Reflux Esophagitis in Dogs

Overview of Canine Reflux Esophagitis

Reflux esophagitis is an inflammation of the esophagus that results from the backward flow of gastric or intestinal fluid into the esophagus. This fluid contains acids and other irritating substances that can cause severe inflammation and ulceration in dogs.

Causes of Reflux Esophagitis in Dogs

• Poor patient positioning during anesthesia
• Failure to have the patient fast prior to anesthesia
• Frequent or chronic vomiting
• Hiatal hernia is a protrusion of abdominal contents into the chest cavity through the esophageal hiatus, which is the naturally occurring opening through the diaphragm.
• Young animals often have a lazy lower esophageal sphincter muscle that separates the esophagus from the stomach.
• Cancer of the esophagus
• Esophageal foreign body

Reflux esophagitis is seen in both dogs and cats. It occurs in males and females and all ages are affected, although younger animals with congenital hiatal hernia are at increased risk.

There is no breed predilection reported, but Chinese shar-pei dogs may be prone as it is associated with hiatal hernia.

What to Watch For

• Regurgitation, the effortless evacuation of fluid, mucus and undigested food from the esophagus
• Salivation
• Anorexia, or poor, decreased appetite
• Excessive/persistent gulping
• Discomfort while swallowing
• Weight loss
• Coughing with associated/secondary pneumonia

Diagnosis of Reflux Esophagitis in Dogs

A thorough knowledge of history and clinical signs is very important and is most often helpful in the diagnosis. Diagnostic tests are necessary to confirm a diagnosis of reflux esophagitis. They include:

• Complete blood count (CBC)
• Biochemical profile
• Urinalysis
• Chest X-rays
• Esophagram (barium/dye swallow)
• Fluoroscopy, a type of radiographic evaluation that uses dye to assess the esophagus in motion
• Endoscopy/esophagoscopy, a visual inspection of the esophagus with a specialized instrument

Treatment of Reflux Esophagitis in Dogs

• Patients are generally managed as outpatients, but hospitalization/supportive care may be necessary in extreme/severe cases.
• Low-fat, low-protein meals in small frequent feedings.
• Nutritional support by feeding through a stomach tube or by intravenous feeding in severe cases.
• Gastric (stomach) acid inhibitors such as Tagamet (cimetidine), Pepcid (famotidine), Zantac (ranitidine), Cytotec (misoprostol) and Prilosec (omeprazole) are of benefit in many cases.
• Esophageal/gastric medications that protect or sooth are felt to coat an irritated esophageal lining. Carafate (sucralfate) is most commonly used.
• Gastrointestinal motility (movement) modifiers
• Antibiotic therapy in cases of severe inflammation and associated secondary infection.
• Endoscopic removal of a foreign body
• Surgical intervention may be indicated in certain cases, such as to repair a hiatal hernia.

Home Care for Dogs with Reflux Esophagitis

Administer prescribed medication/diet and treat esophageal reflux as directed by your veterinarian. Control vomiting, limit anesthesia and avoid other disorders that predispose to reflux esophagitis.

Avoid late night feedings, as late feedings tend to diminish gastroesophageal sphincter pressure during the animal’s sleep, contributing to reflux.