Esophageal strictures in dogs can have quite an impact on dogs, causing them to fail to absorb enough nutrients and lose weight if not corrected in a timely matter. In order to better understand esophageal strictures in canines, it helps to fist gain a closer understanding of how the dog's esophagus works, what can cause it to narrow and how it impacts the dog's overall health and well-being. Veterinarian Dr. Ivana explains esophageal strictures in dogs and what conditions may cause a stricture along with some treatment options.
The Esophagus in Dogs
Your dog's esophagus is an elastic, muscular tube through which the swallowed chunks of food and liquids are transported to the stomach. The swallowed mouthfuls of material do not just passively move along the esophagus. Instead, they are actively squeezed and pushed by the rhythmical contractions performed by the esophageal muscular walls.
These muscular contractions are called peristalsis and are not under conscious control. The transportation of food is additionally aided by the lubricating mucus produced on the lining of the esophageal wall.
The contractions and the lubricating mucus effectively drive the food toward the stomach independent of the force of gravity. As a result, dogs can stand and eat or drink with their heads down.
A variety of problems can develop in the esophagus. Sadly, most of them are painful and hard to treat or manage. The most common esophageal problems are: an enlarged esophagus, foreign bodies stuck in the esophagus, esophagitis (inflammation of the esophagus) and esophageal tumors.
All of the above listed issues, if left untreated for a longer period of time, can potentially lead to more permanent issue manifested by narrowing of the esophageal lumen – esophageal stricture.
Although uncommon, esophageal strictures, once developed are considered to be a serious medical condition. In the majority of cases, the strictures develop secondary to inflammation of the esophagus (esophagitis). The esophagitis can be triggered by either mechanical or chemical irritation. Mechanical irritations are caused by foreign bodies (toys, ropes, rawhide) and traumatic events. Chemical irritations are caused by frequent vomiting episodes or gastroesophageal refluxes (during anesthesia).
The most common causes of esophageal strictures in dogs are:
- Inflammation of the esophagus (esophagitis)
- Presence of foreign object in the esophagus
- Frequent vomiting episodes
- Gastroesophageal reflux disease (GERD)
- Tumors (benign or malignant).
According to some newer studies, there are several risk factors for developing esophageal strictures. Those risk factors include: a recent history of a general anesthesia, the oral administration of antimicrobial drugs and a frequent vomiting tendency.
Signs of Esophageal Strictures in Dogs
Esophageal strictures also tend to have a gender predisposition – they are more frequently reported in females. The signs and symptoms of esophageal strictures are versatile, non-specific and usually progressive. The most commonly observed signs and symptoms include:
- Impaired swallowing (dysphagia)
- Frequent regurgitation (usually of food while water is generally well-tolerated)
- Altered appetite – ranges from polyphagia (increased appetite) to anorexia (complete absence of appetite)
- Excessive drooling (ptyalism)
- Persistent and exaggerated gulping
- Weight loss
- Distress and pain of the dog while eating (yelping, howling, moaning, whining or even crying).
In severe cases, the esophageal stricture may lead to aspiration pneumonia (inhalation of fluid or food into the lungs). Dogs with aspiration pneumonia will show:
- Extreme weight loss
- Labored breathing
- Abnormal breathing sounds
- Weakness and general lethargy.
At the Vet's Office
As in any other case, the diagnostic process starts with taking the dog’s history and performing a full physical examination. The owner should provide an accurate and thorough medical history that includes information such as contact with potential irritants, recent surgeries and current unrelated treatments and medications.
During the physical examination, the vet will pay particular attention to the neck and throat region where he checks for swellings and excessive tenderness. The medical history, combined with the findings of the physical examination, are enough to start suspecting esophageal strictures in dogs.
To make things clearer and rule out other conditions, the vet will perform: blood tests (including complete blood count or CBC and full biochemistry panel), and possibly, urinalysis. Finally, the diagnosis can be definitively confirmed through 3 diagnostic procedures:
- Barium contrast esophagram – x-ray imagining of the esophagus with barium sulfate as a contrast solution (the contrast solution enables better visualization of the esophagus)
- Fluoroscopy – allows determining the esophageal motility
- Esophagoscopy – direct visualization of the esophagus with an endoscope.
In cases of esophageal stricture due to growths, the vet will suggest biopsy or endoscopic exfoliative cytology. These procedures will help determine the nature of the growth (its malignancy).
The course of the treatment depends on the exact underlying cause. Generally speaking, strictures cannot be cured, they can only be managed. In most cases, the treatment of choice is mechanical dilation with a balloon catheter. During the procedure, a special balloon is passed down to the stricture (under endoscopic guidance) and then inflated.
The special balloon is soft enough not to cause damage to the surrounding healthy tissues but strong enough to break down the unnecessary adhesions and growths. Performing only one esophageal dilation procedure is not enough. Usually, it is necessary to repeat the procedure between 2 and 4 times.
Once the dilation is performed, if the patient cannot eat on it its own, it is advisable to place a stomach feeding tube for dogs. The stomach feeding tube provides proper nutrition while allowing the esophagus to rest and heal properly. Based on the underlying cause, some dogs require lifelong administration of prescription drugs such as sucralfate, cimetidine, ranitidine, omeprazole and cisapride.
Cost of Treating a Dog Esophageal Stricture
As with the course, the cost also depends on the underlying cause. If the underlying cause is GERD, the diet change and over-the-counter gastric acid blockers, cost between 10 and 100 dollars.
Esophageal injuries, which require endoscopic procedures as well as post-procedure pain and inflammation medications, usually cost between 2000 and 3000 dollars. Abnormal growths and lesions require biopsy which usually costs around 150-350 dollars.
The Bottom Line
Esophageal strictures in dogs are not a frequently diagnosed problem. However, if present, they are serious and require proper management. Generally speaking, in most cases, esophageal strictures occur due to esophagitis caused by mechanical or chemical irritants.
Dogs with esophageal strictures tend to frequently regurgitate and eventually become malnourished. If left untreated, they can be a serious and life-threatening medical issue. Depending on the exact underlying cause, the course of the treatment strategy varies from, simple balloon dilatation procedures and diet changes, to complicated surgeries and lifelong use of prescription drugs.
About the Author
Dr. Ivana Crnec is a graduate of the University Sv. Kliment Ohridski’s Faculty of Veterinary Medicine in Bitola, Republic of Macedonia.
She currently practices as a veterinarian in Bitola and is completing her postgraduate studies in the Pathology of Domestic Carnivores at the Faculty of Veterinary Medicine in Zagreb, Croatia.
Ivana’s research has been published in international journals, and she regularly attends international veterinary conferences.