Evaluating acidic gastroesophageal reflux with wireless pH monitoring in French bulldogs with sliding hiatal herniation

Abstract

Background: Sliding hiatal herniation (SHH) and gastroesophageal reflux (GER) commonly occur in French bulldogs. Wireless pH monitoring can quantitatively assess acidic GER in dogs affected by SHH. Hypothesis/Objectives: Measure acidic GER in French bulldogs with SHH, pre- and post-brachycephalic obstructive airway syndrome (BOAS) surgery, utilizing a wireless pH capsule (Bravo Calibration-free, Medtronic, Minnesota), and correlate with owners' observations of regurgitation. Animals: Eleven French bulldogs diagnosed with SHH via swallowing fluoroscopy. Methods: Prospective cohort study. A pH capsule was endoscopically placed in the esophagus. Up to 96 hours of data were acquired as the owner logged clinical signs. Spearman's correlation and Wilcoxon rank-sum tests evaluated factors correlated with acid exposure time (AET), defined by the % time pH < 4. In 4/11 dogs, Bravo monitoring was repeated 2-4 months after BOAS surgery. Results: Medians (Q1-Q3) for age and weight were 21 months (17-35.5) and 10.0 kg (8.9-11.5). BOAS severity was mild (3), moderate (4), or severe (4). Medians (Q1-Q3) for AET and reflux events were 3.3% (2.6-6.4) and 70 (34-173). Clinical score (P =.82) and BOAS severity (P =.60) were not correlated with AET, but age was negatively correlated (rho = −.66, P =.03). Median probability (Q1-Q3) that regurgitation was associated with a reflux event was 72.5% (0-99). Percent AET numerically improved in all 4 dogs that underwent BOAS surgery although not statistically assessed. Conclusions and Clinical Importance: Wireless pH monitoring documented acidic GER in French bulldogs with SHH, captured subclinical events, and showed improvements after BOAS surgery.