Wireless Ambulatory Esophageal pH Monitoring in Dogs with Clinical Signs Interpreted as Gastroesophageal Reflux

Abstract

BackgroundAlthough gastroesophageal reflux (GER) often is assumed to be causative for upper gastrointestinal and respiratory signs in dogs, no attempts have been made to verify this assumption.ObjectivesTo monitor esophageal pH with the Bravo pH system in healthy dogs and client‐owned dogs displaying signs commonly attributed to GER.AnimalsSeven healthy and 22 client‐owned dogs.MethodsAfter routine esophagogastroduodenoscopy, radiotelemetric pH capsules were placed in distal esophagus for continuous pH recording. Reflux was defined as single pH measurement <4. At discharge, owners were instructed to press individually predefined clinical sign‐buttons on the receiver whenever indicated. Results between groups were compared using Mann–Whitney U‐test.ResultsThe median (range) number of refluxes in client‐owned and healthy dogs, respectively, was 17 (1–205) and 10 (1–65), the number of refluxes >5 minutes in duration was 1 (0–14), and 1 (0–4), duration of longest reflux (min) was 10 (0–65) and 8 (0–27), and fractional time pH <4 (%) was 0.76% (0.01–6.28), and 0.3% (0–3.1). No differences were found between groups. The median of 7 (1–35) clinical sign‐button pushes were recorded in 21 dogs. Median of 12.5% (2.8% [1/35]–50% [2/4]) reflux‐positive clinical sign‐button pushes was found in 10 dogs with reflux‐positive pushes. Five (22.7%) dogs had increased esophageal acid exposure, and mild esophagitis was noted in 1 dog.Conclusion and Clinical ImportanceDespite evidence of increased GER in some dogs, the clinical sign‐reflux association remained poor. Future investigation should focus on dogs with esophagitis.

The Effect of Orally Administered Ranitidine and Once‐Daily or Twice‐Daily Orally Administered Omeprazole on Intragastric pH in Cats

“…View of the Bravo ™ capsule attached to the feline gastric mucosa. Compared to dogs, comparatively large parts of the gastric mucosa became lodged in the suction well of the capsule.…”

“…We chose the Bravo ™ pH monitoring system because we found it reliable and minimally invasive for extended continuous gastric pH monitoring in dogs . This system allows longer measurement periods than catheter‐based pH probes .…”

“…The approach for gastric capsule placement was similar to what has been described recently in dogs, with the exception that the external vacuum suction (510 mm Hg) applied to the capsule delivery system was decreased from approximately 30 seconds to a median of 20 seconds during the study . After capsule placement, gastric pH recordings were obtained telemetrically at 6‐second sampling intervals for 4 days (96 hours).…”

“…The recent introduction of pH monitoring devices such as the Bravo ™ system has allowed noninvasive, continuous assessment of intragastric pH over prolonged periods. This technique has been evaluated for extended recordings of intragastric pH in dogs . The effects of twice‐daily omeprazole versus standard dosages of famotidine on intragastric pH in cats recently have been reported using this new technique.…”

Evaluation of capsule endoscopy to detect mucosal lesions associated with gastrointestinal bleeding in dogs

“…, Kook et al . ). Initial capsule studies in dogs focused on evaluating GI transit time and motility (Chang et al .…”