As anyone who has gone through it knows, heartburn is an unpleasant feeling that happens when stomach acid splashes into the esophagus. Although heartburn describes the feeling, this condition is also known as acid reflux, which accurately describes what happens to cause the unpleasant sensations. Chronic or severe acid reflux is known as gastroesophageal reflux disease (GERD) and is sometimes associated with serious conditions. As with many conditions, our beloved cats and dogs can also be affected by pet GERD.
What Is GERD?
When heartburn or acid reflux becomes chronic, it is referred to as GERD. This condition occurs when there is an uncontrolled backflow of intestinal or gastric fluids into the esophagus, the tube that connects the throat to the stomach. Just like in people who suffer from GERD, these gastrointestinal fluids can damage the mucosal lining of the esophagus in cats and dogs.
Typical Symptoms of GERD
As with most conditions, recognizing GERD in cats and dogs is not always easy. Pets cannot tell us how they feel or where it hurts. They can’t describe a burning sensation in their chests or why they don’t feel like eating, or that they feel like there is a lump in their throats. However, there are some symptoms that can tell you that your pet is feeling off or in pain, such as:
- Difficulty swallowing
- Reduced appetite
- Vomiting
- Signs of generalized discomfort, such as behavior changes or resisting petting or touch
- Change in the bark or meow
- Chronic non-productive coughing
- Nasal discharge and/or sneezing
- Gas and bloating
- Bad breath
- Food intolerances
What Causes Pet GERD?
There are many reasons dogs and cats may develop GERD, however, the following are the most common:
Problems during anesthesia
GERD risks increase whenever a cat or dog is given anesthesia that relaxes the esophageal sphincter and creates an opening between the esophagus and the stomach. This can occur if the dog or cat hasn’t fasted properly prior to the surgery or if they are improperly positioned during it.
Congenital condition
If a cat or dog is born with a hiatal hernia, abdominal content will protrude into the chest cavity. Younger pets are at higher risk since their esophageal sphincters are not yet completely developed.
Chronic vomiting
Chronic vomiting not only increases the risk of pets getting GERD but also increases their chances of getting esophageal cancer.
In addition to the cause listed above, obesity is another common cause of GERD in people and dogs. Like humans, dogs need a healthy diet to help keep their weight under control. There are many ways to help our dogs maintain a healthy weight and live a healthy life.
How Is GERD Diagnosed?
If you notice any of the symptoms above, have your veterinarian examine your pet. A physical exam is always the first step. It may not reveal what the issue is, but it can rule things out. And it gives the veterinarian the chance to ask you questions about your pet’s symptoms and behavior that may help with the diagnosis.
After the examination and a thorough review of your pet’s medical history and symptoms, the veterinarian will perform some diagnostic tests to check for underlying conditions that may contribute to GERD. Below is a list of tests that your veterinarian may prescribe.
Complete blood count (CBC) –evaluates red blood cells, white blood cells, and platelets (the cells that help the body form blood clots).
Urinalysis – a urine test to check for kidney damage, infection, and some metabolic conditions.
Biochemical profile – a blood test that provides information on kidney function, liver health, gastrointestinal enzymes, and electrolytes such as sodium and potassium.
Abdominal imaging – ultrasound or x-rays that let the veterinarian get a good look at the organs in the abdominal cavity.
Thoracic/Chest imaging – chest radiographs are essential for getting a good look at the esophagus, lungs, and heart.
In addition to the tests above, endoscopy uses an endoscope – a minimally invasive camera – to check the inside of the esophagus, trachea (windpipe), and lower airways, which is essential for thoroughly evaluating pet patients suspected to have GERD. Board-certified veterinary internal medicine specialists have extensive training on these procedures.
How Is GERD Treated?
The goal when treating GERD is to reduce the acidity of the stomach fluid and promote proper gastrointestinal motility (the contraction of the muscles in the GI tract). The majority of treatments are done at home. Common treatments include:
Fasting – prior to any dietary changes, withhold food a day or two.
Dietary manipulation – feeding low-fat, low protein meals help reduce stomach acid production. Fat decreases the strength of the esophageal sphincter, and protein increases acid production. Smaller, more frequent meals may help regulate gastric acid production.
Medication – pantoprazole, a proton pump inhibitor (PPI), is often used to treat GERD. Pantoprazole reduces stomach acid secretions and can protect the lining of the stomach. Histamine-2-antagonists may also be given to reduce acid production, either with pantoprazole or as a stand-alone treatment. Monitoring is recommended for pets taking these medications.
Pro-Motility / Esophageal Sphincter Strength Therapy – drug therapy may be used to strengthen the lower esophageal sphincter.
Protection for Esophageal Mucosa – a medication called sucralfate is often used to coat the lining of the esophagus to protect and prevent the disease’s progression.
Using more than one approach when treating GERD in dogs and cats is beneficial. In addition, a board-certified veterinary internal medicine specialist can be vital for developing an effective treatment plan. The goal is to gradually taper and discontinue medication if the clinical signs are controlled. Medications need to be tapered and discontinued one at a time. It may not be possible to get rid of all the clinical signs, and some pets require lifelong therapy.
How to Prevent Pet GERD
Eliminating unhealthy food from your pets’ diet is the first step in preventing GERD. It is key to understand how certain foods affect your dog or cat. A saliva test can help eliminate any allergenic food from your pet’s diet. Adding probiotics to their diet may also help.
It is also important to know exactly what affects your pet’s physical condition. Both overproduction and underproduction of stomach acid can cause GERD, so you’ll need to know which affects your pet. Supplementing for the wrong condition will make their GERD worse.
If the root cause of your pet’s GERD is a hiatal hernia, repairing that condition can help eliminate their symptoms. In addition, reducing or eliminating late-night feedings can reduce the chances of symptoms occurring in the morning.
Because Pet GERD has numerous causes and symptoms, it can be a complex condition to diagnose. And our pets can’t tell us how they feel. This makes it extremely important to be aware of how your pet feels and recognize any unusual behaviors, as this is often the first sign of any illness.
If you think your pet may have GERD, it’s essential to immediately take them to your veterinarian. The proper diagnosis can help eliminate the symptoms and improve your pet’s quality of life. Even if their symptoms disappear, it is a good idea to continue monitoring for gastroesophageal reflux. Keeping your dog or cat on a healthy diet low in fatty foods is the best way to keep GERD in check.
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