High-resolution manometric evaluation of the effects of cisapride and metoclopramide hydrochloride administered orally on lower esophageal sphincter pressure in awake dogs

Kempf, Jennifer; Lewis, Fraser; Reusch, Claudia E; Kook, Peter H

doi:10.2460/ajvr.75.4.361

Cited by 30 publications

(35 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, before the adoption of the HRM in people, contrast swallow studies were used to diagnose LES achalasia and, although only moderately sensitive, were considered highly specific for this condition . Only a few manometric studies in dogs with ME have been performed, and these did not identify LES achalasia to the extent documented in our study . The response to treatment in our patient population makes misdiagnosis unlikely, and this discrepancy between our study and previous studies may reflect limitations in available diagnostic tests at the time those studies were performed.…”

Section: Discussioncontrasting

confidence: 55%

“…High‐resolution manometry is considered the gold standard for diagnosis of LES achalasia in people. Unfortunately, this modality is not routinely performed in veterinary medicine because of limited availability, high cost, need for operator expertise, and patient compliance . However, before the adoption of the HRM in people, contrast swallow studies were used to diagnose LES achalasia and, although only moderately sensitive, were considered highly specific for this condition .…”

Section: Discussionmentioning

confidence: 78%

See 1 more Smart Citation

Mechanical dilation, botulinum toxin A injection, and surgical myotomy with fundoplication for treatment of lower esophageal sphincter achalasia‐like syndrome in dogs

Grobman

Hutcheson

Lever

et al. 2019

Veterinary Internal Medicne

View full text Add to dashboard Cite

Background Megaesophagus (ME) carries a poor long‐term prognosis in dogs. In people, lower esophageal sphincter (LES) achalasia is a rare cause of ME that may respond to targeted intervention. Dogs with lower esophageal sphincter achalasia‐like syndrome (LES‐AS) have been described recently, warranting investigation of analogous targeted treatment. Hypothesis/Objectives Evaluate response of dogs with LES‐AS to LES mechanical dilation and botulinum toxin A (BTA) injections, with or without surgical myotomy and fundoplication. We hypothesized that clinical and videofluoroscopic swallow study (VFSS) features of LES‐AS would improve after treatment targeting functional LES obstruction. Animals Fourteen client‐owned dogs with LES‐AS diagnosed by VFSS. Methods Retrospective study. Dogs diagnosed with LES‐AS underwent treatment between April 2015 and December 2017. Outcome measures included client perception of clinical severity, body weight (BW), body condition score (BCS), regurgitation frequency, and VFSS parameters (ME, esophageal motility, gastric filling). Dogs with positive responses were considered candidates for LES myotomy with fundoplication. Results By a median IQR of 21 (IQR, 14‐25) days after mechanical dilation and BTA, clients reported clinical improvement in 100% of dogs, BW increased 20.4% (IQR, 12.7%‐25%), pre‐ and post‐treatment BCS was 3 (IQR, 3‐4) and 5 (IQR, 4‐5), respectively, and frequency of regurgitation decreased by 80% (IQR, 50%‐85%). Duration of effect was 40 (IQR, 17‐53) days. Despite clinical improvement, ME and abnormal esophageal motility persisted in 14 dogs. Six dogs subsequently underwent myotomy and fundoplication and maintained improvement observed after mechanical dilation and BTA. Conclusions and Clinical Importance Dogs with LES‐AS experienced significant, temporary, clinical improvement after mechanical dilation and BTA. Preliminary results suggest myotomy with fundoplication provide lasting clinical benefit despite persistence of ME.

show abstract

Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 78%

Mechanical dilation, botulinum toxin A injection, and surgical myotomy with fundoplication for treatment of lower esophageal sphincter achalasia‐like syndrome in dogs

Grobman

Hutcheson

Lever

et al. 2019

Veterinary Internal Medicne

View full text Add to dashboard Cite

show abstract

“…Management of intestinal leiomyositis in humans is supportive generally and aimed at relieving signs arising from intestinal dysmotility as well as optimizing nutritional support . Prokinetic treatment is a mainstay of treatment, and cisapride has been shown to increase the antroduodenal motility index and improve enteral feeding in people as well as to increase lower esophageal sphincter (LES) pressure and decrease gastroesophageal reflux in dogs . Metoclopramide is a less potent and effective prokinetic agent compared to cisapride in dogs .…”

Section: Discussionmentioning

confidence: 99%

Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs

Zacuto

Hill

McAlister³

et al. 2015

Veterinary Internal Medicne

View full text Add to dashboard Cite

BackgroundIntestinal leiomyositis is a suspected autoimmune disorder affecting the muscularis propria layer of the gastrointestinal tract and is a cause of chronic intestinal pseudo‐obstruction in humans and animals.ObjectiveTo characterize the clinical presentation, histopathologic features, and outcome of dogs with intestinal leiomyositis in an effort to optimize treatment and prognosis.AnimalsSix client‐owned dogs.MethodsRetrospective case series. Medical records were reviewed to describe signalment, clinicopathologic and imaging findings, histopathologic diagnoses, treatment, and outcome. All biopsy specimens were reviewed by a board‐certified pathologist.ResultsMedian age of dogs was 5.4 years (range, 15 months–9 years). Consistent clinical signs included vomiting (6/6), regurgitation (2/6), and small bowel diarrhea (3/6). Median duration of clinical signs before presentation was 13 days (range, 5–150 days). Diagnostic imaging showed marked gastric distension with dilated small intestines in 4/6 dogs. Full‐thickness intestinal biopsies were obtained in all dogs by laparotomy. Histopathology of the stomach and intestines disclosed mononuclear inflammation, myofiber degeneration and necrosis, and fibrosis centered within the region of myofiber loss in the intestinal muscularis propria. All dogs received various combinations of immunomodulatory and prokinetic treatment, antimicrobial agents, antiemetics, and IV fluids, but none of the dogs showed a clinically relevant improvement with treatment. Median survival was 19 days after diagnosis (range, 3–270 days).Conclusions and Clinical ImportanceIntestinal leiomyositis is a cause of intestinal pseudo‐obstruction and must be diagnosed by full‐thickness intestinal biopsy. This disease should be considered in dogs with acute and chronic vomiting, regurgitation, and small bowel diarrhea.

show abstract

“…Several pharmacological approaches, especially with prokinetic drugs such as metoclopramide, domperidone or cisapride, have been proposed, with modest or varying results (Washabau 2003). However, recent studies with high-resolution manometry showed that cisapride significantly increased LOS pressure in healthy dogs, and this could represent a serious concern in dogs with megaoesophagus (Kempf and others 2014, Ullal and others 2016). …”

Section: Introductionmentioning

confidence: 99%

Sildenafil improves clinical signs and radiographic features in dogs with congenital idiopathic megaoesophagus: a randomised controlled trial

et al. 2017

View full text Add to dashboard Cite

We evaluated the efficacy of oral sildenafil citrate in dogs with congenital idiopathic megaoesophagus (CIM). Twenty-one puppies were randomly assigned to two groups (treatment and control). The dogs were given sildenafil oral suspension 1 mg/kg every 12 hours for 14 days or placebo in a masked fashion. Clinical signs (frequency of regurgitation and weight gain) and oesophagrams (relative oesophageal diameter, ROD) were evaluated in order to assess the efficacy of drug treatment, by examiners who were unaware of the study protocol. In addition, a set of in vitro experiments on isolated samples of canine lower oesophageal sphincter (LOS) was performed, and the effects of increasing concentrations of sildenafil on basal tone and electrically-stimulated motility were assessed. Sildenafil administration significantly reduced the number of regurgitation episodes (0.88±1.40 v 2.65±1.56, P<0.0001) and significantly increased weight gain in the treated dogs compared to controls (79.76±28.30 per cent v 53.40±19.30 per cent, P=0.034). ROD values, at the end of the treatment period, were significantly decreased in the sildenafil group, compared to pre-treatment values (0.97±0.19 v 0.24±0.14, P<0.0001), in contrast to control subjects (0.98±0.17 v 1.10±0.25, P=0.480). In accordance with the in vivo findings, sildenafil dose-dependently reduced basal tone and increased electrically-induced relaxation of dog LOS samples. These results suggest that sildenafil citrate helps ameliorate clinical and radiographic signs in dogs with CIM by reducing LOS tone, and could represent a novel therapeutic tool for the treatment of this disease.

show abstract

High-resolution manometric evaluation of the effects of cisapride and metoclopramide hydrochloride administered orally on lower esophageal sphincter pressure in awake dogs

Abstract: Results suggested that orally administered cisapride may be of benefit in canine patients for which an increase in LES pressure is desirable, whereas orally administered metoclopramide did not affect LES resting pressures in dogs.

Cited by 30 publications

References 18 publications

Mechanical dilation, botulinum toxin A injection, and surgical myotomy with fundoplication for treatment of lower esophageal sphincter achalasia‐like syndrome in dogs

Mechanical dilation, botulinum toxin A injection, and surgical myotomy with fundoplication for treatment of lower esophageal sphincter achalasia‐like syndrome in dogs

Intestinal Leiomyositis: A Cause of Chronic Intestinal Pseudo‐Obstruction in 6 Dogs

Sildenafil improves clinical signs and radiographic features in dogs with congenital idiopathic megaoesophagus: a randomised controlled trial

Contact Info

Product

Resources

About