• 1.

    Poncet CM, Dupré GP, Freiche VG, et al. Prevalence of gastrointestinal tract lesions in 73 brachycephalic dogs with upper respiratory syndrome. J Small Anim Pract 2005;46:273279.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Poncet CM, Dupré GP, Freiche VG, et al. Long-term results of upper respiratory syndrome surgery and gastrointestinal tract medical treatment in 51 brachycephalic dogs. J Small Anim Pract 2006;47:137142.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Mayhew PD, Marks SL, Pollard R, et al. Prospective evaluation of surgical management of sliding hiatal hernia and gastroesophageal reflux in dogs. Vet Surg 2017;46:10981109.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Broux O, Clercx C, Etienne AL, et al. Effects of manipulations to detect sliding hiatal hernia in dogs with brachycephalic airway obstructive syndrome. Vet Surg 2018;47:243251.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Darcy HP, Humm K, Ter Haar G. Retrospective analysis of incidence, clinical features, potential risk factors, and prognostic indicators for aspiration pneumonia in three brachycephalic dog breeds. J Am Vet Med Assoc 2018;253:869876.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Hardie EM, Ramirez O III, Clary EM, et al. Abnormalities of the thoracic bellows: stress fractures of the ribs and hiatal hernia. J Vet Intern Med 1998;12:279287.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Lorinson D, Bright RM. Long-term outcome of medical and surgical treatment of hiatal hernias in dogs and cats: 27 cases (1978–1996). J Am Vet Med Assoc 1998;213:381384.

    • Search Google Scholar
    • Export Citation
  • 8.

    Rådmark T, Pettersson GB. The contribution of the diaphragm and an intrinsic sphincter to the gastroesophageal antireflux barrier: an experimental study in the dog. Scand J Gastroenterol 1989;24:8594.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Herregods TVK, Bredenoord AJ, Smout AJPM. Pathophysiology of gastroesophageal reflux disease: new understanding in a new era. Neurogastroenterol Motil 2015;27:12021213.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Martin CJ, Dodds WJ, Liem HH, et al. Diaphragmatic contribution to gastroesophageal competence and reflux in dogs. Am J Physiol 1992;263:G551G557.

    • Search Google Scholar
    • Export Citation
  • 11.

    Leonard HC. Collapse of the larynx and adjacent structures in the dog. J Am Vet Med Assoc 1960;173:360363.

  • 12.

    Hayward N, Schwarz T, Weisse C. The trachea. In: Schwarz T, Johnson V, eds. BSAVA manual of canine and feline thoracic imaging. Gloucester, England: BSAVA, 2008;213277.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Reiter AM, Holt DE. Palate. In: Johnston SA, Tobias KM, eds. Veterinary surgery: small animal. 2nd ed. St Louis: Elsevier, 2018;19351945.

    • Search Google Scholar
    • Export Citation
  • 14.

    Sivacolundhu RK, Read RA, Marchevsky AM. Hiatal hernia controversies—a review of pathophysiology and treatment options. Aust Vet J 2002;80:4853.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Prymak C, Saunders HM, Washabau RJ. Hiatal hernia repair by restoration and stabilization of normal anatomy. An evaluation in four dogs and one cat. Vet Surg 1989;18:386391.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    White RN. A modified technique for surgical repair of oesophageal hiatal herniation in the dog. J Small Anim Pract 1993;34:599603.

  • 17.

    Ellison GW, Lewis DD, Phillips L, et al. Esophageal hiatal hernia in small animals: literature review and a modified surgical technique. J Am Anim Hosp Assoc 1987;23:391399.

    • Search Google Scholar
    • Export Citation
  • 18.

    Guiot LP, Lansdowne JL, Rouppert P, et al. Hiatal hernia in the dog: a clinical report of four Chinese Shar Peis. J Am Anim Hosp Assoc 2008;44:335341.

  • 19.

    Farré R, Sifrim D. Regulation of basal tone, relaxation and contraction of the lower oesophageal sphincter. Relevance to drug discovery for oesophageal disorders. Br J Pharmacol 2008;153:858869.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Shafik A. Recognition of a gastroesophageal reflex in dogs and its role in lower esophageal sphincter competence. Eur Surg Res 1998;30:352358.

  • 21.

    Boesch RP, Shah P, Vaynblat M, et al. Relationship between upper airway obstruction and gastroesophageal reflux in a dog model. J Investig Surg 2005;18:241245.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Fenner JVH, Quinn RJ, Demetriou JL. Postoperative regurgitation in dogs after upper airway surgery to treat brachycephalic obstructive airway syndrome: 258 cases (2013–2017). Vet Surg 2020;49:5360.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Moore LE. Esophagus. In: Steiner JM, Allenspach K, eds. Small animal gastroenterology. Hannover, Germany: Schlütersche Verlagsgesellschaft mbH & Co KG, 2008;139147.

    • Search Google Scholar
    • Export Citation
  • 24.

    Hananoki M, Haruma K, Tsuga K, et al. Evaluation of lower oesophageal sphincter pressure using endoscopic manometric sleeve assembly. J Gastroenterol Hepatol 2000;15:121126.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Kahrilas PJ, Wu S, Lin S, et al. Attenuation of esophageal shortening during peristalsis with hiatus hernia. Gastroenterology 1995;109:18181825.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Bersenas AME, Mathews KA, Allen DG, et al. Effects of ranitidine, famotidine, pantoprazole, and omeprazole on intragastric pH in dogs. Am J Vet Res 2005;66:425431.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement

Circumferential esophageal hiatal rim reconstruction for treatment of persistent regurgitation in brachycephalic dogs: 29 cases (2016–2019)

View More View Less
  • 1 Department of Small Animal Surgery, School of Veterinary Medicine, Murdoch University, Perth, WA 6150, Australia.

Abstract

OBJECTIVE

To describe a technique for circumferential esophageal hiatal rim reconstruction and to report outcomes in brachycephalic dogs with persistent regurgitation treated with the technique.

ANIMALS

29 client-owned brachycephalic dogs.

PROCEDURES

Dogs that had undergone circumferential esophageal hiatal rim reconstruction between January 1, 2016, and December 31, 2019, for treatment of persistent regurgitation were identified through a search of the medical record database of The Animal Hospital at Murdoch University. Circumferential esophageal hiatal rim reconstruction involved apposition of the medial margins of the left and right pars lumbalis dorsal to the esophagus (reconstructing the dorsal margin) and ventral to the esophagus (reducing the ventral hiatal aperture and completing the circumferential reconstruction). Data collection from the medical records included preoperative, intraoperative, and postoperative (short- and long-term outcomes [≤ 14 days and ≥ 6 months, respectively]) data.

RESULTS

In all dogs, substantial laxity of the left and right pars lumbalis and failure of dorsal coaxial alignment were observed, and circumferential esophageal hiatal rim reconstruction and esophagopexy were performed. Results of short-term follow-up indicated reduced regurgitation frequency; however, 7 of 29 dogs continued to have mild regurgitation, which was attributed to esophagitis and resolved with medical management. Long-term follow-up information was available for 19 dogs: regurgitation had resolved in 16 dogs and occurred once weekly in 3 dogs. No ongoing medication was required for any dog.

CONCLUSIONS AND CLINICAL RELEVANCE

Circumferential hiatal rim reconstruction combined with esophagopexy substantially reduced regurgitation frequency in dogs of the present study, and we recommend that this procedure be considered for brachycephalic dogs presented with a history of regurgitation unresponsive to medical management.

Abstract

OBJECTIVE

To describe a technique for circumferential esophageal hiatal rim reconstruction and to report outcomes in brachycephalic dogs with persistent regurgitation treated with the technique.

ANIMALS

29 client-owned brachycephalic dogs.

PROCEDURES

Dogs that had undergone circumferential esophageal hiatal rim reconstruction between January 1, 2016, and December 31, 2019, for treatment of persistent regurgitation were identified through a search of the medical record database of The Animal Hospital at Murdoch University. Circumferential esophageal hiatal rim reconstruction involved apposition of the medial margins of the left and right pars lumbalis dorsal to the esophagus (reconstructing the dorsal margin) and ventral to the esophagus (reducing the ventral hiatal aperture and completing the circumferential reconstruction). Data collection from the medical records included preoperative, intraoperative, and postoperative (short- and long-term outcomes [≤ 14 days and ≥ 6 months, respectively]) data.

RESULTS

In all dogs, substantial laxity of the left and right pars lumbalis and failure of dorsal coaxial alignment were observed, and circumferential esophageal hiatal rim reconstruction and esophagopexy were performed. Results of short-term follow-up indicated reduced regurgitation frequency; however, 7 of 29 dogs continued to have mild regurgitation, which was attributed to esophagitis and resolved with medical management. Long-term follow-up information was available for 19 dogs: regurgitation had resolved in 16 dogs and occurred once weekly in 3 dogs. No ongoing medication was required for any dog.

CONCLUSIONS AND CLINICAL RELEVANCE

Circumferential hiatal rim reconstruction combined with esophagopexy substantially reduced regurgitation frequency in dogs of the present study, and we recommend that this procedure be considered for brachycephalic dogs presented with a history of regurgitation unresponsive to medical management.

Contributor Notes

Address correspondence to Dr. Appelgrein (c.appelgrein@murdoch.edu.au).