Idiopathic megaoesophagus in a dog

2 Idiopathic megaoesophagus in a dog

Initial presentation

Vomiting and regurgitation every 1 to 3 days for at least 6 months; concurrent weight loss and recent (2 to 3 weeks) cough

Signalment: 2-year-old neutered male German shepherd dog, body weight 23.1 kg

Case history

The dog had been obtained from a rescue centre 6 months earlier. The owner said that he was de-wormed regularly with a product from the grocery store and had been vaccinated at the time they obtained him.

He was usually bringing up food that appeared undigested and did not contain bile, although occasionally he also did bring up digested food and bile. There was no abdominal effort and he would bring up the food from minutes to about an hour after eating. It was determined that he was usually regurgitating, although sometimes there was an episode of true vomiting.

He was coughing occasionally during the previous 2 weeks and his exercise tolerance had decreased. The dog’s stools had been normal and his water intake and urine output had not changed. The owner estimated that the dog had lost about 8 kg over the last couple of weeks.

His usual diet was a mixture of dry and canned dog food and he was normally fed twice a day. He was not fed table scraps and did not scavenge. His appetite had decreased over the past 2 to 3 weeks, but had been good prior to that time.

His prior treatment included oral cimetidine and metoclopramide, which the owner thought may have slightly helped decrease the frequency of the vomiting or regurgitation.

Physical examination

The dog was bright and responsive. He had a body condition score (BCS) of 2/9. His mucous membranes were pink and his capillary refill time was less than 2 seconds. Thoracic auscultation revealed normal heart and lung sounds, with a heart rate of 90 beats per minute (bpm) and a respiratory rate of 36 breaths per minute. There was no evidence of pain on abdominal palpation. Rectal temperature was 38.8° C.

When the dog was observed eating, it was found that he could prehend the food, appeared to form a normal bolus and could initiate swallowing without a problem. This made a pharyngeal disorder less likely to be the cause of the regurgitation.

Clinical tip

Differentiating vomiting from regurgitation can be a challenge and in some cases both are occurring. The time after eating does not always provide a clue, as some animals may vomit immediately after eating and others, especially those with megaoesophagus, may regurgitate hours after eating (Table 2.1).

Table 2.1 Differentiating regurgitation from vomiting

Clinical sign	Regurgitation/oesophageal disorders	Vomiting
Abdominal effort	None	Present
Time of food ejection after eating	Immediate to delayed, possibly for hours	Delayed, possibly for hours, but may also happen immediately
Appearance of food	Undigested	Partly digested, may have bile present
pH of contents	Should not be acidic	Acid pH implies vomiting, but alkaline material may also be vomited

Problem list and discussion of problems

• Regurgitation

• Weight loss

The dog’s primary problem appeared to be regurgitation, although he also appeared to vomit occasionally as well. The weight loss was likely due to inadequate assimilation of food due to the regurgitating.

Differential diagnosis

Tags: Solutions Veternary Practice Small Animal Gastroentrology

Sep 22, 2016 | Posted by admin in SMALL ANIMAL | Comments Off

Full access? Get Clinical Tree

Get Clinical Tree app for offline access

Get Clinical Tree app for offline access