Hiatal Hernia

What is it and what is the cause?

A hiatal hernia is a condition where part of the stomach lining, or the stomach wall is pulled into the chest cavity. The most common cause of hiatal hernia is increased effort in breathing in. Therefore, the most commonly affected dogs are those diagnosed with brachycephalic obstructive airway syndrome (BOAS), including Pugs, French Bulldogs and English Bulldogs.

What are the symptoms?

Dogs with hiatal hernias often regurgitate or vomit, and this is commonly associated with excitement and exercise, but can also happen at rest. The stomach acid leads to irritation of the oesophagus, leading to acid reflux (reflux oesophagitis), which can lead to yet more regurgitation. Dogs can cough up and breathe in some stomach content, so some dogs develop a cough and general signs of illness, related to pneumonia.

Investigation and treatment

A member of our internal medicine or surgical team will discuss your pet’s history and symptoms to decide a tailor-made diagnostic plan. This will include a full assessment of the mouth and upper airways, but can also include X-rays, a CT-scan, and fluoroscopy (moving X-rays). Dogs that have not had surgical management for BOAS are encouraged to correct this first, as for many dogs, this will resolve all symptoms. If the palate is the correct length, but the dog continues to have symptoms of hiatal hernia, further investigation is warranted. Surgery would involve suturing the stomach and oesophagus into the correct place within the abdomen, preventing it from being pulled into the chest.

Why has my pet been referred?

Paragon Referrals can offer state of the art diagnostic tests to ensure the correct surgery is performed to give your pet the best possible outcome. Our experienced surgeons can discuss with you how badly your dog is affected, and therefore the type of surgery that will be required. Our hospital is staffed 24h per day with vets and nurses, who can assist your pet’s recovery from surgery and anaesthesia. In addition, if your pet has a poor recovery from anaesthesia, we are staffed to offer one-on-one level of care in our dedicated ICU.


Dogs often have a good recovery from hiatal hernia surgery and the frequency of regurgitation is reduced. Some dogs do require long term medication to prevent further acid reflux.