Antacid Treatment May Be Beneficial To Brachycephalic Dogs Undergoing Surgery
A new study, published in the latest issue of the Journal of Small Animal Practice (JSAP), found that the addition of antacid treatment during the pre- and postoperative period for brachycephalic dogs undergoing surgery may result in a faster and greater improvement in treated dogs.
The study titled “Diagnosis and treatment of gastro-oesophageal junction abnormalities in dogs with brachycephalic syndrome” included thirty-six client-owned brachycephalic dogs (French bulldogs, pug and English bulldogs) in a prospective, randomised trial. Antacid treatment (omeprazole (1mg/kg PO q24 hours) and magaldrate (5-10mL/dog PO q8-12 hours)) was randomly prescribed in 18 dogs before and after surgery, while the other 18 dogs did not receive any gastrointestinal medical treatment. Digestive clinical signs and gastro-oesophageal junction abnormalities (GJA) were assessed and scored at presentation, at the time of surgery and at recheck. GJA were assessed during endoscopy in standard conditions, as well as during endotracheal tube obstruction. All endoscopic procedures were recorded and reviewed by a single, blinded reviewer.
In order to assess whether endotracheal tube obstruction manoeuvre accurately detects GJA, the procedure was also performed during the examination of the gastro-oesophageal junction in a group of 10 control dogs. Control dogs were healthy or had diseases that were not expected to interfere with gastro-oesophageal junction dynamics, and were anaesthetised for independent purposes.
Dr Emilie Vangrinsven, corresponding author for the paper said: “Although results of multivariate analysis failed to demonstrate a direct effect of antacid treatment, a significant interaction between antacid treatment status and improvement of digestive clinical score throughout the endoscopies was present, meaning that treated animals seem to improve faster and have lower clinical scores after surgery than untreated animals. Furthermore, a significant improvement in GJA-obstruction score was present in the treatment group only.
“In contrast to standard endoscopy, the obstruction manoeuvre during endoscopy allowed detection of GJA in dogs, even in the absence of clinical signs. We were concerned that the obstruction manoeuvre may induce false positive results for the diagnosis of dynamic GJA; in the control group, GJA during obstruction manoeuvre were found to be negligible suggesting that this technique does not significantly overestimate the presence of GJA.”
Nicola Di Girolamo, Editor of JSAP concluded: “Based on this study, antacid treatment administered to brachycephalic dogs undergoing surgery may be beneficial. It should be noted that a direct influence of antacid treatment on digestive clinical and lesion scores could not be significantly demonstrated, which may have been because of the lack of an actual difference, or as a result of the small sample size.”
The full article can be found in the March issue of the Journal of Small Animal Practice and can be read online here: https://www.onlinelibrary.wiley.com/doi/10.1111/jsap.13279
The Journal of Small Animal Practice is published monthly and access to articles is free for BSAVA members. For information on how to become a BSAVA member visit https://www.bsava.com/Membership/Member-categories
Short of face but long on potential problems, brachycephalics present many challenges. Explore some of the most common issues facing you when dealing with these cases at BSAVA’s Virtual Congress (25 to 27 March), from respiratory assessment and BOAS surgery to anaesthesia and the importance of a team approach. A review of a number of the other important conditions to watch out for, as well as regurgitation and hiatal hernia, brachycephalic ocular issues, and nursing the BOAS patient will also be covered. Find out more here.
1E. Vangrinsven, O. Broux, L. Massart, S. Claeys, C. Clercx and F. Billen (2021) Diagnosis and treatment of gastro-oesophageal junction abnormalities in dogs with brachycephalic syndrome. Journal of Small Animal Practice, 62 (3). Available at: https://www.onlinelibrary.wiley.com/doi/10.1111/jsap.13279
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