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Bell SM, Evans JM, Greif EA, Tsai KL, Friedenberg SG, Clark LA. GWAS using low-pass whole genome sequence reveals a novel locus in canine congenital idiopathic megaesophagus. Mamm Genome 2023; 34:464-472. [PMID: 37041421 PMCID: PMC10600401 DOI: 10.1007/s00335-023-09991-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/29/2023] [Indexed: 04/13/2023]
Abstract
Congenital idiopathic megaesophagus (CIM) is a gastrointestinal disorder of dogs wherein the esophagus is dilated and swallowing activity is reduced, causing regurgitation of ingesta. Affected individuals experience weight loss and malnourishment and are at risk for aspiration pneumonia, intussusception, and euthanasia. Great Danes have among the highest incidences of CIM across dog breeds, suggesting a genetic predisposition. We generated low-pass sequencing data for 83 Great Danes and used variant calls to impute missing whole genome single-nucleotide variants (SNVs) for each individual based on haplotypes phased from 624 high-coverage dog genomes, including 21 Great Danes. We validated the utility of our imputed data set for genome-wide association studies (GWASs) by mapping loci known to underlie coat phenotypes with simple and complex inheritance patterns. We conducted a GWAS for CIM with 2,010,300 SNVs, identifying a novel locus on canine chromosome 1 (P-val = 2.76 × 10-10). Associated SNVs are intergenic or intronic and are found in two clusters across a 1.7-Mb region. Inspection of coding regions in high-coverage genomes from affected Great Danes did not reveal candidate causal variants, suggesting that regulatory variants underlie CIM. Further studies are necessary to assess the role of these non-coding variants.
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Affiliation(s)
- Sarah M Bell
- Department of Genetics and Biochemistry, Clemson University, Clemson, SC, USA
| | - Jacquelyn M Evans
- College of Veterinary Medicine, Baker Institute for Animal Health, Cornell University, Ithaca, NY, USA
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Elizabeth A Greif
- Department of Genetics and Biochemistry, Clemson University, Clemson, SC, USA
| | - Kate L Tsai
- Department of Genetics and Biochemistry, Clemson University, Clemson, SC, USA
| | - Steven G Friedenberg
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, USA.
| | - Leigh Anne Clark
- Department of Genetics and Biochemistry, Clemson University, Clemson, SC, USA.
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Nakazawa Y, Ohshima T, Fujita M, Fujiwara-Igarashi A. Retrospective study of 1050 dogs with respiratory symptoms in Japan (2005-2020). Vet Med Sci 2023; 9:638-644. [PMID: 36253879 PMCID: PMC10029908 DOI: 10.1002/vms3.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Few studies have investigated the incidence of respiratory diseases based on anatomical sites or the relationship between breed and these diseases. OBJECTIVE The objective of this study was to investigate the prevalence of canine respiratory diseases among dogs in Japan, with relationship to the breed. METHODS We retrospectively reviewed the medical records of dogs with respiratory symptoms and calculated the odds ratio (OR) to evaluate the relationship between breed and disease. RESULTS A total of 1050 dogs with respiratory symptoms were included in this study. Miniature dachshunds were the most common breed affected by respiratory diseases. Among tracheobronchial diseases, there was a significant association between some small breeds and tracheobronchial collapse, miniature dachshunds (OR: 4.44, 8.43, 95% confidence interval [CI]: 3.17-6.22, 4.33-16.0) and chronic bronchitis and bronchiectasis. Among nasal diseases, miniature dachshunds (OR: 27.2, 95% CI: 16.8-44.8) and golden retrievers (OR: 21.0, 95% CI: 6.43-69.3) were the most affected by non-infectious rhinitis and nasal aspergillosis, respectively. Brachycephalic obstructive airway syndrome was the most common disease among pharyngeal and laryngeal diseases, with a relationship with breed being found in some brachycephalic breeds, and Pomeranians (OR: 2.7, 95% CI: 1.42-5.17). CONCLUSIONS Respiratory diseases in dogs are strongly correlated with popular breeds in Japan. Miniature dachshunds, in particular, are associated with many respiratory diseases, which may differ from international reports. Thus, this result may help in the early detection, prevention, treatment, and elucidation of the pathophysiology of canine respiratory diseases.
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Affiliation(s)
- Yuta Nakazawa
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Takafumi Ohshima
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Michio Fujita
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Aki Fujiwara-Igarashi
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
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3
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Winston JM, Mann FAT, Dean L. Management and outcomes of 13 dogs treated with a modified Heller myotomy and Dor fundoplication for lower esophageal sphincter achalasia-like syndrome. Vet Surg 2023; 52:315-329. [PMID: 36458673 DOI: 10.1111/vsu.13912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/30/2022] [Accepted: 10/17/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To report the management and outcomes of dogs treated for lower esophageal sphincter achalasia-like syndrome (LES-AS) with modified Heller myotomy, Dor fundoplication, and with the use of a temporary gastrostomy tube. STUDY DESIGN Retrospective. SAMPLE POPULATION Thirteen client-owned dogs. METHODS Medical records and a client survey were used to assess frequency of vomiting/regurgitation, quality of life (QoL), bodyweight, and feeding modifications at the following time points: prior to referral, postoperatively from discharge to first recheck (4-6 weeks), and from first recheck to survey (48 months). Postoperative and gastrostomy tube complications were surveyed and recorded. Pretreatment and 4-6 weeks postoperative videofluoroscopic swallow studies (VFSS) were compared. Two-sided t-tests were used to compare outcomes between survey time points. RESULTS Postoperative VFSS scores (available in 9 dogs) improved over preoperative scores in 6 dogs, and 12/13 dogs survived to discharge. One dog was euthanized 3 days postoperatively due to aspiration pneumonia. Postoperative gastrostomy tube complications occurred in half of the dogs that survived to discharge. According to the owners, scores assigned to vomiting/regurgitation improved by 180% (P = .004), QoL by 100% (P = .004), and bodyweight by 63% (P = .035). CONCLUSION Modified Heller myotomy with Dor fundoplication and the use of a temporary gastrostomy tube improved clinical signs and owners' perceived quality of life in half of the dogs treated for LES-AS in our clinical setting. Oral sildenafil therapy discontinued postoperatively suggests that surgery was equally efficacious. CLINICAL SIGNIFICANCE Modified Heller myotomy with Dor fundoplication and temporary gastrostomy tube is a treatment option with potentially sustained benefits for dogs that have LES-AS.
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Affiliation(s)
- John M Winston
- University of Missouri Veterinary Health Center, Columbia, Missouri, USA
| | - F A Tony Mann
- University of Missouri Veterinary Health Center, Columbia, Missouri, USA
| | - Lauren Dean
- University of Missouri Veterinary Health Center, Columbia, Missouri, USA
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Hernández-Pinilla JE, Buriticá-Gaviria EF, Echeverry-Bonilla DF. Doble cuarto arco aórtico persistente en un perro (Canis familiaris): reporte de caso. REVISTA U.D.C.A ACTUALIDAD & DIVULGACIÓN CIENTÍFICA 2022. [DOI: 10.31910/rudca.v25.n2.2022.2310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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5
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Ullal TV, Marks SL, Belafsky PC, Conklin JL, Pandolfino JE. A Comparative Assessment of the Diagnosis of Swallowing Impairment and Gastroesophageal Reflux in Canines and Humans. Front Vet Sci 2022; 9:889331. [PMID: 35754550 PMCID: PMC9228035 DOI: 10.3389/fvets.2022.889331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/05/2022] [Indexed: 11/24/2022] Open
Abstract
Swallowing impairment is a highly prevalent and clinically significant problem affecting people and dogs. There are myriad causes of swallowing impairment of which gastroesophageal reflux is the most common in both species. Similarities in anatomy and physiology between humans and canines results in analogous swallowing disorders including cricopharyngeus muscle achalasia, esophageal achalasia, hiatal herniation, and gastroesophageal reflux with secondary esophagitis and esophageal dysmotility. Accordingly, the diagnostic approach to human and canine patients with swallowing impairment is similar. Diagnostic procedures such as swallowing fluoroscopy, high-resolution manometry, pH/impedance monitoring, and endolumenal functional luminal imaging probe can be performed in both species; however, nasofacial conformation, increased esophageal length, and the difficulty of completing several of these procedures in awake dogs are inherent challenges that need to be considered. Human patients can convey their symptoms and respond to verbal cues, whereas veterinarians must rely on clinical histories narrated by pet owners followed by comprehensive physical examination and observation of the animal eating different food consistencies and drinking water. Dogs may also be unwilling to drink or eat in the hospital setting and may be resistant to physical restraint during diagnostic procedures. Despite the species differences and diagnostic challenges, dogs are a natural animal model for many oropharyngeal and esophageal disorders affecting people, which presents a tremendous opportunity for shared learnings. This manuscript reviews the comparative aspects of esophageal anatomy and physiology between humans and canines, summarizes the diagnostic assessment of swallowing impairment in both species, and discusses future considerations for collaborative medicine and translational research.
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Affiliation(s)
- Tarini V Ullal
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Stanley L Marks
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Peter C Belafsky
- Department of Otolaryngology, Center for Voice and Swallowing, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Jeffrey L Conklin
- The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, UCLA Robert G. Kardashian Center for Esophageal Health, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - John E Pandolfino
- Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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6
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Lyngby JG, Haines JM, Guess SC. Use of a videofluoroscopic feeding evaluation to guide management of dogs with congenital idiopathic megaoesophagus. Vet Med Sci 2022; 8:1434-1442. [PMID: 35476311 PMCID: PMC9297758 DOI: 10.1002/vms3.821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background Evidence‐based guidelines for determining dietary management in dogs with megaoesophagus are lacking. Objectives This study looked to compare oesophageal clearance times (ECT) of liquid and two food consistencies using a contrast videofluoroscopy feeding evaluation, and to assess if recommendations made based on findings could improve regurgitation and quality of life in dogs with congenital megaoesophagus. Methods Twenty‐one dogs with congenital megaoesophagus and nine healthy dogs received liquid, slurry, and meatball diets containing barium while in an upright position. Follow‐up was performed to determine response to recommendations. Results Healthy dogs had significantly shorter median ECT for all consistencies (p < 0.001). In the megaoesophagus group, ECT varied by consistency and individual. The number of dogs in the megaoesophagus group with complete clearance was four (median ECT 10 min) for liquid, five (median ECT 5 min) for slurry, and two (median ECT 5 and 30 min, respectively) for meatballs. Partial clearance was seen in 11 dogs (median clearance 25%) with liquid, seven with slurry (median clearance 50%), and five with meatballs (median clearance 60%). Recommendations included altering current medications (13/21 dogs), diet consistency (6/21), time upright (12/21), water delivery (21/21), and adding activity (7/21). Regurgitation episodes/week decreased significantly from 5.5 to 2.5 (p < 0.001) at follow‐up 3–5 weeks post‐evaluation, with 95% of owners reporting improvement in quality of life. Seventy percent were alive 46–777 days after last recheck. Three dogs died from megaoesophagus associated complications (median survival 461 days after diagnosis). Conclusions The findings of this study suggest that a videofluoroscopic feeding evaluation may help guide management of dogs with congenital megaoesophagus.
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Affiliation(s)
- Janne G Lyngby
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Jillian M Haines
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Sarah C Guess
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
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Bell SM, Evans JM, Evans KM, Tsai KL, Noorai RE, Famula TR, Holle DM, Clark LA. Congenital idiopathic megaesophagus in the German shepherd dog is a sex-differentiated trait and is associated with an intronic variable number tandem repeat in Melanin-Concentrating Hormone Receptor 2. PLoS Genet 2022; 18:e1010044. [PMID: 35271580 PMCID: PMC8912139 DOI: 10.1371/journal.pgen.1010044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/20/2022] [Indexed: 11/19/2022] Open
Abstract
Congenital idiopathic megaesophagus (CIM) is a gastrointestinal (GI) motility disorder of dogs in which reduced peristaltic activity and dilation of the esophagus prevent the normal transport of food into the stomach. Affected puppies regurgitate meals and water, fail to thrive, and experience complications such as aspiration pneumonia that may necessitate euthanasia. The German shepherd dog (GSD) has the highest disease incidence, indicative of a genetic predisposition. Here, we discover that male GSDs are twice as likely to be affected as females and show that the sex bias is independent of body size. We propose that female endogenous factors (e.g., estrogen) are protective via their role in promoting relaxation of the sphincter between the esophagus and stomach, facilitating food passage. A genome-wide association study for CIM revealed an association on canine chromosome 12 (P-val = 3.12x10-13), with the lead SNPs located upstream or within Melanin-Concentrating Hormone Receptor 2 (MCHR2), a compelling positional candidate gene having a role in appetite, weight, and GI motility. Within the first intron of MCHR2, we identified a 33 bp variable number tandem repeat (VNTR) containing a consensus binding sequence for the T-box family of transcription factors. Across dogs and wolves, the major allele includes two copies of the repeat, whereas the predominant alleles in GSDs have one or three copies. The single-copy allele is strongly associated with CIM (P-val = 1.32x10-17), with homozygosity for this allele posing the most significant risk. Our findings suggest that the number of T-box protein binding motifs may correlate with MCHR2 expression and that an imbalance of melanin-concentrating hormone plays a role in CIM. We describe herein the first genetic factors identified in CIM: sex and a major locus on chromosome 12, which together predict disease state in the GSD with greater than 75% accuracy. German shepherd dogs (GSDs) are predisposed to an inherited motility disorder of the esophagus, termed congenital idiopathic megaesophagus (CIM), in which swallowing is ineffective and the esophagus is enlarged. Affected puppies are unable to properly pass food into their stomachs and consequently regurgitate their meals and show a failure to thrive, often leading to euthanasia. Here, we discovered that male GSDs are affected at a ratio of almost 2-to-1 over females, suggesting a protective biological advantage in females. In humans, estrogen is thought to play a role in the male predominance of esophageal disorders like reflux esophagitis and esophageal cancer. In a genome-wide scan, we identified an association with CIM on chromosome 12 and, within this region, a repetitive sequence in MCHR2. This gene encodes a receptor for melanin-concentrating hormone, a signaling molecule that is linked to appetite, weight, and gut motility. Together, sex and the MCHR2 repeat sequence accurately predict affection status in over 75% of dogs, and a genetic test is now available to facilitate breeding decisions aimed at reducing disease incidence.
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Affiliation(s)
- Sarah M. Bell
- Department of Genetics and Biochemistry, Clemson University, Clemson, South Carolina, United States of America
| | - Jacquelyn M. Evans
- Department of Genetics and Biochemistry, Clemson University, Clemson, South Carolina, United States of America
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Katy M. Evans
- The Seeing Eye Inc., Morristown, New Jersey, United States of America
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, United Kingdom
| | - Kate L. Tsai
- Department of Genetics and Biochemistry, Clemson University, Clemson, South Carolina, United States of America
| | - Rooksana E. Noorai
- Department of Genetics and Biochemistry, Clemson University, Clemson, South Carolina, United States of America
- Clemson University Genomics and Bioinformatics Facility, Clemson University, Clemson, South Carolina, United States of America
| | - Thomas R. Famula
- Department of Animal Science, University of California, Davis, California, United States of America
| | - Dolores M. Holle
- The Seeing Eye Inc., Morristown, New Jersey, United States of America
| | - Leigh Anne Clark
- Department of Genetics and Biochemistry, Clemson University, Clemson, South Carolina, United States of America
- * E-mail:
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8
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Mehain SO, Haines JM, Guess SC. A randomized crossover study of compounded liquid sildenafil for treatment of generalized megaesophagus in dogs. Am J Vet Res 2022; 83:317-323. [DOI: 10.2460/ajvr.21.02.0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
OBJECTIVE
To determine whether delivery of compounded liquid sildenafil directly to the stomach of dogs with megaesophagus (ME) would affect esophageal clearance, regurgitation frequency, body weight, or quality of life.
ANIMALS
10 client-owned otherwise healthy dogs with stable ME.
PROCEDURES
A randomized crossover study was performed. Dogs received either sildenafil (1 mg/kg, PO, q 12 h) or a placebo for 14 days, followed by a 7-day washout period, then the opposite treatment for 14 days. Esophageal clearance time was assessed by means of videofluoroscopy prior to treatment and on day 1 of each treatment period. Owners maintained logs of regurgitation episodes and quality of life.
RESULTS
Compounded liquid sildenafil moved into the stomach during 21 of 30 (70%) videofluoroscopy sessions. Sildenafil resulted in a significant reduction in the number of regurgitation episodes (median, 3.5 episodes/wk; range, 0 to 14.5 episodes/wk), compared with baseline (median, 6.5 episodes/wk; range, 1.5 to 19.5 episodes/wk) and the placebo (median, 4 episodes/wk; range, 0 to 28 episodes/wk), and a significant increase in body weight (median, 22.05 kg; range, 6 to 26.3 kg), compared with baseline (median, 21.55 kg; range, 5.1 to 26.2 kg) and the placebo (median, 22.9 kg; range, 5.8 to 25.9 kg). There were no differences in esophageal clearance times or quality-of life-scores between sildenafil and placebo.
CLINICAL RELEVANCE
Although significant differences with placebo administration were identified, clinically relevant improvements were not seen with the use of compounded liquid sildenafil in dogs with ME.
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Affiliation(s)
- Susan O. Mehain
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
| | - Jillian M. Haines
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
| | - Sarah C. Guess
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
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Renwick M, Stevenson MA, Wiethoelter A, Mansfield C. A case-control study to identify risk factors for adult-onset idiopathic megaoesophagus in Australian dogs, 2017-2018. BMC Vet Res 2020; 16:157. [PMID: 32448348 PMCID: PMC7247263 DOI: 10.1186/s12917-020-02376-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 05/14/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Epidemiological investigations were carried out following detection of an outbreak of megaoesophagus in Victorian Police working dogs in early 2018 and an increase in the number of canine megaoesophagus cases reported by companion animal veterinarians in Eastern Australia starting in late 2017. VetCompass Australia data were used to quantify the incidence of canine megaoesophagus for the period January 2012 to February 2018 and a matched case-control study carried out to identify individual animal risk factors for canine megaoesophagus in 2017-2018. RESULTS There was a 7-fold increase in the incidence rate of canine megaoesophagus from 2014 (0.11 [95% CI 0.02 to 0.58] cases per 100,000 dogs per day) to 2018 (0.82 [95% CI 0.19 to 4.2] cases per 100,000 dogs per day). Since 2013, the incidence of megaoesophagus in Australia has shown a seasonal pattern, with greater numbers of cases diagnosed during the warmer months of the year. In the case-control study, use of Mars Petcare Advance Dermocare as a source of food was 325 (95% CI 64 to 1644) times greater for cases, compared with controls. CONCLUSIONS Our analyses provide evidence that the feeding of Advance Dermocare was responsible for the majority of cases in the outbreak of megaoesophagus in Eastern Australia in 2017-2018. The increase in the incidence rate of megaoesophagus in Australia since 2014-2015 warrants further investigation.
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Affiliation(s)
- M Renwick
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - M A Stevenson
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia.
| | - A Wiethoelter
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - C Mansfield
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia
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Affiliation(s)
- Jonathan D Dear
- Department of Medicine and Epidemiology, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA. https://twitter.com/jddear
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Gomes SA, Van Ham L, Van Ham A, Ives EJ, Vanhaesebrouck A. Canine Nonstructural Megaesophagus as a Clinical Sign of Potential Neurological Disease: 99 Cases. J Am Anim Hosp Assoc 2019; 56:7-16. [PMID: 31715113 DOI: 10.5326/jaaha-ms-6955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Knowledge regarding the etiology and prognosis for canine megaesophagus (ME) is currently limited to small case series that may now be out of date in light of recent advances in the understanding of neurological syndromes and the availability of advanced diagnostic testing. Ninety-nine dogs diagnosed with nonstructural ME were included. Congenital idiopathic ME was present in 10 cases, with complete resolution of clinical signs in a single case. Eighty-nine cases were considered acquired, with most cases being either idiopathic (42.7%) or associated with myasthenia gravis (38.2%). Idiopathic cases represented a smaller percentage of acquired ME than previously reported. Death or euthanasia directly related to ME occurred in almost 50% of acquired cases, whereas clinical signs persisted in ∼20% of cases and resolved in 30% of cases. A diagnosis of an underlying etiology, in particular myasthenia gravis, was associated with a better outcome in acquired ME. ME continues to be a challenging condition to manage, with a guarded-to-poor prognosis, particularly when an underlying etiology is not identified. Thorough diagnostic testing for an underlying neurological disorder is important in cases with ME as this may allow institution of appropriate treatment and the potential for a better prognosis.
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Affiliation(s)
- Sergio A Gomes
- From Dovecote Veterinary Hospital, Derby, United Kingdom (S.A.G.); Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, University of Ghent, Ghent, Belgium (L.V.H., A.V.H.); Anderson Moores Veterinary Specialists, Winchester, United Kingdom (E.J.I.); and Department of Veterinary Medicine, The Queen's Veterinary School, University of Cambridge, Cambridge, United Kingdom (A.V.)
| | - Luc Van Ham
- From Dovecote Veterinary Hospital, Derby, United Kingdom (S.A.G.); Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, University of Ghent, Ghent, Belgium (L.V.H., A.V.H.); Anderson Moores Veterinary Specialists, Winchester, United Kingdom (E.J.I.); and Department of Veterinary Medicine, The Queen's Veterinary School, University of Cambridge, Cambridge, United Kingdom (A.V.)
| | - Anouk Van Ham
- From Dovecote Veterinary Hospital, Derby, United Kingdom (S.A.G.); Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, University of Ghent, Ghent, Belgium (L.V.H., A.V.H.); Anderson Moores Veterinary Specialists, Winchester, United Kingdom (E.J.I.); and Department of Veterinary Medicine, The Queen's Veterinary School, University of Cambridge, Cambridge, United Kingdom (A.V.)
| | - Edward J Ives
- From Dovecote Veterinary Hospital, Derby, United Kingdom (S.A.G.); Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, University of Ghent, Ghent, Belgium (L.V.H., A.V.H.); Anderson Moores Veterinary Specialists, Winchester, United Kingdom (E.J.I.); and Department of Veterinary Medicine, The Queen's Veterinary School, University of Cambridge, Cambridge, United Kingdom (A.V.)
| | - An Vanhaesebrouck
- From Dovecote Veterinary Hospital, Derby, United Kingdom (S.A.G.); Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, University of Ghent, Ghent, Belgium (L.V.H., A.V.H.); Anderson Moores Veterinary Specialists, Winchester, United Kingdom (E.J.I.); and Department of Veterinary Medicine, The Queen's Veterinary School, University of Cambridge, Cambridge, United Kingdom (A.V.)
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12
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Grobman ME, Schachtel J, Gyawali CP, Lever TE, Reinero CR. Videofluoroscopic swallow study features of lower esophageal sphincter achalasia-like syndrome in dogs. J Vet Intern Med 2019; 33:1954-1963. [PMID: 31381208 PMCID: PMC6766503 DOI: 10.1111/jvim.15578] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 07/11/2019] [Indexed: 12/20/2022] Open
Abstract
Background Megaesophagus (ME) carries a poor long‐term prognosis in dogs. In people, lower esophageal sphincter (LES) disorders causing functional obstruction are rare causes of ME that may respond to targeted treatment. Functional LES disorders are reported rarely in dogs because of challenges in diagnostic methodologies. Hypothesis/Objectives To identify dogs with videofluoroscopic swallow study (VFSS) features of LES achalasia‐like syndrome (LES‐AS). We hypothesized that dogs with LES‐AS could be distinguished from normal dogs using standardized VFSS criteria. Animals Dogs with LES‐AS by VFSS (n = 19), healthy normal dogs (n = 20). Methods Retrospective study. One‐hundred thirty dogs presented to the University of Missouri Veterinary Health Center (MU‐VHC) between April 2015 and December 2017 for a free‐feeding VFSS; 20 healthy dogs were included as controls. Swallow studies were evaluated for failure of the LES to relax during pharyngeal swallow (LES‐AS). Affected dogs subsequently were evaluated using standardized criteria to identify metrics important for identifying and characterizing dogs with LES‐AS. Results Nineteen dogs with LES‐AS were identified out of 130 VFSS. Megaesophagus was present in 14 of 19 (73.7%) dogs with LES‐AS. A baseline esophageal fluid‐line and “bird beak” were present in 68.4% (95% confidence interval [CI], 47.5%‐89.3%) and 63.2% (95% CI, 41.5%‐84.8%) of affected dogs, respectively. The esophagus was graded as acontractile (8/19), hypomotile (8/19), or hypermotile (3/19). Conclusions and Clinical Importance Dogs with LES‐AS may successfully be identified by VFSS using a free‐feeding protocol. These data are of critical clinical importance because a subpopulation of dogs with functional LES obstruction may be candidates for targeted intervention.
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Affiliation(s)
- Megan E Grobman
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri
| | | | - C Prakash Gyawali
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri
| | - Teresa E Lever
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, Missouri
| | - Carol R Reinero
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri
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Haines JM, Khoo A, Brinkman E, Thomason JM, Mackin AJ. Technique for Evaluation of Gravity-Assisted Esophageal Transit Characteristics in Dogs with Megaesophagus. J Am Anim Hosp Assoc 2019; 55:167-177. [PMID: 31099601 DOI: 10.5326/jaaha-ms-6711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Movement of food material in the esophagus during upright feeding in dogs with megaesophagus (ME) is poorly characterized. A standardized contrast videofluoroscopy technique was used to evaluate esophageal transit characteristics in dogs with ME while in an upright position. Twelve dogs with ME (congenital, acquired idiopathic, or secondary to myasthenia gravis) were placed in an upright position using Bailey chairs and given liquid barium, canned food meatballs, and their normal diet consistency if different than meatballs. Passage of ingesta was videofluoroscopically evaluated by direct observation and change in ingesta area as determined by manual tracing or barium column product calculations. Significant individual variation was seen. Complete esophageal clearance of liquid was seen in four dogs, and complete clearance of meatballs in three dogs, with a median time of 5 min for both. Two of seven dogs fed a slurry diet had complete clearance by 10 min. No significant difference was found between area calculated via tracing or barium column product. Based on imaging results, alterations in food consistency, duration upright, or medication were recommended for nine dogs. In dogs with ME accustomed to a Bailey chair, contrast videofluoroscopy was technically straightforward and allowed for more specific physician-guided management recommendations.
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Affiliation(s)
- Jillian M Haines
- From the Department of Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington (J.M.H.); Upstate Veterinary Specialties, Latham, New York (A.K.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, Mississippi (E.B., J.M.T., A.J.M.)
| | - Alison Khoo
- From the Department of Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington (J.M.H.); Upstate Veterinary Specialties, Latham, New York (A.K.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, Mississippi (E.B., J.M.T., A.J.M.)
| | - Erin Brinkman
- From the Department of Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington (J.M.H.); Upstate Veterinary Specialties, Latham, New York (A.K.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, Mississippi (E.B., J.M.T., A.J.M.)
| | - John M Thomason
- From the Department of Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington (J.M.H.); Upstate Veterinary Specialties, Latham, New York (A.K.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, Mississippi (E.B., J.M.T., A.J.M.)
| | - Andrew J Mackin
- From the Department of Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington (J.M.H.); Upstate Veterinary Specialties, Latham, New York (A.K.); and Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, Mississippi (E.B., J.M.T., A.J.M.)
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14
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Grobman ME, Hutcheson KD, Lever TE, Mann FA, Reinero CR. Mechanical dilation, botulinum toxin A injection, and surgical myotomy with fundoplication for treatment of lower esophageal sphincter achalasia-like syndrome in dogs. J Vet Intern Med 2019; 33:1423-1433. [PMID: 30968469 PMCID: PMC6524387 DOI: 10.1111/jvim.15476] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 02/26/2019] [Indexed: 12/17/2022] Open
Abstract
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.
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Affiliation(s)
- M E Grobman
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, Columbia, Missouri
| | - K D Hutcheson
- Department of Veterinary Medicine and Surgery, University of Missouri Columbia College of Veterinary Medicine Ringgold Standard Institution, Columbia, Missouri
| | - T E Lever
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri Columbia School of Medicine Ringgold Standard Institution, Columbia, Missouri
| | - F A Mann
- Department of Veterinary Medicine and Surgery, University of Missouri Columbia College of Veterinary Medicine Ringgold Standard Institution, Columbia, Missouri
| | - C R Reinero
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri
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15
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Viitanen SJ, Lappalainen AK, Koho NM, Pessa-Morikawa T, Ressel L, Rajamäki MM. Recurrent bacterial pneumonia in Irish Wolfhounds: Clinical findings and etiological studies. J Vet Intern Med 2019; 33:846-855. [PMID: 30666726 PMCID: PMC6430867 DOI: 10.1111/jvim.15413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 12/12/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Increased incidence of bacterial pneumonia (BP) has been reported in Irish Wolfhounds (IWHs), and recurrence of BP is common. The etiology of recurrent pneumonia in IWHs is largely unknown. OBJECTIVES To describe clinical findings in IWHs with recurrent BP and investigate possible etiologies. ANIMALS Eleven affected IWHs, 25 healthy IWHs, 28 healthy dogs of other Sighthound breeds, and 16 healthy dogs of other breeds. METHODS Prospective cross-sectional observational study. All affected IWHs underwent thorough clinical examinations including thoracic radiographs, thoracic computed tomography, electron microscopic evaluation of ciliary structure, and bronchoscopy and bronchoalveolar lavage fluid (BALF) cytology and culture. Serum and BALF immunoglobulin concentrations were measured using an ELISA method, and peripheral blood lymphocyte subpopulations were analyzed using flow cytometry. Esophageal function was assessed by fluoroscopy (n = 2). RESULTS Median age of onset was 5.0 years (range, 0.4-6.5 years), and when presented for study, dogs had experienced a median of 5 previous episodes of BP (range, 2-6). The following predisposing factors to BP were detected: focal bronchiectasis (10/11), unilateral (2/9) and bilateral (1/9) laryngeal paralysis, and esophageal hypomotility (2/2). Local or systemic immunoglobulin deficiencies or primary ciliary defects were not detected. CONCLUSIONS AND CLINICAL IMPORTANCE Recurrent BP affects mostly middle-aged and older IWHs without any evident immune deficit or primary ciliary defects. Focal BE was a frequent finding in affected dogs and likely contributed to the development of recurrent respiratory infections. Laryngeal and esophageal dysfunction identified in a minority of dogs may contribute to recurrent BP.
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Affiliation(s)
- Sanna J Viitanen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Anu K Lappalainen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Ninna M Koho
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Tiina Pessa-Morikawa
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Lorenzo Ressel
- Department of Veterinary Pathology and Public Health, University of Liverpool, Liverpool, United Kingdom
| | - Minna M Rajamäki
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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16
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Nakagawa T, Doi A, Ohno K, Yokoyama N, Tsujimoto H. Clinical features and prognosis of canine megaesophagus in Japan. J Vet Med Sci 2019; 81:348-352. [PMID: 30626762 PMCID: PMC6451904 DOI: 10.1292/jvms.18-0493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Megaesophagus (ME) is a common esophageal disease in dogs and the prognosis is generally poor, especially with aspiration pneumonia (AP). We retrospectively investigated the clinical
features and prognosis of canine ME in Japan. Twenty-eight dogs were included in this study, with the Miniature Dachshund breed being significantly overrepresented (odds ratio: 4.33). Most
cases (21 of 28) were diagnosed as idiopathic ME and Myasthenia gravis was the most common cause of secondary ME. The overall median survival time (MST) was not reached and the 3-month
survival rate was 85.7%. Ten dogs were diagnosed with AP, at least once during the study period, and the MST of ME dogs with AP was 114 days. The survival time overall and even with AP, was
notably more prolonged compared to the previous studies. We hypothesized that treatment for canine ME could prolong the survival time, even in those with both ME and AP.
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Affiliation(s)
- Taisuke Nakagawa
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Akihiro Doi
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Koichi Ohno
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Nozomu Yokoyama
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Hajime Tsujimoto
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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17
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Haines JM. Survey of owners on population characteristics, diagnosis, and environmental, health, and disease associations in dogs with megaesophagus. Res Vet Sci 2018; 123:1-6. [PMID: 30543946 DOI: 10.1016/j.rvsc.2018.11.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 11/29/2022]
Abstract
Megaesophagus affects dogs worldwide but limited information is available regarding its characteristics in the general population of dogs. The objectives of this study were to provide information on a large population of dogs diagnosed with megaesophagus in regards to population characteristics, medical and family history, diagnosis, concurrent disease, and predisposing factors. A link to a web-based survey was provided on megaesophagus support websites and 838 eligible surveys were evaluated. Breeds most frequently associated with congenital megaesophagus were German shepherds, mixed breed "goldendoodles", Labrador retrievers, great Danes, and dachshunds. Breeds most often associated with acquired megaesophagus were Labrador and golden retrievers, Chihuahuas, boxers, German shepherds, dachshunds, and Rottweilers. Diagnosis was most often by a general practitioner (63.6%) via plain radiographs (63.3%) and/or barium study (45%). Congenital megaesophagus was diagnosed in 41.3% of dogs and persistent right aortic arch in 4.3%. Diseases most commonly associated with acquired megaesophagus were myasthenia gravis (19.3%), esophagitis (10.8%), hypothyroidism (8.8%). Survey results support previous breed predilections and identified dachshunds, boxers, Chihuahuas, Rottweilers, and "goldendoodles" as additional at risk breeds. Myasthenia gravis was found at lower rates than previous described and contrary to recent studies, hypothyroidism was found in relatively high prevalence. Most dogs were diagnosed by a general practitioner suggesting previous studies at referral facilities may be biased towards dogs with more severe disease and worse outcomes.
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Affiliation(s)
- Jillian M Haines
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, PO Box 647060, Pullman, WA 99164-7060, USA.
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18
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Sherman R, Karagiannis M. Aspiration Pneumonia in the Dog: A Review. Top Companion Anim Med 2017; 32:1-7. [PMID: 28750782 DOI: 10.1053/j.tcam.2017.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 05/10/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To review the human and veterinary literature pertaining to aspiration pneumonitis and pneumonia. MATERIAL AND METHODS Data sources included scientific reviews and original research publications from the human and veterinary literature. All reviews and studies that added to the understanding of aspiration pneumonia were included. RESULTS Compared to human medicine, aspiration pneumonia can be difficult to diagnose in the canine patient and is often a diagnosis of presumption. Multiple risk factors exist increasing the likelihood of aspiration pneumonia and a thorough understanding of these can aid in prevention. Treatment recommendations center primarily on supportive care, oxygen therapy and antibiotic administration. CLINCIAL SIGNIFICANCE Aspiration pneumonia is a common finding in the canine patient and a thorough understanding of the disease will lead to better treatment outcomes. Further studies on treatment and prevention in veterinary medicine are warranted.
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Quintavalla F, Menozzi A, Pozzoli C, Poli E, Donati P, Wyler DK, Serventi P, Bertini S. Sildenafil improves clinical signs and radiographic features in dogs with congenital idiopathic megaoesophagus: a randomised controlled trial. Vet Rec 2017; 180:404. [PMID: 28188161 DOI: 10.1136/vr.103832] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2017] [Indexed: 11/04/2022]
Abstract
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.
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Affiliation(s)
- F Quintavalla
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - A Menozzi
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - C Pozzoli
- Department of Neuroscience, University of Parma, Parma, Italy
| | - E Poli
- Department of Neuroscience, University of Parma, Parma, Italy
| | | | - D K Wyler
- The Animal Medical Hospital and Whitestone Veterinary Care, New York, NY, USA
| | - P Serventi
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - S Bertini
- Department of Veterinary Science, University of Parma, Parma, Italy
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20
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Kanemoto Y, Fukushima K, Kanemoto H, Ohno K, Tsujimoto H. Long-term management of a dog with idiopathic megaesophagus and recurrent aspiration pneumonia by use of an indwelling esophagostomy tube for suction of esophageal content and esophagogastric tube feeding. J Vet Med Sci 2016; 79:188-191. [PMID: 27853047 PMCID: PMC5289259 DOI: 10.1292/jvms.16-0374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 10-year-old neutered male Labrador Retriever dog was diagnosed with idiopathic megaesophagus. Despite receiving conventional treatments including elevated
feeding, the dog showed repeated regurgitation and aspiration pneumonia, consequently developing weight loss and severe malnutrition. For the purpose of
controlling regurgitation, an esophagostomy tube was placed for draining the esophageal fluid. Additionally, an esophagogastric tube was placed for nutritional
support. After tube placement, the average frequency of regurgitation was reduced from 2.4 times a day to 0.1 times a day. The nutritional state of the dog
improved gradually, and the body weight increased from 18.5 to 27.9 kg. The dog died on day 951, and necropsy revealed a gastric ulcer (2.5 cm in diameter),
presumably esophagostomy tube-induced injury. This case report suggests that patients with idiopathic megaesophagus and persistent regurgitation might benefit
from esophageal drainage through an esophagostomy tube.
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Affiliation(s)
- Yuka Kanemoto
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo,1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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21
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Manning K, Birkenheuer AJ, Briley J, Montgomery SA, Harris J, Vanone SL, Gookin JL. Intermittent At-Home Suctioning of Esophageal Content for Prevention of Recurrent Aspiration Pneumonia in 4 Dogs with Megaesophagus. J Vet Intern Med 2016; 30:1715-1719. [PMID: 27481487 PMCID: PMC5032866 DOI: 10.1111/jvim.14527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/26/2016] [Accepted: 06/27/2016] [Indexed: 11/30/2022] Open
Abstract
Background Megaesophagus carries a poor to guarded prognosis due to death from aspiration pneumonia. Options for medical management of regurgitation are limited to strategic oral or gastrostomy tube feeding. Objectives To describe the use and efficacy of intermittent esophageal suctioning to prevent regurgitation and associated episodes of aspiration pneumonia in dogs with megaesophagus. Animals Four dogs with acquired idiopathic megaesophagus and recurrent aspiration pneumonia. Methods Retrospective review of medical records of dogs with megaesophagus in which intermittent suctioning of esophageal content was employed for management of recurrent aspiration pneumonia. Results Intermittent suctioning of the esophagus was initiated in 4 dogs after failure of strict gastrostomy tube feeding failed to prevent regurgitation and repeated episodes of aspiration pneumonia. Suctioning was accomplished by esophagostomy tube in 3 dogs and per os in 1 dog. After initiation of esophageal suctioning, dogs survived for a median of 13.5 additional months (range, 10–30 months) during which time 2 dogs had no additional episodes of aspiration pneumonia and 2 dogs had infrequent episodes of pneumonia, but aspiration was suspected to be a contributing factor in their death. Complications included clogging of the esophagostomy tube, esophagostomy site infections, and esophagitis. Conclusions and Clinical Importance Use of intermittent esophageal suctioning in dogs with megaesophagus that continue to regurgitate despite gastrostomy tube feedings can reduce or abolish clinical episodes of aspiration pneumonia.
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Affiliation(s)
- K Manning
- Veterinary Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - A J Birkenheuer
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - J Briley
- Veterinary Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - S A Montgomery
- Veterinary Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - J Harris
- Veterinary Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - S L Vanone
- Veterinary Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - J L Gookin
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC.
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22
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Affiliation(s)
- Jonathan D Dear
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, One Shields Avenue, Davis, CA 95616, USA.
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23
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Levine JS, Pollard RE, Marks SL. Contrast videofluoroscopic assessment of dysphagic cats. Vet Radiol Ultrasound 2014; 55:465-71. [PMID: 24547892 DOI: 10.1111/vru.12150] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 12/06/2013] [Indexed: 11/27/2022] Open
Abstract
The diagnostic utility of contrast-enhanced videofluoroscopic esophagography in dysphagic cats has been rarely studied relative to dogs. Current literature regarding feline dysphagia typically consists of individual case reports or small case series. This retrospective study analyzed the imaging findings in 11 cats undergoing 15 videofluoroscopic swallow studies. Hiatal hernia (n = 5), esophageal stricture (n = 3), and esophageal dysmotility (n = 7) were the most common diagnoses (some cats having more than 1 diagnosis) in dysphagic cats that underwent videofluoroscopic swallow studies. Esophageal dysmotility appeared to be associated with a higher percentage of swallows from which no peristaltic waves were generated. Oropharyngeal and cricopharyngeal causes of dysphagia were not identified in any cat and quantitative assessment of the swallowing reflex (pharyngeal constriction ratio = 0.17 ± 0.09; time to maximum pharyngeal contraction = 0.13 ± 0.02 s; time to proximal esophageal sphincter opening = 0.07 ± 0.02 s; time to proximal esophageal sphincter closed = 0.23 ± 0.05 s; time to opening of the epiglottis = 0.27 ± 0.04 s) was similar to quantitative swallowing parameters previously reported in healthy dogs. In conclusion, videofluoroscopy is a diagnostic tool that can identify esophageal abnormalities that are not readily apparent on survey radiographs. Limitations include the potential need for multiple studies, and the possibility of poor compliance in the feline patient. Results of this study are intended to help veterinarians define a prioritized differential diagnosis list for dysphagic cats.
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Affiliation(s)
- Jonathan S Levine
- School of Veterinary Medicine, Veterinary Medical Teaching Hospital, University of California, Davis, CA, 95616
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24
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Pollard RE. Imaging evaluation of dogs and cats with Dysphagia. ISRN VETERINARY SCIENCE 2012; 2012:238505. [PMID: 23762579 PMCID: PMC3671744 DOI: 10.5402/2012/238505] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 09/19/2012] [Indexed: 01/20/2023]
Abstract
The current literature is reviewed in this paper regarding the application of diagnostic imaging in the evaluation of swallowing disorders of the dog. The applications of radiography, contrast radiography, and contrast videofluoroscopy are discussed with pertinent case examples provided for emphasis. The indications for image-guided interventions are also described.
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Affiliation(s)
- Rachel E Pollard
- Department of Surgical and Radiological Sciences, Davis School of Veterinary Medicine, The University of California, Davis, CA 95616, USA
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