2002: Hiatal hernia in a puppy

Complications and outcome following staphylectomy and folded flap palatoplasty in dogs with brachycephalic obstructive airway syndrome

OBJECTIVE

To compare the prevalence of pre-, intra-, and postoperative variables and complications associated with staphylectomy (S) and folded flap palatoplasty (FFP).

STUDY DESIGN

Retrospective study.

SAMPLE POPULATION

Client-owned dogs (n = 124).

METHODS

Medical records of S and FFP dogs from a veterinary teaching hospital were reviewed between July 2012 and December 2019. Signalment, clinical pre-, intra-, and postoperative data were collected and reviewed. Median (interquartile range) was reported.

RESULTS

A total of 124 dogs among 14 breeds underwent surgical treatment for an elongated soft palate with either a S (n = 64) or FFP (60). FFP dogs without concurrent non-airway procedures were associated with longer duration of surgery (p = .02; n = 63; S, median = 51 min [34-85]; FFP, median = 75 min [56.25-94.5]) and anesthesia (p = .02; n = 63; S, median = 80 min [66-125]; FFP, median = 111 min [91-140.8]). Neither soft palate surgery was associated with the occurrence of anesthetic complications (p = .30; 99/120; S, 49; FFP, 50), postoperative regurgitation (p = .18; 27/124; S, 17; FFP, 10), or with hospitalization duration (p = .94; n = 124; S, median = 1 day [1]; FFP, median = 1 [1]). Postoperative aspiration pneumonia (9/124; S, 4; FFP, 5) and major complications were rare (5/124; S, 3; FFP, 2).

CONCLUSION

S and FFP had similar anesthetic and perioperative complications, although FFP dogs had longer anesthetic and operative times.

CLINICAL SIGNIFICANCE

Although FFP took longer, no other clinically significant differences were appreciated between S and FFP procedures. Because of limitations inherent in study design, surgeons should continue to use clinical judgment when deciding on a procedure.

Incidence of alimentary and respiratory disease in brachycephalic dogs presenting to primary care veterinary practices participating in the SAVSNET project

BACKGROUND

Brachycephalic dogs clinically affected by brachycephalic obstructive airway syndrome have been shown to have a high incidence of gastrointestinal disease, with French Bulldogs (FBD) identified as a particularly affected breed.

METHODS

Clinical records of 750 brachycephalic dogs attending over 500 practices participating in the small animal veterinary surveillance network (SAVSNET) project were analysed in this cohort study to determine the incidence of alimentary and respiratory disease within FBD, Bulldogs (BD) and Pugs attending primary care veterinary practice. Electronic clinical records were studied for treatment or acknowledgement of specific clinical signs that could be attributed to different anatomical locations. Disease of the different anatomical locations was marked as either being present or not present which allowed for statistical analysis.

RESULTS

Significant differences in the incidence of oesophageal (p = 0.006), gastric (p = 0.001) and intestinal (p = 0.001) diseases were present among the breeds studied. FBD had significantly increased odds ratios of having oesophageal (2.0, 2.2), gastric (2.4, 1.5) and intestinal (1.7, 1.5) diseases relative to Pugs and BD, respectively. Pugs had significantly increased odds ratios of having upper respiratory tract disease relative to BD (1.9).

CONCLUSION

The results show the incidence of gastrointestinal disease and upper respiratory tract disease is significantly different between the brachycephalic breeds studied. Furthermore, the general population of FBD has the highest incidence of gastrointestinal disease.

Computed tomographic comparison of esophageal hiatal size in brachycephalic and non-brachycephalic breed dogs

OBJECTIVE

To determine whether an anatomical difference in esophageal hiatus (EH) size exists between brachycephalic and nonbrachycephalic dogs.

STUDY DESIGN

Retrospective clinical study.

ANIMALS

Client-owned dogs (n = 87).

METHODS

Clinical records and images of dogs that underwent computed tomography between June 2015 and September 2018 were reviewed. For the first part of the study, EH and aortic (Ao) cross-sectional surface areas were measured in brachycephalic (group 1) and nonbrachycephalic dogs of similar body size (<15 kg) without respiratory or gastroesophageal (GE) signs (group 2) by using multiplanar reconstruction. Esophageal hiatus:aortic ratio was calculated. In the second part of the study, absolute EH measurements were also compared in weight-matched (WM) dogs (8-10 kg) from groups 1 and 2.

RESULTS

Mean (±SD) of EH:Ao values for group 1 (8.1 ± 2.8) were higher (P < .0001) than those for group 2 (3.7 ± 1.1). In addition, EH measurements of 20 WM dogs in group 1 were higher than those of 20 dogs in group 2 (P < .05).

CONCLUSION

Esophageal hiatus cross-sectional surface area (directly and indirectly measured) in brachycephalic dogs was considerably larger than that in nonbrachycephalic dogs of generally similar body size.

CLINICAL SIGNIFICANCE

Results of this study provide evidence to support the existence of a specific anatomical factor that could likely correlate to functional GE alterations (eg, regurgitation, gastroesophageal reflux, and sliding hiatal hernia) commonly seen in brachycephalic dogs.

Hiatal Hernia in the Dog: A Clinical Report of Four Chinese Shar Peis

Four Chinese shar pei littermate puppies were presented for vomiting, regurgitation, hypersalivation, and poor growth. Diagnosis of hiatal hernia was made for each of the four dogs based on survey radiographs and barium esophagram studies. All dogs initially underwent medical therapy, to which only one dog responded. All dogs underwent surgical treatment, which included manual hernia reduction followed by phrenoplasty, esophagopexy, and left incisional gastropexy, 5 to 40 days following initiation of medical therapy. The three surgical techniques described eliminated the need to enter the pleural cavity and offered excellent long-term results with no recurrence of clinical signs following surgery.

Paraoesophageal hiatal hernia and megaoesophagus in a three-week-old Alaskan malamute

Paraoesophageal hiatal hernia was diagnosed in a three-week-old Alaskan malamute. Reduction of the hernia was followed by an oesophagopexy and a bilateral gastropexy. During the early postoperative period, the puppy continued to have signs that were thought to be related to a concurrent megaoesophagus. At nine months of age the dog had gained weight and was well except for occasional episodes of regurgitation. These episodes responded well to medical therapy, and at the time of writing the dog had not required further treatment.

Prevalence of gastrointestinal tract lesions in 73 brachycephalic dogs with upper respiratory syndrome

OBJECTIVES

To determine the prevalence of gastrointestinal tract lesions in brachycephalic dogs with upper respiratory tract disease.

METHODS

The gastrointestinal tract and respiratory disorders of 73 brachycephalic dogs presented with upper respiratory signs were evaluated. Clinical signs and endoscopic and histological anomalies of the upper digestive tract were analysed.

RESULTS

A very high prevalence of gastrointestinal tract problems in brachycephalic dogs presented with upper respiratory problems was observed clinically, endoscopically and histologically. Endoscopic anomalies of the upper digestive tract were present even in dogs without digestive clinical signs. Furthermore, histological evaluation of the digestive tract sometimes showed inflammatory lesions not macroscopically visible at endoscopy. Statistical analysis showed a relationship between the severity of the respiratory and digestive signs. This was significant in French bulldogs, males and heavy brachycephalic dogs.

CLINICAL SIGNIFICANCE

These observations show a correlation between upper respiratory and gastrointestinal tract problems in brachycephalic breeds with upper respiratory disease. Surgical treatment of respiratory disease could improve the digestive clinical signs, and/or gastro-oesophageal medical treatment could improve the outcome for surgically treated brachycephalic dogs.