Dog Reflux: Symptoms and Treatment [Vet Recommendations

Reflux in a dog that is, pathological discharge of contents into the stomach and esophagus.

• What is reflux?
• What is the difference between acid reflux and acid reflux disease??
• Anatomy of the upper gastrointestinal tract
• Cause dog reflux
  • Gastric erosions and ulcers
  • Inflammation of the esophagus
  • Urolithiasis
• Why is bile so dangerous?
• Dog reflux symptoms
  • Neoplastic diseases of the esophagus
  • Neoplastic diseases of the stomach
• Diagnosis of dog reflux
  • Medical interview
  • Clinical examination
  • Ultrasound examination
  • Radiological overview examination
  • Contrast radiological examination
  • Endoscopic examination
• Treatment of dog reflux
  • Reflux and diet
  • Drugs for reflux
  • Antacids
  • Histamine type 2 receptor antagonists
  • Proton pump inhibitors (PPIs)
  • Sukralfat
• Prognosis of dog reflux

What is reflux?

Reflux is a condition when the content of the duodenum flows back through the pylorus to the stomach, then we speak of duodenal-gastric reflux (DGR), or from the stomach to the end of the esophagus.

In the second case, it is gastroesophageal reflux disease (GOR / GER).

Sometimes both conditions occur simultaneously and this situation is called duodenogastro-oesophageal reflux (DGER).

In dogs in the upper gastrointestinal tract, food should move in one direction - towards the intestines. In pathological conditions, there may be a situation where the mixture of bile, bile acids and pancreatic juice in the duodenum returns to the stomach, where it mixes with gastric juice containing hydrochloric acid and pepsin, and can be thrown even higher, into the esophagus.

What is the difference between acid reflux and acid reflux disease?

The very pathological regression of the content is called reflux, while the appearance of tissue changes and accompanying symptoms is referred to as reflux disease.

We call reflux diseases analogously to the corresponding reflux, that is:

• duodenal-gastric reflux disease,
• duodenal - gastro - esophageal,
• gastro-esophageal also known as gastroesophageal reflux disease.

The line between acid reflux and reflux disease is very fluid and sometimes it is difficult to clearly determine whether a given patient suffers from reflux or reflux disease. Additionally, in one case, reflux may be the cause of the disease, and in another, it may be only one of the symptoms of the entire disorder complex.

It is assumed that human reflux is mainly gastro-oesophageal and duodenogastro-oesophageal reflux, while in animals, especially dogs, it is mainly referred to duodenogastric reflux.

When looking for information about reflux, you can also come across the concept of regurgitation, which is sometimes mistakenly used as a synonym for reflux. Regurgitation, however, is severe acid reflux, in which stomach contents reach the throat, causing a sour, unpleasant taste or a feeling of excessive saliva in the mouth.

Anatomy of the upper gastrointestinal tract

The digestive tract is divided into the following sections:

• esophagus,
• stomach,
• small intestine,
• large intestine,
• anal canal,
• anus.

As in this article we discuss issues related to reflux, I will present the structure of only selected elements of the digestive system.

The esophagus and the stomach form the initial section of the gastrointestinal tract. The esophagus is a tubular, extensible structure with three sections:

• the cervical part,
• the thoracic part,
• the abdominal part.

Next is the stomach, which is a hook-shaped extension of the digestive tract, lies between the esophagus and duodenum. In this part of the digestive tract, the digestive content is chemically processed under the influence of gastric juice.

Dogs have a single-chamber simple stomach, with a capacity of 0.6 liters in small breed dogs to as much as 8 liters in very large breed dogs. It consists of three basic parts:

• inlet,
• shank,
• the pylorus.

We also distinguish the fundus and two curves - smaller and larger.

In the gastric mucosa there are, inter alia, parietal cells that produce hydrochloric acid (HCl).

An important element of these cells is the so-called. proton pump. Protons are also called hydrogen ions (H +), the proton pump has the ability to transport them outside the cell, where, when combined with chloride (Cl-) ions, they form hydrochloric acid escaping into the stomach.

In addition to digesting food, hydrochloric acid lowers the pH of the gastric environment, which in dogs is around 1. Such a low pH has a bactericidal effect and activates the inactive pepsinogen produced by other stomach cells - the main cells - into active pepsin, responsible for digesting proteins.

The pylorus, in turn, passes into the initial part of the small intestine - the duodenum, which then passes into the jejunum. It is in the duodenum that the bile and pancreatic ducts have their openings, and the chyme mixes with pancreatic juice, bile and intestinal gland secretions.

For the proper functioning of the digestive system, the so-called accessory glands are also necessary, i.e. the salivary glands, liver and pancreas - they are responsible for the production of bile and pancreatic juice.

The pancreas is a gland that has both exocrine and endocrine functions. It produces insulin and glucagon, two hormones whose main action is to regulate blood glucose levels.

Pancreatic enzymes are trypsin, amylase and lipase, these are enzymes necessary to digest starch, proteins and fats and are part of pancreatic juice. This organ is also responsible for the production of a fluid with a high concentration of carbonate groups, mainly sodium bicarbonate, which is used to neutralize hydrochloric acid in the duodenum.

The liver, on the other hand, is the body's largest gland with many important functions. I will not discuss all of them, I will just point out that liver cells, hepatocytes, produce bile, which is transported through the bile ducts to the gallbladder, where it is stored, and then through the bile duct to the duodenum.

Cause dog reflux

The regurgitation of duodenal contents into the stomach in dogs is a natural phenomenon, if it occurs sporadically, it occurs in the period between meals and is not associated with the appearance of disorders in the work or structure of the gastrointestinal tract.

In a healthy dog, the work of the upper gastrointestinal tract is based on the full synchronization of all organs and systems involved in the passage of food content. We are talking about the salivary glands, the esophagus with the muscles, the sphincter of the esophagus, stomach, pylorus, duodenum, as well as the liver with the gallbladder and the pancreas.

Thanks to their cooperation, none of the tissues is damaged. It is mainly about the mucosa, and more precisely about its mucosa, i.e. the outermost layer. It is a natural barrier and protects the esophagus and stomach against self-digestion and damage.

It can perform its functions through the specific anatomical structure of the gastric mucosa and thanks to its physicochemical properties, i.e. the difference in electric potentials between the basal part and the lumen of epithelial cells, as well as from the mucus layer covering the surface of epithelial cells.

The surface mucus is sticky, rich in bicarbonates produced by the proper glands of the stomach and shows the phenomenon of adherence, i.e. very strong adherence to the surface of gastric epithelial cells. Thus, it prevents potential damage to the mucosa during digestion or stress.

The epithelial cells on the surface form a barrier that is impermeable to gastric acid, while the basal membrane, i.e. the innermost layer of the mucosa, takes part in intensive regeneration processes in the event of even the slightest damage.

However, when there are disturbances in the work or construction of one of the elements of this complicated machine, the functioning of the other components is impaired relatively quickly and, as a consequence, they become damaged.

The clear causes of reflux are not exactly known. It is believed that the causes listed below play an important role in this process, however, in order to understand the relationship between these mechanisms and verify the pathogenesis of reflux, we must wait for more detailed studies of this issue. Reflux, as I have already mentioned, in addition to an independent disease, it can also be a symptom of other disorders, hence it is difficult to determine what is the cause and what is a consequence of certain disorders.

Disturbed motility of the gastrointestinal tract plays a large role in the formation of reflux, for example, the appearance of migrating anti-peristaltic contractions, i.e. those that shift the food in the opposite direction than normal. These can occur in the esophagus when being sick or sick.

Their formation is probably influenced by the cholinergic system, regulating, inter alia, the work of the gastrointestinal tract, and lowering the secretion of somatostatin, i.e. a hormone that inhibits the secretion of gastrointestinal-pancreatic peptides:

• gastrin,
• secrets,
• vasoactive intestinal peptide,
• glucagon and insulin,
• as well as pepsin and hydrochloric acid in the stomach and pancreatic enzymes.

Disturbed peristalsis may also be intensified by the formation of a sometimes inverted pressure gradient in the lumen of the gastrointestinal tract, so that the content of the duodenum or stomach moves back from the place of higher pressure to the area of ​​lower pressure.

Another cause of reflux may be the relaxation of the sphincter, allowing the content to flow freely. With duodenal-gastric reflux it is the pylorus, while with gastroesophageal reflux it is the lower esophageal sphincter.

It is assumed that anti-peristaltic contractions are more likely to cause duodenogastric reflux, while pressure differences and abnormal sphincter function are responsible for the occurrence of gastro-oesophageal reflux.

In the case of duodenogastric reflux, we can additionally indicate a few more reasons for its occurrence. The frequency of peristaltic contractions may be reduced or the strength of these contractions may be reduced, leading to a slower gastric emptying. The cause of this reflux may also be structural abnormalities or dysfunction of the pyloric sphincter.

However, another cause of gastroesophageal reflux may also be a sliding hiatal hernia.

It is a disorder involving the movement of the abdominal part of the esophagus and / or the stomach to the chest through the esophagus in the diaphragm, i.e. through the opening in the diaphragm, through which the esophagus passes through the chest to the abdominal cavity. This leads to impairment of the operation of the lower esophageal sphincter, which promotes the reflux of stomach contents.

The hernia may be congenital or acquired.

Congenital hernia may be caused by disturbances during embryonic development, while acquired hernia may be caused by chronic vomiting, obstructive airways disorders or trauma.

Predisposed to this disorder are dogs of the following breeds:

• shar pei,
• chow chow,
• English bulldogs,
• french bulldogs.

Gastroesophageal reflux may also appear as a result of the use of general anesthesia, because most anesthetics and atropine reduce the tone of the lower esophageal sphincter. According to research studies, 10 to 55 percent of dogs undergoing orthopedic surgery that did not have any gastrointestinal disorders experienced transient perioperative reflux.

Sometimes the appearance of reflux is also observed in patients who suffer from other diseases, such as gastric erosions or ulcers, esophagitis or gallstones, but it is not always known what is the cause and what the effect in a given case.

Gastric erosions and ulcers

A superficial defect in the epithelium and mucosa that does not reach the muscular layer of the mucosa is called erosion.

Over time, the defect deepens, damages the muscle layer as well as blood vessels, and an ulcer forms.

Two mechanisms are cited as the causes of gastric ulcers:

1. Weakening of the protective ability of the so-called mucosal barrier.
2. Increasing the intensity of the action of aggression factors.

Aggression factors include hydrochloric acid, pepsinogen, microbial toxins, or other substances that can enter the stomach.

Systemic changes, such as:

• uraemia,
• sepsis,
• hypovolemic shock,
• chronic anemia,
• hypercalcemia,
• liver dysfunction,
• as well as gastric motility disorders and the associated regurgitation of the duodenal contents into the stomach.

Symptoms of peptic ulcer disease in dogs are identical to those in reflux disease, and gastric ulcers may also be accompanied by reflux, so a visit to the veterinarian is necessary to make a definitive diagnosis.

Inflammation of the esophagus

It is a disease that can have many causes. During its course, inflammatory changes most often include the mucosa, less often the submucosa and the muscles.

The causes of esophagitis include:

• gastroesophageal reflux,
• duodenal-gastric reflux,
• diseases with acute or chronic vomiting,
• physicochemical factors such as irritants, corrosives,
• foreign bodies,
• infectious agents.

The changes may affect the cervical part, the thoracic part or the entire esophagus. However, they most often occur in the thoracic part, near the lower esophageal sphincter.

Clinical symptoms depend on the severity of the lesions and the underlying disease.

The most common findings are:

• downpour,
• vomiting,
• excessive salivation,
• swallowing frequently,
• reduced or no appetite,
• unpleasant smell from the mouth,
• difficult swallowing,
• painful swallowing.

In the case of minor changes, the course of the disease may be asymptomatic.

Urolithiasis

The presence of stones in the gallbladder is called gallstone disease.

Gallstones are rarely found in small animals and are often not accompanied by clinical symptoms, but when they appear, they appear in the form of:

• vomiting,
• lack of appetite,
• jaundice,
• apathy.

The causes of gallstones are:

• the presence of inflammatory and post-inflammatory changes in the bile ducts,
• stagnation of bile,
• metabolism disorders,
• canine roundworm invasion.

It is presumed that a spontaneously occurring one of the given reasons is not able to cause the formation of deposits or stones, there must be several of them simultaneously. In addition, the occasional occurrence of gallstone disease in dogs is probably due to lower cholesterol levels and a higher concentration of cholesterol dissolving substances and agents that counteract the precipitation of calcium carbonate in the bile.

Why is bile so dangerous?

The components of bile can be conventionally divided into two groups.

1. The first one includes those responsible for the performance of bile tasks in the body, they include the so-called solid components of bile, or basic components. They are present in bile in a more or less constant concentration and they are mainly:
   • water,
   • bile acids,
   • phospholipids,
   • basic electrolytes (HCO3 -, Na +, K +, Cl-),
   • partly also bile pigments.
2. The second group includes substances whose content in bile fluctuates significantly or is periodic. These compounds are generally found in the bile in relatively small amounts and are of little importance in the digestive processes in the duodenum.

Bile acids are detergents, i.e. surface-active substances that have the ability to reduce the surface tension of solutions, thanks to which they enable the action of pancreatic lipase - an enzyme responsible, among others, for digesting fats in the intestine.

The second component of bile are bile pigments, which are of diagnostic importance - they accumulate in the gastric mucosa, encrusting it and giving it a characteristic orange color; they are also responsible for the characteristic orange color of vomiting.

A very important property of bile acids is the possibility of damaging cell membranes and nerve endings, not only in the stomach or esophagus, but also in the intestines, if they are in them without food.

The flow of bile into the stomach causes changes in the structure of the gastric mucosa, leading to a significant reduction in the amount of mucus and degeneration of epithelial cells. These changes appear after 3 to 6 months of continuous contact of the cells lining the stomach with bile and other components of the duodenal contents.

Dog reflux symptoms

The symptoms of reflux mainly affect the upper gastrointestinal tract (mouth, pharynx, pharyngeal sphincter, upper esophagus) and include:

• a burning sensation in the stomach,
• nausea,
• vomiting,
• pains in the chest and stomach area,
• dehydration,
• feelings of fullness in the stomach area.

The animal may cough, cough up foamy secretions, and regurgitate gas. With advanced gastritis, there may be a decrease in appetite and, consequently, weight loss.

Vomiting may appear in the morning, on an empty stomach, or during the day, between meals. They often contain large amounts of mucus and turn yellowish-orange in color due to the presence of bile. After the excess bile is returned, the dog's well-being improves significantly.

If your dog is behaving differently, adopting unnatural positions, howling or squeaking, refusing to eat or eating less, vocalizing while eating, swallowing a lot, drooling more, rainstorms or vomiting - even occasionally - be sure to take him to your vet.

An easily noticeable symptom is nausea, which in animals is expressed through the characteristic movement of the tongue and munching.

The variety of symptoms is therefore very large, and in addition to the upper gastrointestinal tract, changes may also appear in the nasal cavity, nasal sinuses, larynx, Eustachian tube, middle ear and lungs.

In the oral cavity, damage to the tooth enamel or periodontitis can be observed, and on the part of the respiratory system:

• runny nose,
• wheeze,
• hoarseness,
• cough,
• congestion,
• asthma, bronchitis and pneumonia may also develop.

Sometimes the symptoms may go unnoticed by the owner, especially since they can be expressed in various, often non-specific ways. They are initially poorly visible and only as the disease progresses do they become easier to observe.

Reflux disease is the most common cause of esophagitis and gastritis.

It can also lead to erosions and ulcers in the stomach and esophagus, scarring of the esophagus, i.e. replacing the healthy mucosa lining the esophagus with hard, fibrous tissue that narrows the lumen of the esophagus.

This narrowing causes severe pain when swallowing and after eating, difficulties arise with swallowing first hard and then soft food and liquids, the animal salivates excessively, vomits after eating and becomes thinner.

In the case of untreated reflux disease, the so-called Barrett's esophagus, i.e. changes in the structure of cells in the epithelium lining the esophagus, also occur.

Normally, the esophagus is covered with a multilayered squamous non-keratinized epithelium, but due to the long-term effect of irritating substances contained in the contents of the stomach ejected from the stomach, it is replaced by a columnar epithelium of the gastric or intestinal type. With this type of lesions, apart from a significant worsening of symptoms, the dog may also show shortness of breath.

Chronic, untreated reflux disease can lead to cancer of both the stomach and esophagus.

Neoplastic diseases of the esophagus

Tumors of the esophagus are very rare, accounting for less than 0.5% of all cancers in dogs. Lesions most often develop in older dogs, with the same frequency in both sexes, with no apparent breed predilection.

The most common esophageal neoplasms include:

• squamous cell carcinomas,
• different types of sarcomas - sarcoma leiomyomas, fibrosarcomas,
• osteosarcoma.

Occasionally the esophagus may be secondarily occupied by growing lesions in neighboring organs such as the thyroid gland, thymus and heart.

Clinical signs of esophageal tumors in dogs are a consequence of narrowing and subsequent obstruction of the organ lumen by the developing tumor.

They usually manifest themselves:

• lack of appetite,
• weakening,
• difficulty swallowing, often accompanied by severe pain.

The animal drools profusely, and there is often an unpleasant odor from the mouth. Occasionally, respiratory disturbances are observed which may be the result of aspiration pneumonia.

Occasionally a dog is found to have fever and swelling in the neck area.

The typical and most frequently observed clinical symptom is chronic vomiting that occurs during intake of food and fluids; sometimes regurgitation is observed. Chronic vomiting rapidly leads to weight loss and cachexia.

Neoplastic diseases of the stomach

Patients suffering from cancer are more and more common in the veterinary clinic, and of all domestic animals, dogs are the most common species.

In animals, gastric tumors are relatively rare, accounting for about 1% of all oncological cases.

Most often they are located near the pylorus.

According to statistics, males are more affected than females. There are no unequivocal studies that would indicate racial predisposition, although scientists note that it is more common in:

• west highland white terriers,
• German Shepherds,
• belgian shepherd dogs,
• Scottish Sheepdogs,
• and also beagle.

Most of the described gastric tumors are malignant, of which 60-70% are adenocarcinomas. Less commonly, sarcoma leiomyomas, lymphomas, extramedullary plasmacytomas and fibrosarcomas are diagnosed.

They usually appear in dogs between 8 and 9 years of age, often metastasize to regional lymph nodes, liver and lungs, which makes the prognosis poor.

In many cases, gastric tumors produce clinical symptoms similar to those that occur in the course of esophageal neoplasms. Due to the fact that they are not specific, the diagnosis is usually made when the disease process is already very advanced and the prognosis is unfavorable.

In the course of advanced cancer, but also other diseases of the gastrointestinal tract, such as gastric ulcers, bleeding may occur. The vomit that appears then may be stained with fresh blood, but more often it is coffee grounds - the blood in the stomach is cut by hydrochloric acid.

Another symptom associated with bleeding is pale mucous membranes and tarry black stools that are also colored by blood, affected by stomach acid and digestive enzymes. It's important to remember that fresh blood in your dog's stool comes from the end of the digestive tract, not the stomach.

Diagnosis of dog reflux

Diagnosis of diseases of the esophagus and stomach is most often based on information obtained from:

• intelligence,
• the results of the clinical trial,
• ultrasound examination (USG),
• X-ray examination (X-ray) examination,
• contrast X-ray examinations,
• endoscopic examination.

These studies are not substitutes or competing ones, but complementary to each other. Additionally, blood tests are performed, which in the case of reflux are necessary for premedication and possible general anesthesia, and then additional tests are performed, because reflux itself does not significantly affect blood parameters.

Medical interview

A medical history is the basis of any diagnosis, so it is very important to talk honestly with your veterinarian. It is worth preparing answers to questions such as:

• What disturbing symptoms have appeared in your pet, if you suspect reflux in your dog, be sure to look at the paragraph where I described the symptoms of reflux and think about which of them occur;
• when did you observe them;
• has it changed in severity, for example, is vomiting more frequent;
• have you taken any medications;
• whether the dog is taking medication on a permanent basis;
• have you changed your karma recently;
• do you have other pets at home and whether they have any disturbing symptoms as well.

The more information, the easier it is for a veterinarian to make an initial diagnosis, establish a differential diagnosis, i.e. a list of diseases that manifest themselves in a similar way, and determine what tests should be performed to confirm or exclude the initial diagnosis.

Clinical examination

During a clinical examination, the doctor checks the condition of the mucous membranes and skin, and the organs and lymph nodes available for visual and palpation examination. Assesses whether the animal is dehydrated, shows no signs of anemia or jaundice, assesses the condition of the oral cavity. It also measures temperature, heart rate and the number of breaths.

The remaining tests are performed on an empty stomach.

It is recommended that animals be not given food for 24 hours and no water to drink for six hours. Regurgitation following premedication may cause the patient to suffocate or develop aspiration pneumonia.

In addition, its presence clearly limits the field of view, making it impossible to conduct the examination.

Limiting fluid intake prevents the formation of a so-called gastric puddle, which makes it difficult to observe the gastric mucosa, especially during endoscopy. An additional difficulty may be air bubbles, the presence of which is also minimized by a short-term fast.

Ultrasound examination

It is a non-invasive test and most animals allow this test to be performed without sedation. Most often, however, a thorough shaving of the hair on the stomach is required.

Thanks to ultrasound examination, it is possible to assess the structure and thickness of the stomach and intestines wall, the possible presence of erosions and defects in the mucosa, and gastrointestinal motility. The structure and size of other abdominal organs are also assessed.

The image of the gastrointestinal wall in ultrasound consists of five layers. With gastritis accompanying reflux, its wall thickens and its layered structure becomes blurred.

Radiological overview examination

The radiological examination is performed in premedication, i.e. after administration of sedatives. During this examination, the size, shape and position of the internal organs of the abdominal cavity can be assessed.

Contrast radiological examination

Contrast radiological examination involves the administration of a contrast agent to the gastrointestinal tract.

Contrast X-ray is used to assess intestinal transit time, peristalsis, mucosal surface and gastrointestinal content, as well as to identify intestinal strictures and obstruction, including foreign bodies and tumors.

Endoscopic examination

Endoscopic examination of the esophagus is called esophagoscopy, gastroscopy of the stomach, and duodenal duodenoscopy. It is a test performed under general anesthesia.

This examination enables panendoscopy, i.e. colonoscopy of the esophagus, stomach, duodenum and jejunum.

It allows you to assess the condition of the mucosa, its surface, color, possible presence of erosions, hyperemia, fluids, bile, residual food content. If, after fasting, the presence of residual food content, especially with an admixture of bile, is found, motility disorders of the anterior segment of the gastrointestinal tract are suspected.

In the case of reflux, there will be additionally visible congestion of the esophageal mucosa and / or intestines, thickening of the mucosa, ecchymosis and erosions may also appear.

During such examination, a sample for histopathological examinations can be taken, which assess changes in the structure of cells in the gastric mucosa and / or esophagus.

Both X-ray and endoscopic examinations are safe examinations.

Complications after them are extremely rare, in some respondents respiratory and cardiovascular symptoms are observed, mainly due to general anesthesia. There may be symptoms of hypoxia or aspiration pneumonia.

After endoscopic examination, there are various types of infections, mainly pharyngitis related to the manipulation of the endoscope. The rarest complication is perforation of the gastrointestinal wall, mainly associated with chronic inflammation or ulceration.

Patients with coagulation disorders are also at increased risk of postoperative complications.

However, it should be emphasized once again that these tests are safe procedures, and the information that we obtain thanks to them contributes a lot to both the diagnosis and the development of an effective therapy.

Treatment of dog reflux

Reflux and diet

Diet is the cornerstone of treating acid reflux and other gastrointestinal diseases. Feed easy-to-digest food, ready-made gastrointestinal veterinary food as recommended by your veterinarian, or well-balanced cooked food.

It should be noted that self-cooking is complicated and composing a menu to meet all the nutritional needs of a dog usually requires consultation with a veterinary nutritionist. In addition, it is very important to divide the daily dose of food into several smaller portions.

It is recommended to use an infusion and / or a decoction of linseed, which has a coating and protective effect on the gastrointestinal mucosa. It gives very good results and can be used both therapeutically and prophylactically.

Drugs for reflux

All drugs should be administered only as prescribed by a veterinarian, in doses prescribed by him.

Antacids

Antacids contain insoluble salts and therefore do not have a general effect.

Their effect on the pH of the gastric contents is not very strong and short-lived, therefore it is believed that they are not effective in gastro-oesophageal reflux disease compared to other drugs and are therefore not used in veterinary medicine.

Histamine type 2 receptor antagonists

Histamine receptor antagonists, including cimetidine, famotidine, and the recently used but discontinued ranitidine, inhibit gastric acid secretion by blocking receptors in the parietal cells of the stomach.

These drugs are given once or twice a day and can be given with or without food.

According to studies, they are less effective in treating gastroesophageal reflux disease compared to proton pump inhibitors. The combination of histamine receptor antagonists with proton pump inhibitors may reduce the effectiveness of the latter.

Proton pump inhibitors (PPIs)

Proton pump inhibitors, including omeprazole, pantoprazole, esomeprazole and lansoprazole, have a longer duration of action than antacids or histamine receptor antagonists, with the maximum effect being achieved 2 - 4 days after dosing.

They should be given 30 minutes before eating, twice a day. Long-term use should be limited.

The most common complications associated with the administration of proton pump inhibitors include diarrhea and intestinal dysbiosis.

Sukralfat

Sucralfate is a complex salt that works by creating stable connections with proteins in places where the mucosa of the digestive system is damaged.

The drug is not very effective in veterinary medicine, and it is more effective when given as a suspension rather than in tablets.

Human studies show that reducing acid production may reduce the risk of oesophagitis secondary to gastro-oesophageal reflux disease. While proton pump inhibitors do not prevent gastric reflux in dogs, they can increase the pH of the reflux and thus prevent damage.

The prognosis of dog reflux

The prognosis depends on the advancement of tissue changes at the time of diagnosis.

With a quickly diagnosed and properly treated reflux disease, the symptoms quickly subside and most often the problems, at least temporarily, disappear.

It happens that their relapses occur, it depends on the cause of reflux, but the conscious owner is able to quickly notice disturbing changes and react quickly. In such situations, complications are extremely rare.

The prognosis is cautious or unfavorable in late-diagnosed reflux that has already led to serious changes. The type of complications that you have to deal with plays a big role. Some of them, such as chronic inflammation, require longer treatment, but have a chance of recovery. With complications in the form of neoplasms or strong strictures of the esophagus of various backgrounds, the prognosis will always be poor.

Summary

Reflux or acid reflux disease are conditions that cannot be taken lightly.

Initially, they may be asymptomatic or expressive in easily overlooked ways. Over time, if left untreated, they cause great discomfort and then even suffering to the animal.

Their symptoms are not very characteristic, so it is impossible to make an unequivocal and certain diagnosis based on the observation of the dog. A number of additional tests and consultation with a veterinarian are always necessary. It is not worth delaying it, so as not to lead to serious complications and not to expose your pet to pain.

If the etiology of reflux is known, the factor responsible for its formation should be eliminated if possible. Pharmacological treatment prescribed by a veterinarian is applied periodically, while changes in diet and eating style must be permanently introduced.

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