Idiopathic esophagopathies resembling gastroesophageal reflux disease in dogs

Summary

ObjectivePathologic gastroesophageal reflux (GER) has been demonstrated experimentally in dogs, and it is suspected to occur naturally in dogs, yet its clinical significance is unknown. The aim of the study was to demonstrate clinical indicators of pathologic GER in dogs with idiopathic esophagopathies. Materials and methods: Dogs with clinical signs suggestive for esophageal disease (regurgitation, ptyalism, or dysphagia) and where extraesophageal and specific esophageal diseases had been ruled out, were retrospectively diagnosed with idiopathic esophagopathies. History, physical examination findings, clinicopathologic, radiographic, and endoscopic data, and treatment results were obtained from medical records, reviewed and evaluated. Results: Out of 67 dogs with anamnestic esophageal signs, 12 (17.4%) dogs were identified as having idiopathic esophagopathies and were included in the study. Median age was 3.0 years (range 1.0–11.0), and median bodyweight was 28.2 kg (range 8.2–44.0). The most frequent anamnestic esophageal signs were ptyalism (10/12 dogs), regurgitation (8/12 dogs), signs of discomfort, pain (8/12 dogs), and cough (5/12 dogs). The most common radiographic abnormality was segmental esophageal dilation (8/12 dogs). Esophagoscopy revealed single mucosal surface defects at the gastroesophageal junction in 3/12 dogs. In dogs with altered esophageal motility, cytological and microbiological examinations of bronchial aspirates showed goblet cell hyperplasia (8/8 dogs), neutrophilic infiltration (5/8 dogs) and culturable bacteria (4/8 dogs), respectively. All dogs were treated with omeprazole (median 0.7 mg/kg once per day, range 0.5-1.2). Reported median treatment duration until remission of the main clinical signs was 20.0 days (range 8.0–54.0 days). This endpoint was reached in 11/12 dogs. Conclusion and clinical relevance: Results suggest that in some dogs with esophageal clinical signs, and where no primary disease could be identified, clinical indicators of pathologic GER such as pain, mucosal lesions and motility disturbances of the esophagus, respiratory complications, and response to therapy can be observed.

Zusammenfassung

Gegenstand und Ziel: Ein Vorkommen des in experimentellen Untersuchungen demonstrierten pathologischen gastroösophagealen Refluxes (PGR) wird bei natürlich erkrankten Hunden vermutet, aber die klinische Bedeutung ist unbekannt. Ziel der Studie war der Nachweis klinischer Indikatoren für PGR bei Hunden mit idiopathischen Ösophagopathien. Material und Methoden: Aufnahme in diese retrospektive Studie fanden Hunde mit ösophagealen Symptomen (Regurgitieren, Ptyalismus oder Dysphagie), bei denen extraösophageale und spezifische ösophageale Krankheiten ausgeschlossen worden waren. Diese Fälle galten als idiopathische Ösophagopathien. Ergebnisse der Anamnese, der körperlichen, labordiagnostischen, radiologischen und endoskopischen Untersuchungen sowie der Behandlungen wurden den Krankenakten entnommen und bewertet. Ergebnisse: Bei 12 von 67 (17,4%) Hunden mit ösophagealen Symptomen konnte eine idiopathische Ösophagopathie identifiziert und die Tiere in die Studie eingeschlossen werden. Das mediane Alter betrug 3,0 Jahre (Bereich 1,0–11,0), das mediane Körpergewicht 28,2 kg (Bereich 8,2–44,0). Die laut Anamnese häufigsten Symptome waren Ptyalismus (10/12 Hunde) und Regurgitieren (8/12 Hunde), ferner Unwohlsein oder Schmerzen (8/12 Hunde) und Husten (5/12 Hunde). Als häufigster Röntgen-befund lag eine segmentale ösophageale Dilatation vor (8/12 Hunde). Ösophagoskopisch ließen sich einzelne Mukosadefekte am gastroösophagealen Übergang (3/12 Hunde) darstellen. Bei Hunden mit gestörter Ösophagusmotilität zeigten zytologische und mikrobiologische Untersuchungen von Bronchialspülproben Becherzellhyperplasie (8/8 Hunde), neutrophile Infiltrationen (5/8 Hunde) und kultivierbare Bakterien (4/8 Hunde). Alle Hunde erhielten zur Behandlung Omeprazol (median 0,7 mg/kg einmal täglich, Bereich 0,5–1,3). Die Hauptsymptome gingen unter Therapie in median 20,0 Tagen (Bereich 8,0–54,0) zurück. Diesen Endpunkt erreichten 11/12 Hunden. Schlussfolgerung und klinische Relevanz: Den Ergebnissen zufolge finden sich bei Hunden mit idiopathischen Ösophagopathien ohne nachweisbare Primärkrankheiten klinische Indikatoren für PGR wie Schmerzen, ösophageale Schleimhautläsionen und Motilitätsstörungen sowie respiratorische Komplikationen, die bei adäquater Therapie sistieren.

Key words

Esophagus - endoscopy - radiology - supra-esophageal complication - canine

Schlüsselwörter

Speiseröhre - Endoskopie - Radiologie - supraösophageale Komplikation - kanin

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