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Narrowing of the Esophagus in Dogs

Esophageal Stricture in Dogs

Esophageal stricture in dogs refers to an abnormal narrowing of the tubular organ extending from the throat to the stomach. This condition can manifest at any age in dogs and does not seem to have a genetic component. It is also noteworthy that this medical condition can affect both dogs and cats. For further insights into how this ailment impacts cats.

Symptoms and Types

  • Regurgitation (the return of food or other contents from the esophagus)
  • Liquid meals are often better tolerated than solid meals
  • Difficulty swallowing is observed with upper esophageal strictures
  • Howling, crying, or yelping during swallowing when the animal has active esophageal inflammation
  • Initially good appetite; later lack of appetite due to progressive esophageal narrowing and inflammation
  • Weight loss and malnutrition as the disease advances
  • Weight loss ranging from moderate to severe, with muscle wasting in dogs with chronic or advanced strictures
  • Excessive saliva production and drooling, and/or pain reaction when touched on the neck and esophagus may occur in animals with esophageal inflammation concurrent with stricture
  • Progressive regurgitation and difficulty swallowing can lead to aspiration pneumonia
  • Abnormal lung or breathing sounds, such as wheezing and coughing, may be present in dogs with aspiration pneumonia.

Causes

  • Gastroesophageal reflux, the backward or reverse flow of stomach contents into the esophagus during anesthesia, is the most common cause.
  • Gastroesophageal reflux disease, where stomach contents flow back into the esophagus unrelated to anesthesia.
  • Previous esophageal surgery.
  • Ingestion of chemical irritants.
  • Retention of pills and capsules in the esophagus.
  • Presence of an esophageal foreign object.
  • Persistent vomiting.
  • Cancer.
  • Mass lesion, known as a granuloma, secondary to the parasite Spirocerca lupi, occasionally observed in the southeastern United States.

Diagnosis

To identify the underlying cause of the symptoms, your veterinarian will aim to exclude various diseases or conditions. For instance, if your dog has recently been weaned, a vascular ring anomaly could be the issue. To establish a definitive diagnosis, your veterinarian may perform a barium-contrast X-ray. This procedure involves using a radiopaque fluid in the esophageal passage, allowing abnormalities to be visible on the X-ray image as the liquid passes through. An X-ray might detect a foreign body lodged in the esophagus. Additionally, an endoscope, an insertable visual diagnostic tool, can provide detailed visual examination of the esophagus. Your veterinarian will also be vigilant for any signs of tumors or masses during the diagnostic process.

Treatment

Initially, your dog may require hospitalization. Once hydration needs are met and the affected section of the esophagus is dilated, you may be allowed to bring your dog home. If your dog has aspiration pneumonia and/or esophageal inflammation, it might need extended medical supervision. Intravenous fluids might be necessary to correct hydration levels, and medications may be administered via injection after dilation procedures to aid in healing. Patients with severe aspiration pneumonia may require oxygen therapy.

Furthermore, dogs with severe esophageal inflammation or those who have undergone dilation procedures may not be able to ingest food orally. As a solution, a temporary feeding tube may be inserted during esophageal dilation to ensure continuous nutritional support. When reintroducing oral feeding, bland, easily digestible liquid foods will be necessary. Your veterinarian will guide you on the most suitable diet to facilitate your pet’s recovery.

Living and Management

A barium contrast X-ray, which involves using a radiopaque liquid to trace a passageway and identify abnormalities, or endoscopy, employing an insertable tubular instrument to visually examine the esophagus, should be repeated every two to four weeks until clinical signs resolve and the esophageal lumen size returns to normal.

Esophageal tear or perforation, a life-threatening complication of esophageal stricture dilation, typically occurs during dilation but may also manifest several days to weeks later. Therefore, it’s essential to monitor your dog for signs of this complication. Additionally, remain vigilant for symptoms of aspiration pneumonia resulting from food, liquid, or objects entering the lungs, as the risk remains significant.

Generally, a more guarded prognosis is associated with longer strictures. When strictures are caused by scarring, the prognosis is typically fair to guarded. Despite repeated esophageal dilation, many strictures may recur, making improvement without complete cure a more realistic goal.

Prevention

  • Ensure proper preparation before anesthesia, including a 12-hour preoperative fast.
  • Whenever possible, avoid administering certain drugs before anesthesia.
  • If gastroesophageal reflux is evident, refrain from late-night feedings as they can reduce the muscle’s ability to remain closed between the stomach and esophagus during sleep.
  • Take measures to prevent dogs from ingesting caustic substances and foreign bodies.
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