Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri.
Brames Animal Health, Littleton, Colorado.
J Vet Intern Med. 2019 Sep;33(5):1954-1963. doi: 10.1111/jvim.15578. Epub 2019 Aug 5.
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.
Dogs with LES-AS by VFSS (n = 19), healthy normal dogs (n = 20).
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.
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).
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.
巨食管（ME）在犬中预后不良。在人类中，引起功能性梗阻的下食管括约肌（LES）紊乱是 ME 的罕见原因，可能对靶向治疗有反应。由于诊断方法学的挑战，犬中功能性 LES 紊乱的报道很少。
假设/目的：确定具有 LES 失弛缓症样综合征（LES-AS）的食管造影吞咽研究（VFSS）特征的犬。我们假设可以使用标准化的 VFSS 标准将具有 LES-AS 的犬与正常犬区分开来。
通过 VFSS 确定为 LES-AS 的犬（n=19），健康正常犬（n=20）。
回顾性研究。2015 年 4 月至 2017 年 12 月，130 只犬在密苏里大学兽医学院就诊（MU-VHC）进行自由喂养 VFSS；20 只健康犬作为对照。吞咽研究评估 LES 在咽部吞咽期间是否无法放松（LES-AS）。受影响的犬随后使用标准化标准进行评估，以确定识别和表征 LES-AS 犬的重要指标。
在 130 次 VFSS 中确定了 19 只具有 LES-AS 的犬。19 只 LES-AS 犬中有 14 只（73.7%）患有巨食管。68.4%（95%置信区间[CI]，47.5%-89.3%）和 63.2%（95% CI，41.5%-84.8%）的受影响犬存在基线食管液体线和“鸟嘴”。食管被分级为无收缩（8/19）、低动力（8/19）或高动力（3/19）。
LES-AS 犬可通过使用自由喂养方案的 VFSS 成功识别。这些数据具有重要的临床意义，因为功能性 LES 阻塞的犬亚群可能是靶向干预的候选者。
