Home » Diseases » In dogs » Peritoneopericardial Diaphragmatic Hernia (Tissue Rupture between the Peritoneum and Pericardium)

Peritoneopericardial Diaphragmatic Hernia (Tissue Rupture between the Peritoneum and Pericardium) in Dogs

Occurrence: rarer
Location of illness: Abdomen/pelvis, Chest

Author: Dr. med. vet. Gisa Löwe | Last modified: 06.11.2025

A Peritoneopericardial Diaphragmatic Hernia (PPDH) in dogs is a congenitalCongenital means "present from birth" and refers to characteristics or conditions that are already present at birth. This can include genetic disorders, developmental anomalies, or infections transmitted by the mother. or acquired malformation in which there is an abnormal opening between the abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. cavity (peritoneumThe peritoneum is a thin membrane that covers the inner surface of the abdominal cavity and the outer surface of most abdominal organs. It plays an important role in immune defense and fluid regulation in the abdominal cavity.) and the sac around the heart (pericardiumThe pericardium is the sac around the heart, a double-walled membrane that surrounds the heart, protecting it from infection and facilitating its movement within the thorax / chest. Inflammatory conditions of the pericardium can lead to diseases such as pericarditis.), through which organs or tissues from the abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen. can be displaced into the pericardiumThe pericardium is the sac around the heart, a double-walled membrane that surrounds the heart, protecting it from infection and facilitating its movement within the thorax / chest. Inflammatory conditions of the pericardium can lead to diseases such as pericarditis..

The most important facts at a glance

Peritoneopericardial diaphragmatic hernia (PPDH) in dogs is often congenitalCongenital means "present from birth" and refers to characteristics or conditions that are already present at birth. This can include genetic disorders, developmental anomalies, or infections transmitted by the mother. and results from faulty development of the diaphragm during embryonic development. This malformation can cause organs to be displaced into the pericardiumThe pericardium is the sac around the heart, a double-walled membrane that surrounds the heart, protecting it from infection and facilitating its movement within the thorax / chest. Inflammatory conditions of the pericardium can lead to diseases such as pericarditis.. Genetic factors may play a role, as certain dog breeds such as Weimaraners and Cocker Spaniels are more susceptible. Acquired cases due to traumaA trauma refers to a physical injury or damage caused by external force. Traumas can range from simple cuts to severe multiple injuries. are rare. Symptoms include respiratoryRespiratory refers to breathing or the process of breathing. Respiratory diseases affect the respiratory tract and can impair the ability to breathe effectively. distress, vomiting, and circulatory weakness. DiagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. is usually made by X-rays and ultrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow. to determine the location of the organs. A CT or MRI can be used in unclear cases. Treatment depends on the severity of the condition. Often, surgical correction is necessary, especially in cases of severe symptoms. The prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is generally good with timely treatment. Early detection in predisposed breeds can help avoid complications. Research focuses on genetic factors, predictive genetic testing, and improving surgical techniques. Minimally invasiveInvasive describes medical procedures or pathogens that enter the body or penetrate tissue. In medicine, invasive procedures can range from minimally invasive techniques to open surgery. procedures show promising results. The role of environmental factors is also being investigated to develop preventive measures. Non-surgical treatment methods are also an area of research, but still in an early stage of development.

Causes

Peritoneopericardial diaphragmatic hernia is often congenitalCongenital means "present from birth" and refers to characteristics or conditions that are already present at birth. This can include genetic disorders, developmental anomalies, or infections transmitted by the mother. and results from faulty development of the diaphragm during embryonic development. The diaphragm is a thin plate of muscle and tendon that separates the chest from the abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. cavity. A malformation in this area can lead to a permanent defect through which tissue or organs can be displaced into the pericardiumThe pericardium is the sac around the heart, a double-walled membrane that surrounds the heart, protecting it from infection and facilitating its movement within the thorax / chest. Inflammatory conditions of the pericardium can lead to diseases such as pericarditis..

The exact causes for the development of PPDH are not fully understood, but genetic factors are believed to play a role. Some dog breeds may be predisposed, suggesting a hereditary component. Breeds that appear to be more susceptible include Weimaraners, Cocker Spaniels, and Persian cats, suggesting a possible genetic predispositionA predisposition is an innate inclination or susceptibility of an organism to certain diseases or conditions. In dogs and cats, there may be a genetic predisposition to certain conditions such as hip dysplasia or certain heart diseases..

Acquired cases are rarer and can be caused by traumaA trauma refers to a physical injury or damage caused by external force. Traumas can range from simple cuts to severe multiple injuries., such as strong impacts or accidents, that lead to a tear or weakening of the diaphragm. Such traumaA trauma refers to a physical injury or damage caused by external force. Traumas can range from simple cuts to severe multiple injuries. can increase the pressure within the abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. cavity and tear an existing weakness in the diaphragm, allowing a hernia to form.

Symptoms

Very common symptoms:

Common symptoms:

The symptoms of PPDH can vary greatly, depending on the size of the hernia and the organs involved. In some cases, dogs may be asymptomaticAsymptomatic means that there are no recognizable symptoms of a disease. An animal can have a disease or infection without showing visible signs, which can make diagnosis and treatment more difficult., especially if the hernia is small and no significant organs are affected. However, in larger hernias or when vital organs are affected, the symptoms can be more severe.

The most common symptoms include respiratoryRespiratory refers to breathing or the process of breathing. Respiratory diseases affect the respiratory tract and can impair the ability to breathe effectively. distress, which is caused by a reduced lung capacity due to the displacement of abdominalThe term “abdominal” refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. organs into the chest cavity. Dogs may also show signs of gastrointestinalGastrointestinal refers to the gastrointestinal tract, a system that extends from the oral cavity to the anus and is responsible for the digestion of food and the absorption of nutrients. upset such as vomiting, loss of appetite, or diarrheaDiarrhea refers to the condition of frequent, watery bowel movements, which can be a sign of infections, digestive disorders, or other health problems. if the stomach or intestines are affected.

Other possible symptoms include cough, weakness, weight loss, and in severe cases, a distended abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen. due to fluid accumulation in the pericardiumThe pericardium is the sac around the heart, a double-walled membrane that surrounds the heart, protecting it from infection and facilitating its movement within the thorax / chest. Inflammatory conditions of the pericardium can lead to diseases such as pericarditis.. In some cases, heart murmurs or irregular heartbeat may also occur if the heart is affected by the displaced organs.

Diagnosis

The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. of PPDH usually begins with a thorough clinical examination and a detailed medical historyThe medical history is the systematic collection of a patient's medical history through questioning. It includes information about previous illnesses, treatments, allergies, and lifestyle habits. to determine the symptoms and possible predisposing factors. Due to the variable and often non-specific symptoms, diagnostic imagingDiagnostic imaging includes medical procedures that create images of the inside of the body to diagnose, monitor, or treat diseases and injuries. Examples include X-ray, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). is essential.

X-rays of the chest and abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen. are often the first diagnostic measure. They can show a displacement of organs and help assess the shape and position of the diaphragm. In some cases, an ultrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow. of the heart and abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen. may be necessary to visualize the organs involved and confirm the diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients..

Another diagnostic option is computed tomography (CT)Computed tomography (CT) is an imaging technique that uses X-rays and computer technology to create cross-sectional images of the body. It enables a detailed view of bones, organs, and other structures and is used for the diagnosis of injuries, diseases, and for planning medical interventions., which provides detailed cross-sectional images and allows an accurate assessment of the anatomy. In unclear cases, magnetic resonance imaging (MRI)Magnetic resonance imaging is an imaging technique that uses strong magnetic fields and radio waves to create detailed images of the inside of the body. It is used in veterinary medicine to diagnose diseases of the brain, spine, and other organs. can also be considered to better visualize soft tissue structures.

Therapy

The treatment of a peritoneopericardial diaphragmatic hernia depends on the severity of the condition and the organs involved. In asymptomaticAsymptomatic means that there are no recognizable symptoms of a disease. An animal can have a disease or infection without showing visible signs, which can make diagnosis and treatment more difficult. cases or when symptoms are mild, conservative monitoring may be considered initially, especially if surgical risks exist.

However, in most cases, surgical correction is necessary, especially if significant symptoms are present or vital organs are affected. The surgical procedure typically involves repositioning the displaced organs into the abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. cavity and repairing the diaphragmatic defect. This procedure is demanding and requires an experienced surgeon, especially if the pericardiumThe pericardium is the sac around the heart, a double-walled membrane that surrounds the heart, protecting it from infection and facilitating its movement within the thorax / chest. Inflammatory conditions of the pericardium can lead to diseases such as pericarditis. is affected.

Postoperatively, careful monitoring is required to avoid complications such as infections, bleeding, or recurrent herniation. Most dogs recover well with timely treatment, but the recovery process can vary depending on the individual situation and complexity of the hernia.

Prognosis and follow-up care

The prognosis for dogs with PPDH is generally good if the condition is diagnosed and treated in a timely manner. In dogs that undergo successful surgical correction, most recover completely and lead normal lives.

However, the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. may be worse if the diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. is delayed or if severe complications occur, such as impaired cardiac function or severe infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease.. In such cases, treatment may be more complex and recovery more prolonged.

Long-term follow-up examinations are important to monitor the healing progress and ensure that no recurrentRecurrent refers to a disease that repeatedly returns or worsens after a temporary remission or improvement. herniation or other complications occur.

Prevention

Since many cases of PPDH are congenitalCongenital means "present from birth" and refers to characteristics or conditions that are already present at birth. This can include genetic disorders, developmental anomalies, or infections transmitted by the mother., there are no specific measures to prevent this condition. However, early detection and diagnosis in predisposed breeds or known genetic lines can help optimize treatment and avoid complications.

For acquired hernias caused by traumaA trauma refers to a physical injury or damage caused by external force. Traumas can range from simple cuts to severe multiple injuries., avoiding accidents and injuries is an important preventive measure. This can be achieved through safe keeping and monitoring of the dog, especially outdoors or in potentially dangerous environments.

Breeding dogs with a known genetic predispositionA predisposition is an innate inclination or susceptibility of an organism to certain diseases or conditions. In dogs and cats, there may be a genetic predisposition to certain conditions such as hip dysplasia or certain heart diseases. should be carefully monitored to minimize the risk of passing the condition on to future generations. Genetic counseling and testing for known genetic markers can help reduce the risk.

Outlook on current research

Peritoneopericardial diaphragmatic hernia (PPDH) is a congenitalCongenital means "present from birth" and refers to characteristics or conditions that are already present at birth. This can include genetic disorders, developmental anomalies, or infections transmitted by the mother. defect in which an opening or weakness in the diaphragm allows abdominal organs to enter the pericardiumThe pericardium is the sac around the heart, a double-walled membrane that surrounds the heart, protecting it from infection and facilitating its movement within the thorax / chest. Inflammatory conditions of the pericardium can lead to diseases such as pericarditis.. In recent years, research has focused on genetic factors that may contribute to the development of this condition. Scientists are investigating genetic markers and mutations that may be associated with a higher risk of PPDH. This research could lead to predictive genetic testing in the future, allowing breeders to exclude dogs at risk of PPDH from breeding.

Another significant area of research is the improvement of surgical techniques for the correction of PPDH. New minimally invasiveInvasive describes medical procedures or pathogens that enter the body or penetrate tissue. In medicine, invasive procedures can range from minimally invasive techniques to open surgery. procedures are being developed to shorten recovery time and reduce the risk of complications after surgery. The use of laparoscopic techniques, which require smaller incisions, shows promising results compared to traditional open surgery.

The long-term prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. of dogs undergoing surgical correction is also being intensively studied. Researchers are collecting data on the quality of life and life expectancy of dogs after treatment to provide better recommendations for follow-up care. InitialInitial means beginning or at the start. In medicine, it can refer to the first symptoms of a disease or the first phase of a treatment process. results suggest that dogs diagnosed and treated early can have a normal life expectancy.

In addition, the role of environmental factors in the development of PPDH is being explored. Researchers are investigating whether certain environmental conditions, such as the mother’s diet during pregnancy, may increase the risk of developing this hernia in puppies. These findings could lead to preventive measures to reduce the occurrence of PPDH.

There is also a growing interest in the development of non-surgical treatment methods. Researchers are exploring the possibility of developing drugs or other therapies that could alleviate the symptoms of PPDH and potentially avoid the need for surgery. However, these approaches are still in a very early stage of development.

Frequently asked questions (FAQs)

What is a peritoneopericardial diaphragmatic hernia in dogs? A peritoneopericardial diaphragmatic hernia (PPDH) is a congenital malformation in which there is an opening in the diaphragm that allows abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. organs to enter the pericardiumThe pericardium is the sac around the heart, a double-walled membrane that surrounds the heart, protecting it from infection and facilitating its movement within the thorax / chest. Inflammatory conditions of the pericardium can lead to diseases such as pericarditis.. This can lead to various health problems.
How is PPDH diagnosed? PPDH is usually diagnosed by imaging techniques such as X-rays or ultrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow.. These tests can visualize the position of the organs and the opening in the diaphragm.
What are the symptoms of PPDH? Symptoms can include respiratoryRespiratory refers to breathing or the process of breathing. Respiratory diseases affect the respiratory tract and can impair the ability to breathe effectively. distress, cough, vomiting, loss of appetite, and general weakness. However, some dogs do not show any obvious symptoms until the condition is advanced.
Is PPDH curable in dogs? Yes, PPDH can be corrected by a surgical procedure in which the opening in the diaphragm is closed and the organs are returned to their correct place. The prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is usually good if the surgery is performed early.
Which breeds are most commonly affected by PPDH? Certain breeds such as Weimaraners, Cocker Spaniels, and Persian cats (with respect to cats) show a higher incidenceIncidence refers to the number of new cases of a disease or condition that occur within a specific time period in a specific population group. It provides information about the risk of contracting the disease. of PPDH, suggesting a genetic predispositionA predisposition is an innate inclination or susceptibility of an organism to certain diseases or conditions. In dogs and cats, there may be a genetic predisposition to certain conditions such as hip dysplasia or certain heart diseases..
Can PPDH be inherited? Yes, PPDH is believed to have a genetic component, as it occurs more frequently in certain breeds. However, the exact mechanisms of inheritance are not yet fully understood.
How is PPDH treated? The main treatment for PPDH is surgical correction, in which the hernia is repaired. In some cases, conservative treatment may be considered if there are no severe symptoms.
Can dogs with PPDH live a normal life? If PPDH is successfully operated on, most dogs can live a normal, healthy life. However, follow-up care and regular veterinary check-ups are important to ensure the dog’s well-being.
Are there preventive measures against PPDH? Since the exact cause of PPDH is not fully known, there are no specific preventive measures. However, avoiding breeding dogs with known PPDH susceptibility can help reduce the risk.
What should I do if I suspect my dog has PPDH? If you believe your dog is showing symptoms of PPDH, you should see a veterinarian as soon as possible. Early diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. and treatment are crucial to ensure the best possible outcome for your dog.