Diagnosis and treatment of gastro‐oesophageal junction abnormalities in dogs with brachycephalic syndrome

Abstract

Objectives To determine whether there is a benefit of using pre‐ and postoperative antacid treatment in dogs undergoing surgery for brachycephalic syndrome. To assess the use of an obstruction manoeuvre during endoscopy for the detection of dynamic gastro‐oesophageal junction abnormalities. Materials and Methods Thirty‐six client‐owned brachycephalic dogs were prospectively included in a randomised trial. Antacid treatment was randomly prescribed in 18 dogs before and after surgery while the other 18 dogs did not receive any gastrointestinal medical treatment. At presentation, at the time of surgery and at recheck, digestive clinical signs and gastro‐oesophageal junction abnormalities were assessed using specific scores. Gastro‐oesophageal junction abnormalities were assessed during endoscopy in standard conditions as well as during endotracheal tube obstruction. This manoeuvre was also applied in an unrelated control group. Results The results suggest a beneficial effect of antacid treatment on the improvement of digestive clinical signs and lesions in dogs with brachycephalic syndrome undergoing surgery. At postsurgical control 83% of dogs had a digestive clinical score ≤1 in the treated group in contrast to 44% in the non‐treated group and 39% of dogs had a gastro‐oesophageal abnormalities score (during obstruction manoeuvre) ≤1 in the treated group in contrast to 16.7% in the non‐treated group. The use of the obstruction manoeuvre during endoscopic assessment in a control group revealed that gastro‐oesophageal junction movements are negligible in healthy animals. Clinical Significance The addition of antacid treatment during the pre‐ and postoperative period for brachycephalic dogs undergoing surgery may result in a faster and greater improvement in treated dogs. The obstruction manoeuvre is an interesting technique to improve detection of gastro‐oesophageal junction abnormalities.

Evaluation of aerodigestive disease and diagnosis of sliding hiatal hernia in brachycephalic and nonbrachycephalic dogs

“…Although brachycephalic dogs were not over‐represented compared to nonbrachycephalic dogs in our population, French bulldogs and American bulldogs were the most commonly identified breeds, consistent with previous studies 11,12 . Significant differences were detected between brachycephalic and nonbrachycephalic dogs for age, respiratory distress at presentation, radiographic evidence of AP, and historical recurrent AP.…”

“…Although brachycephalic dogs were not over-represented compared to nonbrachycephalic dogs in our population, French bulldogs and American bulldogs were the most commonly identified breeds, consistent with previous studies. 11,12 Significant differences were detected between brachycephalic and nonbrachycephalic dogs for age, respiratory distress at presentation, radiographic evidence of AP, and historical recurrent AP. Interestingly, despite the severity of respiratory clinical signs in this population, brachycephalic dogs were no more likely to have pathologic reflux, increased reflux margination, regurgitation, or vomiting compared to nonbrachycephalic dogs.…”

“…Importantly, AeroD may present in the absence of GI clinical signs (CS) and with normal thoracic radiographs making clinical recognition challenging 2 . Correction of the underlying AeroD has been demonstrated to improve clinical outcome, making identification of AeroD critical for optimal case management 6,9‐11 …”

“… 2 Correction of the underlying AeroD has been demonstrated to improve clinical outcome, making identification of AeroD critical for optimal case management. 6 , 9 , 10 , 11 …”

“…2 Correction of the underlying AeroD has been demonstrated to improve clinical outcome, making identification of AeroD critical for optimal case management. 6,[9][10][11] Sliding hiatal hernias (sHH; hiatal hernia type 1) are known contributors to GI CS in dogs that have been linked to GERD, EERD, and respiratory pathology, making them an example of an AeroD. 2 Sliding hiatal hernias frequently are identified in brachycephalic dogs, with breed predispositions in French bulldogs 12 and Chinese Shar Peis.…”