University of Missouri, College of Veterinary Medicine, Department of Veterinary Medicine and Surgery, 900 East Campus Drive, Columbia, MO 65211, USA.
Université de Montréal, Faculté de Médecine Vétérinaire, Département of Sciences Cliniques, St-Hyacinthe, Québec, Canada.
Vet J. 2019 Sep;251:105344. doi: 10.1016/j.tvjl.2019.105344. Epub 2019 Jul 27.
Aerodigestive diseases, hybrid disorders representing a pathologic link between respiratory and alimentary tracts, may manifest with respiratory signs without gastrointestinal signs. These are underdiagnosed in dogs due to poor clinical recognition and diagnostic limitations. We hypothesize that a subset of dogs presenting for cough without gastrointestinal signs would have occult aerodigestive disorders identified using videofluoroscopic swallow study (VFSS). Data were retrospectively obtained from 31 client-owned dogs presenting for cough, with thoracic radiographs, and a VFSS between April 2015 and December 2017. Exclusion criteria were cough of cardiac origin or gastrointestinal signs within 6 months. Swallow study parameters included pharyngeal/esophageal motility, laryngeal obstruction/defects, penetration-aspiration, reflux, excessive aerophagia, megaesophagus (ME), lower-esophageal sphincter achalasia-like syndrome (LES-AS), and sliding hiatal hernia (HH). The median (interquartile range) duration of cough was 4 (2-8) months. Thoracic radiographs were unremarkable in 11 dogs, with aspiration pneumonia suspected in seven. In 25/31 dogs (81%), VFSS abnormalities were detected and some dogs had more than one defect: pharyngeal (n=10) or esophageal hypomotility (n=10), reflux (n=9), penetration-aspiration (n=8), excessive aerophagia (n=6), laryngeal obstruction (n=3), ME (n=3), HH (n=2), and LES-AS (n=1). A respiratory disorder causing cough was identified in 17 dogs with VFSS abnormalities (laryngeal obstruction/defect and airway disease including chronic or eosinophilic bronchitis, tracheal/mainstem bronchial collapse, bronchiectasis, and bronchomalacia). An alimentary disorder identified on VFSS in absence of a discrete respiratory disorder causing cough was diagnosed in eight dogs. In conclusion, canine aerodigestive disorders can manifest as cough without alimentary signs. VFSS is a useful diagnostic to determine the contribution of esophageal/gastrointestinal pathology in dogs with cough.
气消化道疾病是呼吸和消化道之间病理联系的混合性疾病,可能表现为呼吸症状而无胃肠道症状。由于临床识别和诊断限制,这些疾病在犬中被误诊。我们假设,一组因咳嗽而就诊但无胃肠道症状的犬,通过食管荧光透视吞咽研究(VFSS)可以发现隐匿性气消化道疾病。数据是从 2015 年 4 月至 2017 年 12 月期间因咳嗽、胸部 X 线检查和 VFSS 就诊的 31 只患犬中回顾性获得的。排除标准为心源性咳嗽或 6 个月内存在胃肠道症状。吞咽研究参数包括咽部/食管动力、喉阻塞/缺陷、渗透-吸入、反流、过度空气吞咽、巨食管(ME)、下食管括约肌类似失弛缓症(LES-AS)和滑动型食管裂孔疝(HH)。咳嗽的中位数(四分位距)持续时间为 4(2-8)个月。11 只犬的胸部 X 线片未见异常,怀疑有 7 只犬存在吸入性肺炎。在 31 只犬中,25/31 只(81%)检测到 VFSS 异常,一些犬有不止一种缺陷:咽部(n=10)或食管低动力(n=10)、反流(n=9)、渗透-吸入(n=8)、过度空气吞咽(n=6)、喉阻塞(n=3)、ME(n=3)、HH(n=2)和 LES-AS(n=1)。在 17 只 VFSS 异常的犬中发现了一种引起咳嗽的呼吸道疾病(喉阻塞/缺陷和气道疾病,包括慢性或嗜酸性支气管炎、气管/主支气管塌陷、支气管扩张和支气管软化)。在没有明确引起咳嗽的呼吸性疾病的情况下,在 VFSS 上诊断出的 8 只犬存在一种消化道疾病。总之,犬的气消化道疾病可能表现为无胃肠道症状的咳嗽。VFSS 是一种有用的诊断方法,可以确定犬咳嗽时食管/胃肠道病理的贡献。