Porcine small intestinal submucosa biomaterial graft for repair of a congenital pleuroperitoneal hernia in a kitten.

In this case, porcine small intestinal submucosa (pSIS) was used to repair a large congenital diaphragmatic hernia in a kitten. The pSIS was moistened in saline, folded in half, and sutured to the remnant of the right hemidiaphragm. The animal was determined to be doing well clinically and radiographically 12 wk after procedure. At 8.5 mo of age, the kitten was spayed, and the diaphragm was inspected, revealing a thin, semitransparent membrane at the central region of the previous pSIS graft. Serial thoracic radiographs may be an effective way to reach a diagnosis of a diaphragmatic hernia if not clearly identifiable on initial radiographs. Surgeons should be prepared to use alternative techniques to close large diaphragmatic defects. Porcine SIS was demonstrated to be a strong, easy-to-use, readily available, and effective technique to close a large defect in the diaphragm with excellent results in the short and medium terms. When hernia repair is employed in juvenile animals, reassessment of the diaphragmatic repair should be considered if future abdominal surgeries, such as ovariohysterectomies, are necessary. A functional 8-ply pSIS should be considered in cats and dogs as it has a lower complication and graft failure rate. Key clinical message: When serial radiographs fail to diagnose a diaphragmatic hernia when one is highly suspected, other modalities, such as ultrasonography or other contrast modalities, should be considered. A functional 8-ply pSIS should be considered to reconstruct the diaphragm, particularly in growing animals, as it is an effective graft with low complication and graft failure rates.