung and consisted of fat that had leaked up through the hole in his diaphragm. The hernia was repaired, the mass removed, and Osiris is now recovering at home. Needless to say, we are very happy at this outcome. Here, finally, is my question: is this an unusual situation? Could some of his other symptoms/medical issues be related to this? We are not second-guessing his veterinary team - just interested in understanding this situation.
Dr. Marie replied:
Wow! Your kitty has been through a lot!
I'll give you my thoughts on what you have written.
I'm guessing that the diaphragmatic hernia may have been there for Osiris' entire life. As you likely know, a diaphragmatic hernia is a hole in the diaphragm. It's possible that the hole has been there since birth. Perhaps, when Osiris was little, he had some intestines or fat protruding through the hole into the chest and that could have caused the breathing issues. It is possible that either the intestines/fat moved back into the intestines, or that his body just adapted to having them in his chest and this is why the breathing issue got better.
It is unusual to have hyperthyroidism
diagnosed at 8 years of age, but not unheard of. But, I can't connect this to his hernia issue at all.
I can totally understand how this recent situation unfolded. If I took a chest xray and saw a large unusual looking area I would certainly think of tumor as well. I'm so glad that you opted for surgery! One of the problems with lung issues is that it is difficult to get an accurate diagnosis sometimes. While some diaphragmatic hernias are obvious, many really are not. So, I don't find it surprising that this was assumed to be a tumor.
It does sound like he's had excellent veterinary care and also excellent owners to support him throughout all of this. I hope he does well!
QUIZ: Is your cat secretly planning to murder you?
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Thanks, Dr. Marie. As the surgeon explained to us, the exact location of the mass (inside or outside the lung) proved rather difficult to determine, even after xray, ultrasound and MRI. It's been a roller coaster ride of a month, let's put it that way. But because the xray showed no indication of lymph node involvement, and the other tests showed no indication of other masses, we opted for surgery, hoping that, if it was cancer, it was a primary tumour that had not spread. Osiris' vet(s) have been wonderful throughout his life. He is a terrific boy, full of energy, enthusiasm, fun and love - and worth every penny we have spent, and every tear we have shed over his health challenges! We feel incredibly lucky to have had such a positive outcome. I saw from your site that you've had a tough day in terms of sad diagnoses. I'm sure your patients' owners feel as my wife and I do - that no matter whether we get good news or bad about our pets (we have two others), our vet is right there with us, doing his best.
Dr. Marie replied:
Thanks so much for the kind words. Fortunately, in this business the good days outnumber the bad!
Thanks for sharing about your cat's interesting case. So glad all went well!