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Background Salivary bile acids are used to diagnose extraesophageal reflux (EER) and to evaluate the risk of reflux aspiration that is associated with respiratory diseases in dogs. Objectives To study total bile acid (TBA) concentrations in saliva and in bronchoalveolar lavage fluid (BALF) to investigate EER and reflux aspiration in dogs with respiratory diseases and in healthy dogs. Animals  Thirty‐one West Highland White Terriers (WHWTs) with idiopathic pulmonary fibrosis (IPF), 12 dogs with inflammatory airway disease (IAD), 6 dogs with recurrent pneumonia (RP), 26 brachycephalic dogs (BD), 27 healthy WHWTs (HW), 52 healthy dogs (HD). All privately‐owned dogs. Methods Saliva and BALF were collected from dogs in each group. Results Salivary TBA concentrations were higher in IPF (median 0.1692 μM, interquartile range [IQR] 0.1115‐0.2925 μM, Cohen's d 3.4, 95% confidence interval [CI] 2.2‐4.0, P < .001) and BD (0.0256 μM, IQR 0.0086‐0.0417 μM, d 0.5, CI −0.1 to 1.1, P = .003) compared to HD (0 μM, IQR not quantifiable [n.q.]‐0.0131 μM). Bronchoalveolar lavage fluid TBA concentrations were higher in IPF (0.0117 μM, IQR 0.0048‐0.0361 μM, d 0.5, CI 0‐1.1, P < .001) compared to HD (0 μM, IQR n.q.‐0.0074 μM). Conclusion and Clinical Importance Extraesophageal reflux and reflux aspiration occur in healthy dogs and those with respiratory diseases.

Background Idiopathic esophageal dysmotility (ED) is increasingly recognized in young dogs of brachycephalic breeds. Few studies have objectively associated specific videofluoroscopic swallowing study (VFSS) features with brachycephaly, leading to under‐recognition of ED in brachycephalic breeds. Hypothesis/objectives To describe and compare VFSS in brachycephalic dogs versus non‐brachycephalic dogs presented for dysphagia or regurgitation, and to investigate associations between these imaging findings and patient signalment. Methods Retrospective analysis of VFSS of dogs presented for dysphagia or regurgitation (not megaesophagus) from 2006 to 2017. Cases were divided into brachycephalic and mesaticephalic breeds. The VFSS were reviewed using a standardized protocol by 2 examiners. Esophageal motility was assessed using specific criteria, and particular imaging features were noted and graded. Fisher's exact test was used to determine associations among signalment (including brachycephaly), final diagnosis, outcomes, and ED features. Results Thirty‐six dogs were included (n = 10 normal, n = 26 presumed ED). Twenty dogs (77%) with presumed ED were brachycephalic with a median age of 1 year (range, 0.2‐10.5 years). Most common were prolonged esophageal transit time (ETT; n = 21/26), decreased propagation of secondary peristaltic waves (n = 20/26), and gastroesophageal reflux (GER; n = 18/28). Eight dogs (all brachycephalic) had hiatal herniation (HH). Morphological esophageal variations were only observed in brachycephalic dogs. Brachycephaly was significantly associated with ED (P = .005), prolonged ETT (P = .41), GER (P = .02), and HH (P = .03). Conclusions and Clinical Importance The majority of dogs with presumed ED was young and brachycephalic and had specific abnormalities that were less frequent in mesaticephalic dogs with regurgitation or dysphagia.

Background Reflux and aspiration in people are associated with respiratory disease, whereas approximately 50% of healthy adults microaspirate without apparent consequence. In dogs, analogous information is lacking. Hypothesis Healthy dogs commonly have gastroesophageal reflux and a proportion of these dogs will have laryngopharyngeal reflux with silent aspiration. Animals Twelve healthy, client‐owned dogs. Methods Prospective study: Dogs were free‐fed a meal containing (111 MBq) colloidal 99m‐technetium phytate. Dynamic‐scans were performed 5 and 30 minutes postingestion. Time‐activity curves, reflux margination, volume, frequency, and duration were evaluated over 7 regions of interest in dorsal ± left‐lateral recumbency. Static scans (dorsal recumbency) were performed 2 and 18 hours postfeeding to detect aspiration. Reflux and aspiration were defined as counts ≥200% background activity ± decreased gastric counts. Between‐group comparisons were performed by Wilcoxon rank‐sum test or one‐way ANOVA on ranks with significance of P < .05. Results In this study, reflux of variable magnitude was detected in 12/12 dogs. No significant differences in outcome parameters were detected with recumbency (P > .05). Margination to the pharynx and proximal, middle, and distal esophagus was identified in 5/12, 2/12, 3/12, and 2/12 dogs, respectively. Median (IQR) reflux frequency and duration were 2 events/5 minutes (1‐3.3 events/5 minutes) and 6 seconds (4‐9 seconds) respectively. No dog had detectable aspiration. Conclusions and Clinical Importance Nuclear scintigraphy can document reflux in dogs. Reflux, but not aspiration, is common in healthy dogs and must be considered when interpreting results in clinically affected dogs.

Background Gastroesophageal reflux and microaspiration (MA) of gastric juice are associated with various human respiratory diseases but not in dogs. Objective To detect the presence of bile acids in bronchoalveolar lavage fluid (BALF) of dogs with various respiratory diseases. Animals Twenty‐seven West Highland White Terriers (WHWTs) with canine idiopathic pulmonary fibrosis (CIPF), 11 dogs with bacterial pneumonia (BP), 13 with chronic bronchitis (CB), 9 with eosinophilic bronchopneumopathy (EBP), 19 with laryngeal dysfunction (LD), 8 Irish Wolfhounds (IWHs) with previous BPs, 13 healthy WHWTs, all privately owned dogs, and 6 healthy research colony Beagles Methods Prospective cross‐sectional observational study with convenience sampling of dogs. Bile acids were measured by mass spectrometry in BALF samples. Total bile acid (TBA) concentration was calculated as a sum of 17 different bile acids. Results Concentrations of TBA were above the limit of quantification in 78% of CIPF, 45% of BP, 62% of CB, 44% of EBP, 68% of LD, and 13% of IWH dogs. In healthy dogs, bile acids were detected less commonly in Beagles (0/6) than in healthy WHWTs (10/13). Concentrations of TBA were significantly higher in CIPF (median 0.013 μM, range not quantifiable [n.q.]‐0.14 μM, P < .001), healthy WHWTs (0.0052 μM, n.q.‐1.2 μM, P = .003), LD (0.010 μM, n.q.‐2.3 μM, P = .015), and CB (0.0078 μM, n.q.‐0.073 μM, P = .018) groups compared to Beagles (0 μM, n.q.). Conclusion and Clinical Importance These results suggest that MA occurs in various respiratory diseases of dogs and also in healthy WHWTs.

Background Perioperative lidocaine treatment is commonly used in horses that undergo surgical treatment of colic, to prevent or treat postoperative ileus and reduce the effects of intestinal ischaemia-reperfusion injury. However, its clinical efficacy has not been evaluated in a large population of horses undergoing small intestinal surgery. The aim of the current study was to evaluate whether systemic lidocaine administration reduced the prevalence, volume and duration of postoperative reflux and improved rates of survival following surgical treatment of small intestinal lesions. Data were collected as a part of two prospective studies investigating postoperative survival of surgical colic patients admitted to a UK equine referral hospital during the periods 2004–2006 and 2012–2014. Kaplan-Meier plots of cumulative probability of survival and the log-rank test were used to compare survival between horses that did or did not receive lidocaine. The Wilcoxon rank-sum test was used to compare the total reflux volume and duration of reflux between the groups. A multivariable Cox proportional hazards model was used to identify pre- and intraoperative risk factors for non-survival. Results Data from 318 horses were included in the final analysis. The overall prevalence of postoperative reflux was 24.5 %. This was significantly higher (34.8 %) in horses admitted in 2012–2014 compared to the 2004–2006 cohort (16.7). Perioperative lidocaine treatment had no effect on total reflux volume, duration of reflux or rates of postoperative survival nor was it a risk factor associated with altered postoperative survival. Variables identified to be associated with increased risk of postoperative mortality included packed cell volume on admission (hazard ratio [HR] 1.03 95 %, 95 % confidence interval [CI] 1.004–1.06, p  = 0.024), heart rate on admission (HR 1.014, 95 % CI 1.004–1.024, p = 0.008) and duration of surgery (HR 1.007, 95 % CI 1.002–1.01, p  = 0.008). Conclusions Lidocaine therapy had no effect on the prevalence of postoperative reflux, total reflux volume and duration of reflux nor did it have any effect on postoperative survival in horses undergoing surgical management of small intestinal disease for treatment of colic. There is a need for a well-designed multicentre, prospective randomised controlled trial to fully investigate the efficacy of lidocaine across different hospital populations.

Gastroesophageal reflux is a latent factor that may cause esophagitis, esophageal stenosis, and aspiration pneumonia through the regurgitation of the gastric fluid contents. For laparoscopic surgery, posture-changing and pneumoperitoneum operations are conducted to develop the visual field. However, few studies have examined the influence of these operations on gastroesophageal reflux. In this experiment using 10 Beagles, 10 mL of contrast medium was administered into the stomach, and the dogs were placed in the Trendelenburg position with 10-degree tilting. Pneumoperitoneum treatment with carbon dioxide was performed, with an intraperitoneal pressure of 10 mmHg. The presence or absence of gastroesophageal reflux was evaluated using computed tomography (CT). In horizontal and Trendelenburg positions, there was no reflux of Contrast medium. However, reflux was observed in the Trendelenburg position under pneumoperitoneum (p<0.05). These results suggest that the risk of gastroesophageal reflux increases during laparoscopic surgery in the Trendelenburg position with 10-degree tilting under an intraperitoneal pressure of 10 mmHg.

This research aimed to determine the value of esophageal pH in awake and anesthetized dogs, to evaluate the esophageal pH value in awake dogs, in different body positions, as well as to study the occurrence of gastroesophageal reflux episodes in these positions. Thus, 40 healthy male and female adult dogs with mean body weight of 15.5 ± 4.6 kg were used. Esophageal pHmetry was conducted by inserting a catheter through the oropharynx in 30 dogs (stage 1) anesthetized with acepromazine, propofol and isoflurane, submitted to elective ovariosalpingohysterectomy. In addition, 8-h esophageal pHmetry was carried out transnasally in 10 awake dogs (stage 2), allowed to move and change body positions (lateral and sternal decubitus, and standing position), which were recorded. The mean esophageal pH value was lower ( p  < 0.01) in the anesthetized dogs (7.3 ± 0.82) than in the awake dogs (8.2 ± 0.3). Only four anesthetized dogs (13.33%) suffered reflux episodes. Reflux was not observed in the awake dogs and no esophageal pH differences were found between the body positions studied. Compared to the alert state, general anesthesia in dogs submitted to the previously mentioned anesthesia protocol causes esophageal pH reduction and predisposes to the occurrence of gastroesophageal reflux episodes. Transnasal pHmetry of 8 h in healthy awake dogs reveals that the esophageal pH value is alkaline and does not vary according to body position. In these animals, decubitus position is not a determining factor for reflux episodes to occur.

A 7-mo-old female cougar (Puma concolor) was presented with a 2-wk history of anorexia and a 1-wk history of regurgitation. Barium contrast esophagogram and gastroesophagoscopy revealed the presence of a segmental intraluminal esophageal stricture in the middle third of the esophagus. The stricture was potentially secondary to a previous anesthetic episode. Three endoscopic balloon dilations allowed increasing the luminal diameter to a size that enabled the cougar to eat food softened with water without any signs of discomfort or regurgitation. Two months after being discharged, the cougar was doing well, had gained weight and was eating horsemeat softened with water.

Chronic esophagitis due to gastroesophageal reflux (GER) is rarely reported in the cat. This paper describes the clinical signs and diagnostic findings, including radiographic, endoscopic, and histopathological abnormalities, in three young, purebred, male cats with esophagitis presumed to be secondary to GER. Clinical signs included regurgitation, dysphagia, and weight loss. Contrast radiography revealed GER, esophageal dilatation, and decreased motility. Endoscopy showed hyperemia, increased vascularity, ulcers, erosion, and an abnormal lower esophageal sphincter. Histopathological lesions included squamous hyperplasia and dysplasia, erosions, ulcers, and an inflammatory infiltrate of lymphocytes, plasma cells, and neutrophils. Long-term follow-up demonstrated progression of the disease in two of the cats.

One hundred and five wild-caught emerald tree boas (Corallus caninus) were added to a collection of 15 others, in Central Florida, during a 4-mo period. Eighty-one boas (67%) developed repetitive regurgitation during the 23-mo period after the initial introduction, and 61 (75%) of these died. Regurgitation occurred 3–4 days after feeding. Prevalence of regurgitation in this population of snakes was 25%/mo (range 0–42%), and incidence was 3.52/mo (range 0–13/mo). The cumulative mortality for those boas developing repetitive regurgitation (61 of 120) during the 23-mo epizootic was 51%. Hematologic findings included anemia and leukocytosis, with lymphocytosis, monocytosis, and azurophilia. Histologic evaluation of the gastrointestinal tract showed multifocal to diffuse lymphoplasmacytic inflammation with granuloma formation and positive immunohistochemical staining for chlamydial antigen. Electron microscopic evaluation of granulomas showed organisms consistent with Chlamydophila sp.