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Gastroesophageal reflux and laryngeal dysfunction
A D VA N C E S
PAG E 5
The previous treatment was also continued. Complete resolution of clinical signs was maintained for 4 months.
GASTROESOPHAGEAL REFLUX AND LARYNGEAL DYSFUNCTION Background There have been no reports of gastroesophageal reflux dysfunction (GERD) as a causative factor in laryngeal disease in the veterinary literature, although there has been an association established between secondary gastroesophageal disease and primary airway abnormalities in brachycephalic breeds. Gastroesophageal reflux is the most common cause of esophagitis in animals and humans, and there has been increasing evidence of an association between gastroesophageal reflux and laryngeal dysfunction in humans.
Objectives To report gastroesophageal reflux and laryngeal dysfunction in a dog.
Case Report A 7-year-old, castrated male Saint Bernard dog was evaluated because of a 6-month history of coughing, gagging, change in phonation, excessive panting, and chronic intermittent vomiting and diarrhea. Physical examination revealed panting as the only clinical sign. Total thyroxine concentration and results of a hemogram, serum biochemistry analysis, urinalysis, and thoracic radiography were within reference limits. A laryngeal examination revealed edema, erythema, and ulceration of the larynx and pharynx, with normal laryngeal movement. Results of bronchoscopy and cytologic examination of bronchoalveolar lavage fluid were diagnostic for distal tracheitis. Esophagoscopy and an esophagography revealed esophagitis consistent with gastroesophageal reflux. Gastroduodenoscopy and histologic examination of biopsy specimens revealed Helicobacter colonization and lymphocytic or plasmacytic enteritis. Following treatment for GERD and suspected Helicobacter infection with combination antacid and antimicrobial treatment, the dog’s respiratory signs resolved. However, vomiting continued. Endoscopy revealed complete resolution of the previous laryngitis, pharyngitis, and esophagitis. Treatment for the lymphocytic or plasmacytic enteritis was initiated with prednisone and a novel protein diet.
Author Conclusion This was the first case of laryngeal dysfunction induced by gastroesophageal reflux reported in a dog. This association should be a potential consideration in dogs with concurrent respiratory and gastrointestinal signs.
Inclusions Three figures, 16 references.
Editor Annotation Clinicians should be aware of canine GERD (and associated clinical signs) and a possible laryngeal dysfunction as a sequela. It should be noted that the dog of this report had GI signs that did not resolve with just Helicobacter therapy. Treatment for lymphoplasmacytic enteritis (steroids and novel protein) was necessary to resolve the GI issues. (MM) Lux CN, Archer TM, Lunsford KV. Gastroesophageal reflux and laryngeal dysfunction in a dog. J Am Vet Med Assoc 2012;240:1100-1103.
PAG E 5
The previous treatment was also continued. Complete resolution of clinical signs was maintained for 4 months.
GASTROESOPHAGEAL REFLUX AND LARYNGEAL DYSFUNCTION Background There have been no reports of gastroesophageal reflux dysfunction (GERD) as a causative factor in laryngeal disease in the veterinary literature, although there has been an association established between secondary gastroesophageal disease and primary airway abnormalities in brachycephalic breeds. Gastroesophageal reflux is the most common cause of esophagitis in animals and humans, and there has been increasing evidence of an association between gastroesophageal reflux and laryngeal dysfunction in humans.
Objectives To report gastroesophageal reflux and laryngeal dysfunction in a dog.
Case Report A 7-year-old, castrated male Saint Bernard dog was evaluated because of a 6-month history of coughing, gagging, change in phonation, excessive panting, and chronic intermittent vomiting and diarrhea. Physical examination revealed panting as the only clinical sign. Total thyroxine concentration and results of a hemogram, serum biochemistry analysis, urinalysis, and thoracic radiography were within reference limits. A laryngeal examination revealed edema, erythema, and ulceration of the larynx and pharynx, with normal laryngeal movement. Results of bronchoscopy and cytologic examination of bronchoalveolar lavage fluid were diagnostic for distal tracheitis. Esophagoscopy and an esophagography revealed esophagitis consistent with gastroesophageal reflux. Gastroduodenoscopy and histologic examination of biopsy specimens revealed Helicobacter colonization and lymphocytic or plasmacytic enteritis. Following treatment for GERD and suspected Helicobacter infection with combination antacid and antimicrobial treatment, the dog’s respiratory signs resolved. However, vomiting continued. Endoscopy revealed complete resolution of the previous laryngitis, pharyngitis, and esophagitis. Treatment for the lymphocytic or plasmacytic enteritis was initiated with prednisone and a novel protein diet.
Author Conclusion This was the first case of laryngeal dysfunction induced by gastroesophageal reflux reported in a dog. This association should be a potential consideration in dogs with concurrent respiratory and gastrointestinal signs.
Inclusions Three figures, 16 references.
Editor Annotation Clinicians should be aware of canine GERD (and associated clinical signs) and a possible laryngeal dysfunction as a sequela. It should be noted that the dog of this report had GI signs that did not resolve with just Helicobacter therapy. Treatment for lymphoplasmacytic enteritis (steroids and novel protein) was necessary to resolve the GI issues. (MM) Lux CN, Archer TM, Lunsford KV. Gastroesophageal reflux and laryngeal dysfunction in a dog. J Am Vet Med Assoc 2012;240:1100-1103.