Reflux, aspiration and respiratory disease in dogs : clinical consideration and advances in aerodigestive diagnostics

Abstract

The aspiration of gastric contents into the respiratory tract has been associated with the development and progression of multiple respiratory diseases in humans. In veterinary medicine the term "aspiration" is considered synonymous with "aspiration pneumonia" which, while frequently encountered, does not accurately reflect the breadth of aspiration associated respiratory syndromes (AARS). In the clinical veterinary literature, the effect of alimentary dysfunction on respiratory disease (aerodigestive disease) is rarely investigated despite evidence in the human literature, animal models, and some studies and case reports linking alimentary and respiratory disease in clinical small animal patients. Aerodigestive disease is rarely investigated in veterinary medicine due to lack of clinical recognition and limitations in available diagnostics. Furthermore, AARS may be precipitated by several potentially occult alimentary disorders. Current methods of investigating aerodigestive diseases in veterinary patients are limited by sensitivity, specificity, potential for bias, cost, and availability. This necessitates investigations into advanced diagnostics to identify a potentially underrecognized patient population with AARS. Additionally, similarities in anatomy, physiology, and several pathologic disorders between dogs and humans, make experimental and naturally occurring canine models integral to translational research. Thus, evaluating dogs with aerodigestive disease may represent an area of substantial clinical relevance in human as well as veterinary medicine.