Gastroesophageal Reflux Disease in Dogs

This report described the first documented veterinary case of gastroesophageal reflux disease (GERD) causing laryngeal dysfunction. A 7-year-old neutered Saint Bernard was evaluated for chronic coughing, gagging, voice change, excessive panting, and intermittent vomiting and diarrhea. Oral examination revealed laryngeal and pharyngeal thickening and erythema. Bronchoalveolar lavage fluid revealed no abnormalities and was negative on culture. Esophagoscopy showed diffuse erosions and ulcerations of the esophagus. Fluoroscopy of the esophagus and barium swallow esophagram were consistent with GERD.

Improvement of respiratory signs was noted after antacid and antimicrobial treatment for Helicobacter infection, based on treatment guidelines in humans. However, vomiting persisted. Subsequent gastroduodenoscopy revealed complete resolution of laryngitis, pharyngitis, and esophagitis. Biopsies of gastric wall demonstrated Helicobacter infection and duodenal biopsies showed severe lymphocytic-plasmacytic enteritis. Treatment for Helicobacter infection was continued and treatment for inflammatory bowel disease involved prednisone and a novel protein diet. Complete remission of respiratory and GI signs was noted at follow-up 4 months later.

While GERD is a common cause of laryngitis in human medicine, it has not been described in veterinary literature. Further research is needed, as an association of GERD with laryngeal disease is an important consideration in veterinary patients with concurrent respiratory and GI disease.

Commentary

By presenting the results of extensive lower respiratory and esophageal evaluation, the authors made a case for diagnosis of reversible laryngeal dysfunction induced by GERD. Typical GERD symptoms in humans are heartburn and regurgitation; in dogs, regurgitation is typically the recognized sign. Extra-esophageal signs of GERD include hoarseness, chronic cough, dyspnea from laryngospasm, and dysphagia. While a single case report does not establish a relationship between laryngeal dysfunction and GERD in dogs, this report emphasized that laryngeal inflammation, as well as esophagitis, could be a consequence of vomiting or GERD.—P. Jane Armstrong, DVM, MS, MBA, DACVIM

Source

Gastroesophageal reflux and laryngeal dysfunction in a dog. Lux CN, Archer TM, Lunsford KV. JAVMA 240:1100-1103, 2012.