Esophageal diseases (Proceedings)
Esophageal diseases cause disturbance of food flow through the esophagus due to obstructions from foreign bodies and tumors, inflammation, decreased motility, and compression of the esophagus from intramural or extra-luminal masses. Esophageal diseases in the dog and cat can be very debilitating and require emergency treatment in many cases. Complications of esophageal disease can be life-threatening due to aspiration pneumonia, necrosis of the esophagus, strictures of the esophagus and severe malnutrition. Most esophageal diseases are treatable if diagnosed early and immediate treatment administered. Diagnosis of esophageal disease is usually not difficult although some patients require more expensive diagnostic tools such as fluoroscopy or endoscopy to diagnose the problem. Treatment is specific for each condition with obstructions and esophagitis being most treatable. Primary motility disorders and neoplasia of the esophagus have a poorer prognosis. In general, dogs present more frequently for esophageal diseases than cats however, overlooking the clinical signs of esophageal disease in cats may prevent proper diagnosis with feline patients possibly being under-diagnosed.
Clinical Signs of Esophageal Disease
Regurgitation is the hallmark sign of esophageal disease. It is distinguished from vomiting as being a passive process that contains undigested food in a tubular shape containing mucus and having a neutral Ph. No bile is seen in regurgitation due to the ingesta not reaching the stomach or small intestine. Regurgitation is similar to vomiting in that it can occur immediately after the patient eats or hours later. There is usually no retching or hypersalivation prior to regurgitation as there is with vomiting. Owners are not very good at distinguishing the two so the clinician must be very specific in asking questions to distinguish or to observe the patient during the process. A patient that has had esophageal disease for a period of time will have weight loss, muscle wasting, weakness, dehydration, malnourished, ravenous appetite is not a painful disease and possibly trouble swallowing. Coughing, dyspnea and pyrexia may be present if aspiration pneumonia is present.