Digestive: Esophagus Flashcards
What are the 4 phases of swallowing?
- Oral prepatory phase
- Oral phase
- Pharyngeal phase
- Esophageal phase
Which test should be performed in all cases of acquired dysphagia?
What condition is this testing for?
AchR Ab titer
Myasthenia gravis
What is a possible, deadly zoonotic disease that is a differential for dysphagia?
Rabies
You have a patient that has salivation and retching.
Are this patient’s clinical signs consistent with vomiting or regurgitation?
Vomiting
Regurgitation doesn’t have salivation or retching
What are the 4 abnormalities that may be indicated by cervical and thoracic radiographs +/- contrast?
Esophageal dilation
Radiopaque structures (FB, mass)
WIdening of the mediastinum (thymoma)
Evidence of aspiration pneumonia
What is the difference between cricopharyngeal achalasia or asynchrony?
While both relate to the function of the Upper Esophageal Sphincter (UES). Achalasia is the failure of the UES to relax and asunchrony is the lack of coordination of UES relaxation and pharyngeal contraction
You have a weaning golden shepherd puppy named Lassy who has progressive dysphagia and makes repeated efforts to swallow resulting in gagging, retching, and nasal regurgitation.
What is a likely diagnosis for this case?
Cricopharyngeal achalasia or asynchrony
Based on:
Signalment: juvenile dogs and golden retrievers
CS: progressive dysphagia at weaning and repeated efforts wto wallow, gagging, retching, and nasal discharge
You have a weaning golden shepherd puppy named Lassy who has progressive dysphagia and makes repeated efforts to swallow resulting in gagging, retching, and nasal regurgitation.
What are the diagnostic tests that should be run in this case?
Exclusion of other systemic disorders and cervical and thoracic radiographs
You have a weaning golden shepherd puppy named Lassy who has progressive dysphagia and makes repeated efforts to swallow resulting in gagging, retching, and nasal regurgitation.
You have diagnosed Lassie with Crychoid achalasia.
What are the treatment options?
- Surgical myotomy or myectomy of the cricopharyngeal muscle
Botulism toxin A
Determining the ideal consistency of food and water
What is GER?
Ger is the relaxation of the lower esophageal sphinger (LES) leading to reflux of gastric material into the esophagus, leading to varying degrees of esophagitis
What are the clinicals signs of GERD?
Varies from no clinical signs to anorexia, dysphagia, odynophagia, regurgitation, and hypersalivation.
Acer is a 3 yo GSD with anorexia, dysphagia, hypersalivation, and vomiting.
You believe that he has GERD.
What are some diagnostic tests you would like to perform?
CBC, biochem, and UA- usually unremarkable
Thoracic rads: may see esophageal dilation +/- aspiration pneumonia +/- mediastinal or pleural air or fluid
Contrast rads: unreliable
Videofluroscopy: irregular esophageal surface and motility
Endoscopy: lesions (most sensitive and specific)
Acer is a 3 yo GSD with anorexia, dysphagia, hypersalivation, and vomiting.
Diagnostic tests have confirmed that he has GERD.
What are you possible courses of treatment?
Eliminate predisposing
Smaller sized fat-restricted meals frequently
Gastric acid suppresents if GER is present: antacids, H2RAs, PPIs, Sucralate)
Prokinetic agents
Gastronomy tube?
Corticosteroids?
Antibiotics?
Congenital megasophagus is most common in what breeds?
Great Dage, GSD, Irish Setters, Labrador Retrievers, Newfoundlands, Shar Peis
and Siamese cats
Atari is a 2yo GSD with dysphagia during the esophagial phase, regurgitation, halitosis, and ptyalism.
What diagnostics would you like to perform?
These are the clinical signs of megaesophagus.
PE: Always perform a full neuro exam
Cervical and thoracic rads
Esophagram
Video fuoroscopy
Endoscopy
CBC, Serum, biochem, UA
ACTH stim or resting corisol
Acetylcholine receptor antibody test, blood lead assay
Electromyography
