Esophageal Dz II

Esophageal foreing bodies are always an ____?

Emergency - worse prognosis longer they are in

What are the most common locations of esophageal FB?

LES

Heart base

Thoracic inlet

What are signs of Esophageal FB?

SEVERE Regurgitation

Hypersalivation

Gagging

Odynophagia (hard swallowing)

What are possible sequelae of Esophageal FB?

Ulceration

Necrosis

Perforation

Stricture

Death

We should not use what contrast if we suspect perforation?

Barium

What are some things we could see w/ an esophageal perforation?

Pneumomediastinum

Mediastinitis

SC emphysema

What should you do to tx Esophageal FB?

Endoscopic retrieval

Endoscopic advancement and gastronomy

Esophagotomy

If you see an esophageal granuloma what might you suspect?

Spirocerca lupi - dx w/ fecal float and tx via deworming

What might a dog develop w/ chronic spirocerca lupi?

Neoplastic transformation to fibrosarcoma/ osteosarcoma

What is the primary esophageal neoplasia?

Squamous cell carcinoma

What is a hiatal hernia?

It is when a portion of the stomach herniates through the diaphragm, into the thorax. (Sliding most common)

Who is most likely to ge a hiatal hernia?

Brachycephalics

Shar-peis

Chow chows

Hiatal hernias can be secondary to what?

Chronic airway obstructions

-boas

-lar par

What tool can be used to dx a hiatal hernia on survey rads?

Wooden spoon puts pressure down and cranial to more easily catch the herniation

What is medical management for Hiatal hernias?

PPI

Prokinetics

Sucralfate

What is sx intervention for hiatal hernia?

Airway corrective sx

Reconstruction of the diaphragm and hiatus

What is achalasia?

Failure to relax

What is asynchrony?

Lack of coordination between contraction and relaxation

What is cricopharyngeal dz?

Upper esophageal sphincter is either unable to relax or coordinate correctly - can see at weaning

What is Gastroesophageal reflux dz?

Intestinal fluid/ ingesta moves back into esophagus

-LES function or tone is lost

What are causes of GERD?

Hiatal hernia

Gen anesthesia

Chronic vomiting

Gastroparesis/ ileus

What will we use to tx GERD?

Prokinetics ->Cisapride

PPI

Sucralfate

Reduce fat in diet

No pro kinetic will work on ____ muscle meaning what animal will not have any esophageal benefit?

Skeletal

Dogs

What is esophagitis?

Acute/ chronic inflammation of the esophageal mucosa

What are causes of Esophagitis?

FB

GERD

Anesthesia

Chronic vomiting

Caustic agents

What are tx of esophagitis?

PPI,

Sucralfate

Cisapride - LES function

What is hypomotility?

Ineffective peristalsis w/o megaesophagus

-sim causes to ME

What is the only way to dx hypomotility?

Fluoroscopy

What breeds tend to get Geriatric onset laryngeal paralysis/ polyneuropathy?

Large/ giant breeds

LABS

Goldens

St bernards

Newfies

What progression will you see in Geriatric onset laryngeal paralysis/ polyneuropathy?

Laryngeal paralysis

Dysphagia

Progressive esophageal dysmotility -> ME

Progressive proprioceptive ataxia

What are some things contrast can help us see in the esophagus?

Strictures

Diverticulae

Radiolucent FB

Intraluminal masses

When should you be cautious/ not use contrast?

If aspiration pneumonia

If sedated

What do we typically use for fluoroscopy?

Barium

Non-osmotic iodinated IV contrast

What are some tests to run if you have Diffuse megaesophagus

Neuro exam

CK + Regular labs

ACh antibody titers

Baseline cortisol

+/- T4

What are some symptomatic therapies for regurgitation?

Mosten kibble

Slurry diets

Thick it

Smaller more frequent meals

Restrict fat

A gastronomy tube may or may not improve ___ and ___?

Regurgitation/ Aspiration

Cisapride should be used in caution w/?

Megaesophagus

What might you be suspicious of w/ chronic resp dz?

GI causes -> poss silent regurgitation w/ aspiration