Broux Olivier, Clercx Cécile, Etienne Anne-Laure, Busoni Valeria, Claeys Stéphanie, Hamaide Annick, Billen Frédéric
Department of Clinical Sciences, FARAH, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2, Avenue de Cureghem 3 - B44, Liege, Belgium.
Vet Surg. 2018 Feb;47(2):243-251. doi: 10.1111/vsu.12735. Epub 2017 Nov 2.
To determine the influence of manipulations aimed at increasing the transdiaphragmatic pressure gradient on the gastro-esophageal junction (GEJ) of dogs with brachycephalic airway obstructive syndrome (BAOS), and to identify the manipulation that most improves the detection of GEJ abnormalities and sliding hiatal hernia (SHH) in dogs with BAOS.
In vivo experimental pilot study and prospective clinical study.
Five purpose-bred Beagles and 20 dogs diagnosed with BAOS.
Respiratory and digestive clinical signs as well as respiratory and GEJ abnormalities were scored. The presence of SHH was investigated using radiography and endoscopy in standard conditions. Endoscopic investigation was repeated after manipulations including manual pressure on the cranial abdomen (MP), Trendelenburg position (30°), or temporary complete endotracheal tube obstruction (ETO).
No SHH was detected in any normal dog under any condition. Sixty-five percent of dogs with BAOS presented with digestive clinical signs, including vomiting and/or regurgitation. SHH was observed in only one dog via radiography and was not detected via endoscopy. Manipulations during endoscopy influenced GEJ abnormalities and allowed the detection of SHH in 2 (30°), 4 (ETO), and 5 (MP) dogs, respectively. Digestive clinical signs correlated with GEJ abnormalities observed only in dogs with ETO (P = .02).
Manipulations aimed at increasing the transdiaphragmatic pressure gradient during endoscopy in BAOS dogs allowed the detection of GEJ abnormalities and SHH that were not detected under standard conditions. Although MP allowed detection of SHH in more dogs than ETO, scores under MP did not correlate with digestive clinical signs. Therefore, ETO may be more accurate manipulation for the detection of GEJ abnormalities in BAOS dogs.
确定旨在增加经膈压力梯度的操作对患有短头气道阻塞综合征（BAOS）的犬胃食管交界（GEJ）的影响，并确定哪种操作最能改善BAOS犬GEJ异常和滑动性食管裂孔疝（SHH）的检测。
体内实验性初步研究和前瞻性临床研究。
5只专门培育的比格犬和20只被诊断为BAOS的犬。
对呼吸和消化临床症状以及呼吸和GEJ异常进行评分。在标准条件下使用放射学和内窥镜检查来调查SHH的存在。在进行包括对颅腹部手动加压（MP）、头低脚高位（30°）或临时完全气管内插管阻塞（ETO）等操作后，重复进行内窥镜检查。
在任何条件下，任何正常犬均未检测到SHH。65%的BAOS犬出现消化临床症状，包括呕吐和/或反流。仅通过放射学在1只犬中观察到SHH，内窥镜检查未检测到。内窥镜检查期间的操作影响了GEJ异常，并分别在2只（30°）、4只（ETO）和5只（MP）犬中检测到SHH。消化临床症状仅与ETO犬中观察到的GEJ异常相关（P = 0.02）。
在BAOS犬的内窥镜检查期间，旨在增加经膈压力梯度的操作能够检测到标准条件下未检测到的GEJ异常和SHH。尽管MP比ETO能在更多犬中检测到SHH，但MP下的评分与消化临床症状不相关。因此，ETO可能是检测BAOS犬GEJ异常更准确的操作。
