Münster M, Hörauf A, Lübke-Becker A, Grest P, Rütten M
Tierärztliche Gemeinschaftspraxis Dr. Hörauf und Dr. Münster, Hatzfeldstraße 6, 51069 Köln, Germany.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2013;41(3):173-9.
Pathologic gastroesophageal reflux (GER) has been demonstrated experimentally in dogs, and it is suspected to occur naturally in dogs, yet its clinical significance is unknown. The aim of the study was to demonstrate clinical indicators of pathologic GER in dogs with idiopathic esophagopathies.
Dogs with clinical signs suggestive for esophageal disease (regurgitation, ptyalism, or dysphagia) and where extraesophageal and specific esophageal diseases had been ruled out, were retrospectively diagnosed with idiopathic esophagopathies. History, physical examination findings, clinicopathologic, radiographic, and endoscopic data, and treatment results were obtained from medical records, reviewed and evaluated.
Out of 67 dogs with anamnestic esophageal signs, 12 (17.4%) dogs were identified as having idiopathic esophagopathies and were included in the study. Median age was 3.0 years (range 1.0-11.0), and median bodyweight was 28.2 kg (range 8.2-44.0). The most frequent anamnestic esophageal signs were ptyalism (10/12 dogs), regurgitation (8/12 dogs), signs of discomfort, pain (8/12 dogs), and cough (5/12 dogs). The most common radiographic abnormality was segmental esophageal dilation (8/12 dogs). Esophagoscopy revealed single mucosal surface defects at the gastroesophageal junction in 3/12 dogs. In dogs with altered esophageal motility, cytological and microbiological examinations of bronchial aspirates showed goblet cell hyperplasia (8/8 dogs), neutrophilic infiltration (5/8 dogs) and culturable bacteria (4/8 dogs), respectively. All dogs were treated with omeprazole (median 0.7 mg/kg once per day, range 0.5-1.2). Reported median treatment duration until remission of the main clinical signs was 20.0 days (range 8.0-54.0 days). This endpoint was reached in 11/12 dogs.
Results suggest that in some dogs with esophageal clinical signs, and where no primary disease could be identified, clinical indicators of pathologic GER such as pain, mucosal lesions and motility disturbances of the esophagus, respiratory complications, and response to therapy can be observed.
病理性胃食管反流(GER)已在犬类中通过实验得到证实,并且怀疑其在犬类中自然发生,但其临床意义尚不清楚。本研究的目的是证明患有特发性食管病的犬类病理性GER的临床指标。
对有食管疾病临床症状(反流、流涎或吞咽困难)且已排除食管外疾病和特定食管疾病的犬只进行回顾性诊断,确定为特发性食管病。从病历中获取病史、体格检查结果、临床病理、放射学和内镜检查数据以及治疗结果,并进行回顾和评估。
在67只具有食管症状既往史的犬只中,12只(17.4%)被确定患有特发性食管病并纳入研究。中位年龄为3.0岁(范围1.0 - 11.0岁),中位体重为28.2千克(范围8.2 - 44.0千克)。最常见的食管症状既往史是流涎(12只犬中有10只)、反流(12只犬中有8只)、不适和疼痛症状(12只犬中有8只)以及咳嗽(12只犬中有5只)。最常见的放射学异常是节段性食管扩张(12只犬中有8只)。食管镜检查显示12只犬中有3只在胃食管交界处有单个黏膜表面缺损。在食管动力改变的犬只中,支气管灌洗的细胞学和微生物学检查分别显示杯状细胞增生(8只犬中有8只)、中性粒细胞浸润(8只犬中有5只)和可培养细菌(8只犬中有4只)。所有犬只均接受奥美拉唑治疗(中位剂量为0.7毫克/千克,每日一次,范围0.5 - 1.2)。报告的直至主要临床症状缓解的中位治疗持续时间为20.0天(范围8.0 - 54.0天)。12只犬中有11只达到了这一终点。
结果表明,在一些有食管临床症状且未发现原发性疾病的犬只中,可以观察到病理性GER的临床指标,如疼痛、食管黏膜病变和动力障碍、呼吸道并发症以及对治疗的反应。