SA - Esophageal Diseases Flashcards
The esophagus lies to which side of the trachea?
Left
Where is the affected area with the clinicla sign of dysphagia?
oral cavity/swallowing mechanism
Where is the affected were a if the clinical sign of regurgitation?
Esophagus»_space;»>
Stomach (marked distension)
Where is the affected area if the clinical sign is vomiting?
Abdomen
What diagnostic test do you do to test the swallowing mechanism?
Video fluoroscopic barium swallow
What is cricopharyngeal achalasia
Issue with the swallowing mechanism at the level of the cricopharyngeal
What are the three forms of megaesophagus?
Congenital
Acquired Idiopathic
Acquired Secondary
What is the etiology of congenital megaesophagus?
Unknown but there are a few proposed theories including vagal innervation/esophageal sphincter
How do you diagnose congenital megaesophagus?
History, radiographs, video fluoroscopic barium swallow
What are a few of the most common diseases that cause secondary megaesophagus
-Myasthenia gravis
-Addisons disease
-esophagitis
-esophageal obstruction
-Thymoma
What is a good diagnostic workup for a dog with generalized megaesophagus?
CBC, Chem, UA
Thoracic rads
ACTH stimulation (or baseline cortisol)
Acetylcholine receptor antibody titer
+/- Endoscopy
What is the signalment for acquired idiopathic megaesophagus?
Middle age to older, large breed dogs, GSD, golden, great dane
What is treatment for megaesophagus?
Nutritional management: feed patient from upright position with a high calorie low fat diet
Acid suppression
+/- sucralfate
Prokinetic agents
Why do you want a low fat diet
Fat slows gastric emptying and increases gastric acid production
What is one of the difference between the esophagus in dogs and cats?
Cats have smooth muscle distally but dogs have only skeletal muscle throughout the esophagus
What types of muscle to prokinetic drugs work on?
Smooth muscle only
What is the prognosis for congenital mefaesophagus?
fait to guarded
What is the prognosis for acquired secondary?
Depends on underlying disease
What is the prognosis for acquired idiopathic megaesophagus?
Poor
What is the definitive way to diagnose esophageal foreign body?
Endoscopy
Are esophageal foreign bodies medical emergencies?
YES
What is the prognosis of esophageal FB?
Generally good but depends on the severity of esophagitis
What 2 main medications do we use that cause esohpagitis?
clindamycin and doxycycline in cats
What are the etiologies of esophagitis?
reflux of gastric acid
pressure necrosis
chemical injury
infectious agents
drugs
What are the clinical signs of esophagitis?
Usual signs of esophageal diseases but loss of appetite may be an addition
How do we diagnose esophagitis?
Typically based on clinical suspicion
What is the treatment for esophagitis?
Sucralfate slurry
Antacids
Prokinetics
Nutritional alterations
What is the prognosis for esophagitis generally?
Excellent for mild cases but guarded to poor for severe cases
What is the best way do identify an esophageal stricture?
Endoscopy
What is the treatment for esophageal stricture?
Esophageal balloon dilation
Treat esophagitis
Antiinflammmatories to prevent re-stricture
What is the prognosis for an animal with esophageal stricture?
Fair to guarded
