SA Swallowing diseases

Question 1

What signs are associated with orophayngeal disease?

Answer 1

Dysphagia, drooling saliva, halitosis, odyophagia

Question 2

What clinical signs are indicative of dysphagia?

Answer 2

Difficulty forming bolus/ lapping, excessive motion, dropping food from mouth, drooling, nasal discharge, persistent attempts to swallow, gagging and coughing, reluctant to eat, poor condition

Question 3

Functional oropharyngeal dysphagia

Answer 3

Abnormal neuromuscular activity

• Cricopharyngeal chalasia/achalasia - laryngeal hemiplegia
• Myasthenia gravis

Question 4

Morphological oropharyngeal dysphagia

Answer 4

Morphological

• Congenital abnormalities - cleft, malocclusion, osteopathy
• Inflammation
• Obstruction
• Trauma
• Osteopathy - TMJ
• Neoplasia

Question 5

Cheilitis

Answer 5

Inflammation of the lips

Question 6

What clinical signs are indicative of OESOPHAGEAL disease?

Answer 6

• Dysphagia - poor condition, anorexia
• Drooling saliva
• Halitosis
• Regurgitation - aspiration pneumonia
• Odynophagia

Question 7

What is the difference between vomiting and regurgitation?

Answer 7

Regurgitation is a passive event

Contents is undigested food covered with mucus/ saliva & has a neutral pH

Question 8

Pseudoptyalism

Answer 8

Failure to swallow normal amounts of saliva

Question 9

Ptyalism

Answer 9

Excess saliva production

Question 10

Physical exams of swallowing disorders should concentrate on what areas?

Answer 10

Oral cavity exam

Head exam - jaw, skull, musculature

Neck palpation - oesophagus

Neuro

Systemic

Question 11

Contrast medium often used in practice

Answer 11

Barium sulphate

Question 12

What autoimmune disease of the dog may be characterised by dysphagia?

Answer 12

Masticatory muscle myositis - 2M antibodies

Myesthenia gravis -Anti-ACh receptor antibodies

Question 13

Differentials for oesophageal disorders.

Answer 13

Motility - Megaoesophagus (neural/congenital)

Inflammation - Oesophagitis (infectious), Relfux

Obstruction - Foreign body, congential (structure), neoplasia

Misc - diverticulim, fistula

Question 14

Megaoesophagus

Answer 14

Dilation of the oesophagus with functional paralysis

Causes: idiopathic, secondary to MG, oesophagitis

Radiography - dilation of the oesophagus with ventral displacement of the trachea

Question 15

Treatment of Megaoesophagus?

Answer 15

Feed from a height

If poor motility feed a liquid diet.

If residual activity feed large boluses - may stimulate contraction

Question 16

Differentials for oesophagitis.

Answer 16

Irritant ingestion

Infectious agents

Reflux

Acute and persistent vomiting

Question 17

Treament of oesophagitis.

Answer 17

Frequent small feeds

Antibiotics

Antacids

Local anaesthesia

Gastrostomy

Question 18

What is the difference between an intraluminal, intramural and extramural obstruction?

Answer 18

1. IU - within the tubular lumen
   
   1. Foreign body
2. IM - within the tubular wall
   
   1. Neoplasia
   2. Stricture
   3. Granuloma
3. EM - outide of the tubular wall - compressive
   
   1. Thyroid
   2. Thymic/ mediastinal mass
   3. Vascular ring

Question 19

What can be a pharmacological cause of oesophageal stricture?

Answer 19

Doxycycline

(caused by fibrosis of the oesophagus)

Question 20

Bougienage vs Balloondilation

Answer 20

1. Longitudinal shear - risk of perforation
2. Radial stretch as inflated - less risk of perforation