OROPHARYNX + OESOPHAGUS

Question 1

What are the clinical signs of masticatory muscle myositis?

Answer 1

• dysphagia
• difficulty masticating
• swollen/painful masticatory muscle

Question 2

What causes masticatory muscle myositis?

Answer 2

Autoimmune idiopathic condition against 2M muscle fibres of masticatory muscles

Question 3

How would you diagnose masticatory muscle myositis?

Answer 3

-antibody titre for 2M fibres (specific for masticatory muscles)
-biopsy of temporalis/masseter muscle
ANALGESIA UNTIL RESULTS

Question 4

How is masticatory muscle myositis treated?

Answer 4

Immunosuppressive drugs (care as steroids can cause muscle wastage in large breed dogs)

Question 5

What causes cricopharyngeal achalasia?

Answer 5

Lack of coordination of pharynx w/ food bolus - no relaxation of upper oesophageal sphincter @ cricopharyngeal muscle. Congenital (Golden Retrievers)

Question 6

What are the clinical signs of cricopharyngeal achalasia?

Answer 6

• dysphagia
• aspiration
• pharyngeal regurgitation
• exaggerated swallow

Question 7

How is cricopharyngeal achalasia diagnosed + treated?

Answer 7

DIAGNOSIS = fluoroscopic exam during barium swallow
TREATMENT: -feeding tubes (long term nutritional supplementation)
-injection of botulinum toxin into cricopharyngeal muscle
-myotomy of cricopharyngeal muscle (if sphincter doesn’t open at all)

Question 8

What are the clinical signs of megaoesophagus?

Answer 8

• regurgitation
• aspiration pneumonia
• weight loss

Question 9

What is megaoesophasus and how is it caused?

Answer 9

=chronic dilation + atony of oesophageal body

Either congenital or acquired (underlying myopathy/neuropathy/junctionopathy, lead toxicity, tetanus, botulism)

Question 10

How is megaoesphagus diagnosed?

Answer 10

• thoracic rads-> generalised/focal oesophageal dilation (+oesophageal dilation)
• oesophagram
• screen for underlying disease

Question 11

How would you treat megaoesophagus?

Answer 11

Congenital (young dogs)-> no def. treatment, cisapride

Acquired -> treat underlying disease + cisapride

Question 12

What causes oesophagitis?

Answer 12

=inflam of oesophageal mucosa secondary to something ingested or disease causing persistent V+, reflux or increased gastric acidity

Question 13

What are the clinical signs of oesophagitis?

Answer 13

• cough
• regurgitation
• anorexia
• increased salivation

Question 14

How is oesophagitis treated?

Answer 14

• cisapride (stops reflux)
• sucralfate (protects oeosphageal mucosa)
• protein pump inhibitor (reduces acid production)

Question 15

What is the cause of hiatal hernia?

Answer 15

Congenital/traumatic/condition increasing abdom pressure causes abnormality of diaphragm -> prolapse of stomach cardiac region into thorax

Question 16

What are the clinical signs and treatment of hiatal hernia?

Answer 16

CLIN SIGNS: cough + regurgitation
TREATMENT: -surgery if young patient
-cisapride, sulfacrate, protein pump inhibitors

Question 17

What is vascular ring anomaly?

Answer 17

=congenital persistent r. aortic arch -> form ring around trachea + oesophagus

Question 18

What are the clinical signs of vascular ring anomaly, how is it diagnosed and treated?

Answer 18

CLIN SIGNS: regurgitation + aspiration pneumonia
DIAGNOSIS: thoracic rads w/ barium -> cranial oesophageal dilation w/ norm caudal oesophagus
TREATMENT: surgical resection of abnorm vessels

Question 19

What causes dysautonomia? What are the clinical signs?

Answer 19

=loss of autonomic nervous system function (mostly cats)
CLIN SIGNS: -mydriasis
-regurgitation
-V+
-dry MM
-anorexia/weight loss
-distended bladder
-constipation/dysuria

Question 20

How is dysautonomia diagnosed and treated?

Answer 20

DIAGNOSIS: coin signs, rads -> dilated intestines, pilocarpine admin to eye -> misosis, histopath of autonomic ganglia
TREATMENT = palliative

Question 21

What is the cause of oesophageal strictures?

Answer 21

Fibrous band of tissue causing narrowing of oesophagus, secondary to anything causing mucosal damage e.g.. drugs, reflex, FBs

Question 22

What are the clinical signs of oesophageal stricture and how is it treated?

Answer 22

CLIN SIGNS: regurgitation, aspiration pneumonia
TREATMENT: dilation of stricture with multiple balloon dilations several days apart until the clin signs are manageable, liquidised bland diet, feeding tube for nutritional support if severe

Question 23

What are the clinical signs for an oesophageal foreign body?

Answer 23

Regurgitation, anorexia, hypersalivation

Question 24

How could you treat an oesophageal foreign body?

Answer 24

Endoscopic removal ASAP! If chronic FB/oesophageal perforation -> thoracotomy w/ oesophageal resection + anastomosis (w/ PPIs + sucralfate to prevent oesophageal stricture)