Evaluation of aerodigestive disease and diagnosis of sliding hiatal hernia in brachycephalic and nonbrachycephalic dogs

J Vet Intern Med. 2022 Jul;36(4):1229-1236. doi: 10.1111/jvim.16485. Epub 2022 Jul 5.

Abstract

Background: Aerodigestive diseases (AeroD), hybrid disorders between the respiratory and gastrointestinal (GI) tracts, may present without GI signs. Sliding hiatal hernia (sHH) is an important AeroD in brachycephalic dogs linked to respiratory pathology. The spectrum of other AeroD and respiratory clinical signs (CS) in brachycephalic and nonbrachycephalic dogs with sHH is unknown.

Objectives: Characterize CS of AeroD in dogs with sHH, compare CS between brachycephalic and nonbrachycephalic dogs, and compare thoracic radiographs and videofluoroscopic swallow study (VFSS) for diagnosing sHH.

Animals: Sixty-seven client-owned dogs with sHH.

Methods: Medical records of dogs with sHH presented to the veterinary teaching hospitals at Auburn University and the University of Missouri between 1 January 2009 and 31 December 2020 were retrospectively reviewed. Between group, comparisons were made using Mann-Whitney test, Chi-square analysis, and Spearman correlation (P < .05).

Results: Dogs with sHH presented with exclusively GI signs (28/67), mixed respiratory and GI signs (22/67), or with exclusively respiratory signs (17/67). Wheras brachycephalic dogs were not significantly more likely to present with respiratory CS (P = .145), they were younger (P < .001), and more likely to present in respiratory distress (P = .02), and with radiographic evidence of aspiration pneumonia (P < .001) compared to nonbrachycephalic dogs. Six of 12 dogs with normal thoracic radiographs having sHH presented with respiratory CS. For detection of sHH, VFSS was superior to radiographs (P < .001).

Conclusions and clinical importance: Dogs with sHH may present with exclusively respiratory signs. Respiratory signs may be more severe in brachycephalic compared to nonbrachycephalic dogs. Videofluoroscopic swallow study was superior to thoracic radiographs for detection of sHH in dogs.

Keywords: brachycephalic; dysphagia; radiographs; respiratory; videofluoroscopic swallow study.

MeSH terms

  • Airway Obstruction* / diagnostic imaging
  • Airway Obstruction* / veterinary
  • Animals
  • Craniosynostoses* / veterinary
  • Dog Diseases* / diagnostic imaging
  • Dogs
  • Hernia, Hiatal* / complications
  • Hernia, Hiatal* / diagnostic imaging
  • Hernia, Hiatal* / veterinary
  • Radiography
  • Retrospective Studies