Gastro-Oesophageal Reflux in Dogs and Cats

A special issue of Animals (ISSN 2076-2615). This special issue belongs to the section "Companion Animals".

Deadline for manuscript submissions: closed (15 August 2022) | Viewed by 9041

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Guest Editor
Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
Interests: anaesthesia; gastro-oesophageal reflux; animal pain; diaphragmatic contractility; pulmonary atelectasis
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Guest Editor
Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
Interests: anaesthesia; analgesia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Oesophagitis is an inflammatory process of the oesophageal mucosa which may increase morbidity and lead to severe oesophageal stricture, with detrimental consequences. In dogs and cats, the main cause of oesophagitis is gastro-oesophageal reflux (GOR), which most commonly occurs peri-operatively, and it passes unnoticed (“silent” reflux), showing its aftermath days or weeks later. Several factors have been identified to predispose dogs and cats to GOR, including age, type of surgical procedure, drugs used for pre-medication and/or anaesthesia, volume and acidity of gastric content, and the duration of preoperative fasting. For many years, strict preoperative fasting rules to ensure an empty stomach at induction have been a common practice. However, there is evidence that long periods of pre-anaesthetic fasting may have negative results, such as increased gastric content acidity and risk for GOR.

Another cause of oesophagitis in dogs and cats seems to be the reflux occurring in awake animals, with no apparent causing factors, and  is attributed to insufficiency of the lower oesophageal sphincter. This condition is analogous to the gatro-oesophageal reflux disease in humans, which is widespread and may lead to oesophageal malignancy. In dogs and cats, this “disease” is hardly diagnosed and poorly understood, but it is suspected to cause pain and suffering.

The aim of this Special Issue is to present up-do-date research on GOR in dogs and cats, focusing on the understanding of this condition, clinical implications, and possible prevention strategies.

Prof. Ioannis Savvas
Dr. Kelly Pavlidou
Guest Editors

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Keywords

  • gastro-oesophageal reflux
  • oesophagitis
  • oesophageal stricture
  • dog
  • cat

Published Papers (3 papers)

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14 pages, 283 KiB  
Article
The Effect of Premedication on the Incidence of Gastroesophageal Reflux in 270 Dogs Undergoing General Anesthesia
by Eugenia S. Flouraki, Ioannis Savvas, George Kazakos, Tilemahos Anagnostou and Dimitrios Raptopoulos
Animals 2022, 12(19), 2667; https://doi.org/10.3390/ani12192667 - 4 Oct 2022
Viewed by 1486
Abstract
The aim of this prospective, non-randomized study was to evaluate the effect of nine different premedication medications on the incidence of gastroesophageal reflux (GOR) in anesthetized dogs. Two hundred and seventy dogs undergoing non-intrathoracic, non-intrabdominal elective surgeries or invasive diagnostic procedures were included [...] Read more.
The aim of this prospective, non-randomized study was to evaluate the effect of nine different premedication medications on the incidence of gastroesophageal reflux (GOR) in anesthetized dogs. Two hundred and seventy dogs undergoing non-intrathoracic, non-intrabdominal elective surgeries or invasive diagnostic procedures were included in the study, and were allocated into nine groups (30 dogs/group) defined by the type of premedication administered. Premedication consisted of dexmedetomidine with either morphine, pethidine or butorphanol, acepromazine with either one of the three opioids or midazolam with one of the above-mentioned opioids. Anesthesia was induced with propofol and maintained with isoflurane in oxygen. Esophageal pH was measured with the use of a pH-meter electrode and a pH-value less than 4 and over 7.5 was considered to be GOR. The study revealed that 119/270 (44.1%) dogs experienced a reflux episode during anesthesia. The incidence of reflux did not differ among groups (p = 0.117). In group AB the dogs refluxed within 10 min of the beginning of pH-measurements, in comparison with group DB in which dogs refluxed within 30 min (p = 0.029). Invasive diagnostic procedures had a lower incidence of GOR in comparison to castrations (p = 0.09). The outcome of the study suggests that none of the opioids used increased the incidence of GOR in anesthetized dogs. Full article
(This article belongs to the Special Issue Gastro-Oesophageal Reflux in Dogs and Cats)
10 pages, 254 KiB  
Article
The Effect of the Preoperative Fasting Regimen on the Incidence of Gastro-Oesophageal Reflux in 90 Dogs
by Paraskevi Tsompanidou, Joris H. Robben, Ioannis Savvas, Tilemahos Anagnostou, Nikitas N. Prassinos and George M. Kazakos
Animals 2022, 12(1), 64; https://doi.org/10.3390/ani12010064 - 29 Dec 2021
Cited by 2 | Viewed by 2189
Abstract
This study aimed to investigate the effect of three different preoperative fasting regimens on the incidence of gastro-oesophageal reflux (GOR) in dogs under general anaesthesia. Ninety dogs undergoing non-abdominal and non-thoracic elective surgery were included in the study and equally allocated to three [...] Read more.
This study aimed to investigate the effect of three different preoperative fasting regimens on the incidence of gastro-oesophageal reflux (GOR) in dogs under general anaesthesia. Ninety dogs undergoing non-abdominal and non-thoracic elective surgery were included in the study and equally allocated to three groups. Dogs received canned food providing half the daily resting energy requirements (RER) 3 h prior to premedication (group 3H), a quarter of the daily RER 3 h before premedication (group 3Q), and half the daily RER 12 h before premedication (group 12H). The animals were premedicated with acepromazine and pethidine, anaesthesia was induced with propofol and maintained with isoflurane vaporised in oxygen. Oesophageal pH was monitored throughout anaesthesia. Demographic and surgery-related parameters were not different among groups. The incidence of GOR was 11/30 in group 3H (36.7%), 9/30 in group 3Q (30.0%) and 5/30 in group 12H (16.7%), which was not statistically different (p = 0.262). Reduction of the amount of the preoperative meal from half to a quarter of the daily RER did not reduce the incidence of GOR but resulted in a lower oesophageal pH (p = 0.003). The results of this study suggest that the administration of a meal 3 h before anaesthesia does not have any beneficial effect in the reduction of GOR incidence in dogs compared to the administration of a meal 12 h before anaesthesia. Full article
(This article belongs to the Special Issue Gastro-Oesophageal Reflux in Dogs and Cats)

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17 pages, 1649 KiB  
Systematic Review
Factors Affecting Intraoperative Gastro-Oesophageal Reflux in Dogs and Cats
by Ioannis Savvas, Kiriaki Pavlidou, Tilemachos Anagnostou, Eugenia Flouraki, George Kazakos and Dimitrios Raptopoulos
Animals 2022, 12(3), 247; https://doi.org/10.3390/ani12030247 - 20 Jan 2022
Cited by 3 | Viewed by 3704
Abstract
In animals, gastro-oesophageal reflux (GOR) may occur during anaesthesia, and it can lead to severe consequences such as oesophagitis and oesophageal stricture. This systematic review investigates the effect of fasting duration and anaesthetic and nonanaesthetic drugs on GOR in dogs and cats during [...] Read more.
In animals, gastro-oesophageal reflux (GOR) may occur during anaesthesia, and it can lead to severe consequences such as oesophagitis and oesophageal stricture. This systematic review investigates the effect of fasting duration and anaesthetic and nonanaesthetic drugs on GOR in dogs and cats during general anaesthesia. Fifteen clinical studies met the inclusion criteria in this systematic review. In thirteen studies the population was dogs, while in two studies the population was cats. In the meta-analysis, seven studies were included. Four studies on the effect of fasting duration on GOR in dogs were included in the meta-analysis. In total, 191 dogs had a fasting duration less than 5 h, while 311 dogs had a fasting duration more than 5 h. The heterogeneity of the studies was high and statistically significant (p = 0.0002, I2 = 85%), but the overall effect was statistically nonsignificant (p = 0.82, odds ratio = 0.81, 95% CI 0.15, 4.26), in favour of the low fasting duration (<5 h). Concerning the effect of antacids on GOR, three studies were included in the meta-analysis. The heterogeneity of the studies was low and nonsignificant (p = 0.13, I2 = 52%) and the overall effect was statistically nonsignificant (p = 0.24). The low number of studies and the diverse factors affecting the incidence of reflux prevented us from reaching valuable conclusions on the risk factors for GOR. Full article
(This article belongs to the Special Issue Gastro-Oesophageal Reflux in Dogs and Cats)
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