Evaluating acidic gastroesophageal reflux with wireless pH monitoring in French bulldogs with sliding hiatal herniation

Abstract

Abstract Background Sliding hiatal herniation (SHH) and gastroesophageal reflux (GER) commonly occur in French bulldogs. Wireless pH monitoring can quantitatively assess acidic GER in dogs affected by SHH. Hypothesis/Objectives Measure acidic GER in French bulldogs with SHH, pre‐ and post‐brachycephalic obstructive airway syndrome (BOAS) surgery, utilizing a wireless pH capsule (Bravo Calibration‐free, Medtronic, Minnesota), and correlate with owners' observations of regurgitation. Animals Eleven French bulldogs diagnosed with SHH via swallowing fluoroscopy. Methods Prospective cohort study. A pH capsule was endoscopically placed in the esophagus. Up to 96 hours of data were acquired as the owner logged clinical signs. Spearman's correlation and Wilcoxon rank‐sum tests evaluated factors correlated with acid exposure time (AET), defined by the % time pH < 4. In 4/11 dogs, Bravo monitoring was repeated 2‐4 months after BOAS surgery. Results Medians (Q1‐Q3) for age and weight were 21 months (17‐35.5) and 10.0 kg (8.9‐11.5). BOAS severity was mild (3), moderate (4), or severe (4). Medians (Q1‐Q3) for AET and reflux events were 3.3% (2.6‐6.4) and 70 (34‐173). Clinical score (P = .82) and BOAS severity (P = .60) were not correlated with AET, but age was negatively correlated (rho = −.66, P = .03). Median probability (Q1‐Q3) that regurgitation was associated with a reflux event was 72.5% (0‐99). Percent AET numerically improved in all 4 dogs that underwent BOAS surgery although not statistically assessed. Conclusions and Clinical Importance Wireless pH monitoring documented acidic GER in French bulldogs with SHH, captured subclinical events, and showed improvements after BOAS surgery.

Keywords

• acid exposure time
• brachycephalic
• brachycephalic obstructive airway syndrome
• bravo capsule
• GERD