Retrospective analysis of esophageal imaging features in brachycephalic versus non-brachycephalic dogs based on videofluoroscopic swallowing studies

Caroline Eivers, Rocio Chicon Rueda, Tiziana Liuti, Silke Salavati Schmitz

Background:
Esophageal dysmotility (ED) is increasingly recognized in brachycephalic dogs, often linked with breed-specific anatomical and physiological traits. Despite a suspected higher prevalence of ED in brachycephalic breeds, studies systematically comparing esophageal motility features using videofluoroscopic swallowing studies (VFSS) are limited. This study aimed to analyze VFSS findings in brachycephalic and non-brachycephalic dogs, evaluating associations between breed type and ED features.

Methods:
This retrospective study reviewed VFSS conducted between 2006 and 2017 on 36 dogs presenting with regurgitation or dysphagia, excluding cases of megaesophagus. Dogs were categorized as brachycephalic or non-brachycephalic based on breed. Two blinded reviewers assessed VFSS using standardized criteria to identify motility issues such as prolonged esophageal transit time (ETT), gastroesophageal reflux (GER), and hiatal hernia (HH). Fisher's exact test was applied to assess associations between signalment (breed) and imaging findings.

Results:

• Population: Of 36 dogs, 22 (61%) were brachycephalic breeds.

• Key Findings in Brachycephalic Dogs:
  - Prolonged ETT (15/20, 75%)
  - Ineffective secondary peristaltic waves (15/20, 75%)
  - GER (15/20, 75%)
  - HH (8/20, 40%)

• Brachycephalic dogs were significantly more likely to exhibit ED (P = 0.005), GER (P = 0.02), and HH (P = 0.01). Morphological abnormalities such as redundant esophagus were exclusive to brachycephalic breeds.

• VFSS proved effective for diagnosing GER and HH, often missed by endoscopy.

Limitations:
- Retrospective nature limits control over data uniformity and study conditions.
- Lack of standardized parameters for normal esophageal motility in brachycephalic breeds complicates interpretation.
- Small sample size and reliance on subjective assessments may introduce bias.
- Variability in VFSS protocol (e.g., bolus size, image duration) potentially influenced results.

Conclusions:
The study highlights a high prevalence of presumed ED in young brachycephalic dogs, with imaging features such as prolonged ETT, GER, and HH significantly associated with brachycephaly. VFSS remains the gold standard for ED diagnosis in these breeds. Findings suggest that addressing associated conditions like brachycephalic obstructive airway syndrome (BOAS) through surgery may improve clinical outcomes. Further research is needed to establish baseline swallowing metrics for brachycephalic dogs and to explore postoperative prognoses.

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