Part of the stomach pushes through the diaphragm. More common in brachycephalic breeds. Here's the picture.
Hiatal hernia happens when part of the stomach pushes upward through the diaphragm into the chest cavity. In dogs, it's most commonly seen in brachycephalic breeds — connected to the broader BOAS picture in those breeds. Recognition matters, particularly for owners of at-risk breeds.
Cartilage doesn't read the front of the bag. It reads what reaches it. Here's a working overview of canine hiatal hernia.
What a hiatal hernia is
The diaphragm has an opening (the hiatus) where the esophagus passes through to reach the stomach.
In hiatal hernia, the stomach (or part of it) slides upward through this opening into the chest cavity.
Can be intermittent (sliding) or persistent.
Why brachycephalic breeds are predisposed
Brachycephalic dogs work harder to breathe. The negative pressure generated during labored breathing can pull stomach contents and the stomach itself upward.
Bulldogs, French Bulldogs, Pugs, Boston Terriers, Shar-Peis particularly predisposed.
BOAS (brachycephalic obstructive airway syndrome) management often improves hiatal hernia symptoms by reducing the negative pressure cycle.
Typical signs
Regurgitation (passive food return).
Vomiting in some cases.
Chronic gagging or retching.
Coughing, particularly after meals or at night.
Excessive salivation.
Worsened symptoms during exercise or excitement.
Some dogs are asymptomatic despite imaging findings.
Diagnosis
Chest radiographs — sometimes reveals the hernia, particularly with positional studies.
Contrast esophagrams — feeding contrast material and tracking its passage.
Fluoroscopy — real-time imaging during swallowing can show sliding hernias.
Endoscopy in some cases.
Diagnosis sometimes requires multiple imaging modalities. Your vet will direct the workup.
Treatment approaches
Medical management — acid suppression (omeprazole), prokinetics (metoclopramide), antacids.
Surgical correction — for severe or refractory cases. Procedure tacks the stomach to its normal position.
Brachycephalic airway surgery — addressing the underlying breathing issues often reduces hiatal hernia symptoms.
Dietary modifications — smaller meals, elevated feeding, avoiding food immediately before exercise.
Each case is individualized — your vet will design appropriate management.
Concurrent management for brachycephalic dogs
BOAS evaluation if not already done.
Surgical correction of upper airway issues (stenotic nares, elongated soft palate) in appropriate candidates.
Weight management — overweight brachycephalic dogs struggle more.
Heat management — these dogs overheat easily, which worsens breathing and GI symptoms.
Discuss comprehensive management with your vet.
Aspiration risk
Hiatal hernia with regurgitation creates aspiration pneumonia risk.
Monitor for coughing (particularly post-meal), respiratory symptoms, fever.
Prompt vet attention at first signs of respiratory issues.
Long-term considerations
Many hiatal hernia dogs do well with consistent medical management.
Surgical cases generally have good outcomes when appropriate candidates.
Lifestyle adaptations often needed — feeding positions, exercise timing, food consistency.
Periodic vet reassessment to confirm management is still appropriate.
Quality of life expectations
With appropriate management, most affected dogs have good quality of life.
Severe cases without management can have substantial impact on quality of life.
Catching it early and managing comprehensively gives the best outcomes.
Common questions about hiatal hernia
Is hiatal hernia related to bloat? Different condition, but both involve stomach position issues. Some breeds at risk for both.
Will my dog need surgery? Depends on severity. Many cases respond to medical management.
Can I prevent it? Genetic in brachycephalic predisposition. Weight management and airway management help.
Does my dog need a special diet? Talk to your vet — sometimes dietary modifications help substantially.
What to track at home
Regurgitation episodes — frequency, timing, characteristics.
Coughing or respiratory symptoms.
Response to medication and dietary changes.
Weight stability.
Your records help your vet evaluate management effectiveness.
Where our formulas fit
For dogs with hiatal hernia under veterinary management, soothing daily inputs may complement the medical and dietary plan your vet has designed. Pumpkin Latte exists for the hiatal hernia management under veterinary care use-case — pumpkin for soluble fiber, goat milk for natural enzymes and probiotics, blended into a single powder you can rotate in alongside meals.
Related reading
The bottom line
When you've been doing this long enough, you stop looking for the next miracle and start looking for what's been hiding in plain sight. The evidence-based ingredients have been there for decades. The marketing is what changes.