Evaluating Acidic Gastroesophageal Reflux in French Bulldogs with Sliding Hiatal Herniation Using Bravo pH Monitoring

Abstract: Background: Sliding hiatal herniation (SHH) and gastroesophageal reflux (GER) commonly occur in French bulldogs. Methods to quantify GER and the effect of Brachycephalic Obstructive Airway Syndrome (BOAS) surgery are lacking.
Hypothesis/Objectives: Implement a wireless pH capsule (Bravo Calibration-free, Medtronic, MN) to measure acidic reflux in French bulldogs with SHH, pre- and post-BOAS surgery.
Animals: Eleven French bulldogs videofluoroscopically diagnosed with SHH, off acid suppressant(s) for > 2 weeks.
Methods: A pH capsule was endoscopically placed in the esophagus during a brief anesthesia. Up to 96 hours of data was acquired while the dog was awake and at home. The owner simultaneously logged clinical signs. In 4 dogs, pH monitoring was repeated 2-4 months following BOAS surgery. Spearman’s correlation and Wilcoxon rank-sum tests evaluated factors correlated with acid exposure time (AET).
Results: Medians (Q1-Q3) for age and weight were 30 months (17-35.5) and 10.3kg (8.9-12.2). BOAS severity was mild in 3, moderate in 3, and severe in 5 dogs. Medians (Q1-Q3) for AET and number of reflux events were 5.8% (2.2-7) and 114 (37-188). BOAS severity (p = 0.08) and esophagitis (p = 0.9) were not correlated with AET, but age was negatively correlated (p = 0.03). Median probability that owners observed regurgitation during reflux events was 73%, range 0-99%. In 3 of 4 dogs that underwent BOAS surgery, AET improved following surgery. (Table 1)
Conclusions and clinical Importance: Wireless pH monitoring documented acidic GER in French bulldogs with SHH, captured subclinical events, and showed improvements following BOAS surgery.