Reflux (GERD) in Cats

What is reflux?

Also known as GERD (gastroesophageal reflux disease), reflux is a condition in which gastric juices flow back from the stomach and into the esophagus. Normally, the sphincter, a muscular valve at the top of the stomach closes to prevent acid and food refluxing back up. This results in pain and inflammation (esophagitis). Over time, scar tissue can build up, leading to stricture, which is a narrowing or tightening of the esophagus.

Reflux can occur in cats of all ages, although it is seen more in young cats, there is no sex predilection.

Causes

There are several causes of reflux in cats, some of which include:

• Cats who have undergone anesthesia are at greater risk, particularly cats who are improperly positioned.
• Not fasting a cat before anesthesia.
• Hiatal hernia is a condition that is caused by a tear in the diaphragm, this allows the stomach into the thorax.
• Chronic vomiting.
• Foreign body (such as a hairball) in the esophagus.
• Cancer of the esophagus.
• Kidney disease. The kidneys are responsible for the excretion of gastrin, a gastrointestinal hormone that stimulates the production of stomach acid to digest food. As the kidneys begin to fail, gastrin may remain in the stomach, which in turn stimulates excess amounts of stomach acid

Symptoms

• Frequent vomiting/regurgitation of undigested food
• Salivation/drooling
• Pain while eating
• Reduced appetite
• Weight loss
• Bad breath

Diagnosis

Your veterinarian will perform a physical examination of your cat and obtain a history from you, including symptoms you may have noticed such as frequent vomiting.

Diagnostic workup:

• Endoscopy can confirm the diagnosis. This procedure, performed under anesthetic involves inserting a thin tube with a camera and a light at the end to evaluate the esophagus and digestive tract.
• Baseline tests include complete blood count, biochemical profile and urinalysis to evaluate the overall health of the cat.

The above tests usually don’t show anything out of the ordinary although ultrasound may find a foreign body or cancer.

Treatment

Addressing the underlying cause, such as removing foreign objects or repair of a hernia.

Protecting the esophagus from further damage with the use of antacid medication to inhibit the production of stomach acid.

Low protein and low-fat diets and your veterinarian may recommend your cat be fed small meals more often.

If the esophagus is ulcerated,  Carafate may be prescribed, this gastric protectant lines the esophagus preventing further damage.

If severe damage has occurred to the esophagus, it may be necessary to insert a stomach tube. This is only a short term (months, not years) solution, though.