Incidence and characterization of aerophagia in dogs using videofluoroscopic swallow studies.

Abstract

BACKGROUND: Aerophagia (ingestion of air), is a functional aerodigestive disorder in people. Criteria for diagnosis of aerophagia in dogs are >1/3 of bolus volume containing air or ingested air resulting in gastric distention (>1/3 of end gastric volume). Aerophagia is highlighted during eating and drinking. Videofluoroscopic swallow studies (VFSS) document aerophagia in dogs, but the incidence, clinical signs (CS), and associated disorders are unknown. OBJECTIVES: Identify the incidence of aerophagia, compare CS between dogs with and without aerophagia, and identify associated and predisposing disorders using VFSS. ANIMALS: A total of 120 client-owned dogs. METHODS: Sequential VFSS and associated medical records from dogs presenting to veterinary teaching hospitals at Auburn University and the University of Missouri were retrospectively reviewed. Statistical comparisons were made using Mann-Whitney and chi-squared tests, odds ratios (OR), and multiple logistic regression (P&#x2009;<&#x2009;.05). RESULTS: The incidence (95% confidence interval [CI]) of aerophagia was 40% (31.7-48.9). Dogs with mixed CS (gastrointestinal [GI] and respiratory; P&#x2009;<&#x2009;.001, 58.3%) were more likely to have aerophagia than dogs with exclusively respiratory CS (25%). Aerophagia was significantly more common in brachycephalic dogs (P&#x2009;=&#x2009;.01; 45.8% vs 13.8%), dogs with nonbrachycephalic upper airway obstruction (P&#x2009;<&#x2009;.001; 33.3% vs 4.1%), pathologic penetration and aspiration (P-A) scores (P&#x2009;=&#x2009;.04; 41.6% vs 23.6%), and gagging (P&#x2009;<&#x2009;.001; 25% vs 11.7%). Mixed CS (P&#x2009;=&#x2009;.01), brachycephaly (P&#x2009;<&#x2009;.001), and upper airway obstruction (P&#x2009;<&#x2009;.001) were independent predictors of aerophagia. CONCLUSIONS AND CLINICAL IMPORTANCE: Aerophagia was common, particularly in dogs with mixed CS. Brachycephalic dogs and dogs with upper airway obstruction are predisposed. Aspiration risk was high, emphasizing overlapping upper aerodigestive pathways.