Image Quiz: Why is this 3-year-old pug acutely regurgitating?

Nov 06, 2012

A 3-year-old spayed female pug was presented for evaluation of inspiratory stridor and regurgitation of three weeks' duration. The patient was nonresponsive to medical management consisting of metoclopramide, famotidine, and maropitant citrate.

On physical examination, stenotic nares and inspiratory stertor consistent with brachycephalic upper airway syndrome were noted. The rest of the physical examination findings were normal, and the results of a complete blood count and serum chemistry profile were unremarkable.

Based on the dog's history and physical examination findings, survey radiography (above) and a barium contrast gastrointestinal study were performed (below).

What's your diagnosis?

a) Aspiration pneumonia

b) Megaesophagus

c) Hiatal hernia

d) Gastroesophageal reflux