The stomach is the dog’s main organ of digestion. It produces gastric acid that helps break down ingested food into smaller molecules for further enzymatic digestion or absorption along the intestine. The stomach propels the food down the small intestine through peristalsis, a rhythmic contraction of the stomach and the intestine allowing food to travel down its length.
Gastroesophageal reflux happens when the rate of peristalsis slows down and the opening at the end of the esophagus (called a sphincter) relaxes and opens up, allowing the gastric acid and digestive enzymes from the stomach to flow back, upwards to the esophagus. This irritates the lining of the esophagus resulting in inflammation (esophagitis) and pain.
The condition is more commonly seen in younger dogs, but dogs of any age may be affected. Shar-Peis are over-represented but it can happen to any breed.
Gastroesophageal reflux in dogs often goes unnoticed or sometimes gets misdiagnosed because the initial presenting signs can be easily confused with other acute upper GI problems such as gastritis, vomiting, or regurgitation. Most clinical signs associated with the condition are due to the subsequent esophagitis it causes and varies depending on the severity of the condition and the extent of the damage it does to the esophageal lining.
Mild gastroesophageal reflux usually presents with excessive salivation (drooling), regurgitation, vomiting, burping, and foul-smelling breath. Dogs with gastric reflux are often seen licking the air obsessively in an attempt to swallow down rising gastric fluids. Restlessness and a generalized sign of discomfort are often noticed in dogs with this condition.
Decrease or total loss of appetite may be seen in dogs suffering from the condition. Moderate to severe reflux causes damage to deeper layers of the esophageal lining resulting in pain, usually during eating or swallowing.
If the damage reaches the upper part of the esophagus, it may affect the larynx, causing coughing and laryngitis. Changes in the quality of the dog’s bark may be observed depending on how severe the laryngeal inflammation is.
In severe cases, dogs develop a decreased appetite and eventually lose weight because they experience pain and difficulty swallowing food and water. Severe damage to the lining of the esophagus can lead to esophageal ulceration and cause hematemesis, or vomiting of blood, in dogs with severe gastric reflux. Dogs with advanced gastroesophageal reflux also show signs of severe pain and discomfort, are often reluctant to move around, and may become lethargic.
There are various causes of gastroesophageal reflux in dogs.
Diagnosis of gastroesophageal reflux can be tricky as the common clinical signs associated with it are often misinterpreted and confused with other GI conditions. When you bring your dog to a veterinary clinic, a thorough history of symptoms observed at home will help your vet diagnose or rule out gastroesophageal disease.
Physical exam may reveal localized pain along the neck area which may be suggestive of esophagitis in dogs. Blood work may come back normal in dogs with mild to moderate gastroesophageal reflux, but severe and chronic cases may result in changes in blood values which can help your vet’s diagnosis.
A radiograph (x-ray) can help visualize the esophagus and may reveal evidence of possible esophagitis and gastroesophageal reflux. Contrast imaging by using barium or other contrast media can help better visualize the esophagus and can even detect esophageal ulcers which can be supportive of a gastric reflux diagnosis.
A definitive diagnosis can be made through an endoscopic exam. An endoscope can visualize in real-time inflammatory changes and damage along the esophageal lining. This is usually done under anesthesia.
Most gastroesophageal reflux cases respond well to medical management. Different medications and changes in diet are often necessary to successfully treat the disease.
Transitioning to a highly digestible, low-protein, and low-fat diet helps control the stomach’s acid production which then helps manage the signs associated with gastric reflux.
Antacids such as famotidine help further control gastric acid production, while medications like aluminum hydroxide and sucralfate can be given to neutralize gastric fluids flowing back to the esophagus and coat its lining for protection. Prokinetic medications like metoclopramide help improve the rate of peristalsis of the esophagus, stomach, and intestine and help prevent the backward flow of gastric and intestinal fluid to the esophagus.
Gastroesophageal reflux due to anatomical problems such as hiatal hernia would require surgery to treat. Spreading out meals to smaller portions and more frequent feeding can also help manage the disease.
Most of these treatment and management pointers can easily be done at home with proper diet, medication, and nutrition. It’s best to consult a vet if you suspect that your dog may be having gastric reflux to get appropriate treatment and help.
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