Management and outcomes of 13 dogs treated with a modified Heller myotomy and Dor fundoplication for lower esophageal sphincter achalasia‐like syndrome

Abstract

To report the management and outcomes of dogs treated for lower esophageal sphincter achalasia-like syndrome (LES-AS) with modified Heller myotomy, Dor fundoplication, and with the use of a temporary gastrostomy tube.Study design: Retrospective. Sample population: Thirteen client-owned dogs.Methods: Medical records and a client survey were used to assess frequency of vomiting/regurgitation, quality of life (QoL), bodyweight, and feeding modifications at the following time points: prior to referral, postoperatively from discharge to first recheck (4-6 weeks), and from first recheck to survey (48 months). Postoperative and gastrostomy tube complications were surveyed and recorded. Pretreatment and 4-6 weeks postoperative videofluoroscopic swallow studies (VFSS) were compared. Two-sided t-tests were used to compare outcomes between survey time points. Results: Postoperative VFSS scores (available in 9 dogs) improved over preoperative scores in 6 dogs, and 12/13 dogs survived to discharge. One dog was euthanized 3 days postoperatively due to aspiration pneumonia. Postoperative gastrostomy tube complications occurred in half of the dogs that survived to discharge. According to the owners, scores assigned to vomiting/regurgitation improved by 180% (P = .004), QoL by 100% (P = .004), and bodyweight by 63% (P = .035). Conclusion: Modified Heller myotomy with Dor fundoplication and the use of a temporary gastrostomy tube improved clinical signs and owners' perceived quality of life in half of the dogs treated for LES-AS in our clinical setting. Oral sildenafil therapy discontinued postoperatively suggests that surgery was equally efficacious.

Persistent right aortic arch and aberrant left subclavian artery in a dog

“…The lack of definition of the case was initially due to the correlation of the symptoms of PRAA with megaesophagus. With different etiology, megaesophagus, or esophageal hypomotility, corresponds to a syndrome characterized by segmental or complete esophageal dilation caused by loss of normal esophageal peristalsis through injury to intramural nerve plexuses (Winston 3rd et al, 2023). The diagnosis is based on radiographic history, which makes it possible to delimit the esophageal dilation and correlate it with secondary causes (Mace et al, 2013).…”