Esophageal pH-monitoring in nonbrachycephalic dogs; a reference

Abstract

Objective: To establish parameters that describe acidic gastroesophageal reflux (GER) events in nonbrachycephalic, hospitalized dogs without gastrointestinal disease following short total intravenous anesthesia, to establish upper reference limits for parameters that describe GER. Study design: Clinical prospective study. Animals: Healthy, client-owned dogs presenting for elective orthopedic surgery. Methods: Dogs were sedated with IM methadone (0.2 mg/kg) and medetomidine (5 ug/kg), followed by alfaxalone total intravenous anesthesia. The Digitrapper esophageal dual pH monitoring probe was placed transnasally into the esophagus. Dogs were unsedated during the subsequent recording period. A GER event was defined as esophageal pH less than 4.0. Parameters that described GER were: (1) number of GER events per hour, and (2) cumulative esophageal acid exposure (percentage of recording duration) at each sensor. Upper reference limits were calculated for each parameter. Results: Thirty-five dogs were included (median age 7 years, range 1–12). The median recording duration was 21.1 h (range 13.6–29.3). Productive regurgitation was not noted in any dog. The median number of distal and proximal GER events per hour was 0.3 (range 0–4.3) and 0 (range 0–1), respectively. The median cumulative distal and proximal esophageal acid exposure was 0.2% (range 0.3–9%) and 0% (range 0%–1%), respectively. Conclusion: Upper reference limits for distal and proximal GER per hour was 2.4 and 0.4, respectively, and, for cumulative distal and proximal esophageal acid exposure, 2.3% and 0%, respectively. Clinical significance: Dogs undergoing esophageal pH monitoring in a similar hospital setting with parameters above these upper reference limits have excessive GER.