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Disorders of the Esophagus in Cats

By Dana G. Allen, DVM, MSc, DACVIM, Professor and Chair, Department of Clinical Studies, Ontario Veterinary College, University of Guelph ; Sharon Campbell, DVM, MS, DACVIM, Manager, Pharmacovigilance Regulatory Affairs, Veterinary Medicine Research and Development, Pfizer Inc. ; Ben H. Colmery, DVM, DAVDC ; James G. Fox, DVM, MS, DACLAM, Professor and Director, Division of Comparative Medicine, Massachusetts Institute of Technology ; Carlton L. Gyles, DVM, PhD, Professor Emeritus, Department of Pathobiology, Ontario Veterinary College, University of Guelph ; Walter Ingwersen, DVM, DVSc, DACVIM, Specialist, Companion Animals, Boehringer Ingelheim (Canada) Ltd, Vetmedica ; Lisa E. Moore, DVM, DACVIM ; Sofie Muylle, DVM, PhD, Faculty of Veterinary Medicine, Department of Morphology, Ghent University ; Sharon Patton, MS, PhD, Professor of Parasitology, Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee ; Andrew S. Peregrine, BVMS, PhD, DVM, DEVPC, DACVM, Associate Professor, Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada ; Stanley I. Rubin, DVM, MS, DACVIM, Clinical Professor, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign ; H. Carolien Rutgers, DVM, MS, DACVIM, DECVIM-CA, DSAM, MRCVS, Senior Lecturer, The Royal Veterinary College, University of London ; Jörg M. Steiner, DrMedVet, PhD, DACVIM, DECVIM-CA, AGAF, Associate Professor and Director, Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University ; Thomas W. Swerczek, DVM, PhD, Professor, Department of Veterinary Science, University of Kentucky

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Signs of problems with the esophagus include difficulty swallowing and regurgitation (return of food or fluid before it has reached the stomach). Congenital abnormalities of the esophagus are discussed earlier in this chapter (see Congenital and Inherited Disorders of the Digestive System in Cats : Esophagus).

Inflammation of the Esophagus (Esophagitis)

Inflammation of the esophagus (esophagitis) is usually caused by foreign objects or acid reflux. Other causes include certain drugs, eating an irritating or caustic substance, or cancer. Calicivirus in cats may also cause esophagitis. Mild inflammation may produce no visible signs and often requires no treatment. If the problem is caused by acid reflux (a cause of heartburn in people), drugs that reduce stomach acid can provide relief. Your veterinarian may recommend feeding your pet a diet of soft food, low in fat and fiber, in small, frequent meals. If esophagitis is severe, a feeding tube may need to be surgically placed into the stomach, bypassing the esophagus to allow it to rest. Antibiotics are sometimes prescribed to prevent bacterial infection.

Foreign Objects in the Esophagus

Cats are generally pickier eaters than dogs, but occasionally they will get foreign objects lodged in the esophagus. Bones are the most common, but other objects such as needles, string, thread, fishhooks, and wood may also become stuck. Signs include excessive drooling, gagging, regurgitation, and repeated attempts to swallow. Many foreign objects can be seen on x-rays. If a foreign object is found in the esophagus, a veterinarian will need to remove it as soon as possible. Surgery is necessary if the esophagus has been perforated or the foreign object cannot be removed using endoscopy. In these cases, the outlook for recovery is usually poor.

Esophageal Strictures

Esophageal stricture is a narrowing of the esophagus. It may develop after trauma (for example, ingestion of a foreign object, caustic substance, or certain drugs), inflammation of the esophagus, gastro-esophageal reflux (gastric acid flowing back into the esophagus), or tumor invasion. Signs include vomiting, excessive drooling, difficulty swallowing, and pain. Examining the esophagus using fluoroscopy and endoscopy are the preferred methods for diagnosis. This enables the veterinarian to actually see the number, location, and types of strictures. Endoscopy may also allow the veterinarian to correct the stricture at the time of examination.

Treatment with a balloon catheter has been successful. The catheter is a tube that is placed in the esophagus and then advanced to where the stricture occurs. The tip of the catheter is then inflated like a balloon, which stretches the esophagus and relieves the stricture. Other methods, including surgery, have been less successful.

Esophageal Diverticula

Diverticula are pouch-like expansions (dilations) of the esophageal wall. They can be inherited or acquired; however, they are rare in cats. There are 2 types of acquired diverticula: pulsion and traction. Pulsion diverticula are caused by an increase in pressure inside the esophagus or deep esophageal inflammation, which leads to a rupture (hernia) of the inner lining. Traction diverticula are caused by inflammation in the chest cavity close to the esophagus. Fibrous tissue is formed and then contracts, pulling the esophageal wall outward (Veterinary.heading on page Disorders of the Esophagus in Dogs : Esophageal Diverticula).

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