4 Oesophageal stricture in a cat Initial presentation Regurgitation Signalment: 9-year-old male neutered Siamese cat, body weight 3.5 kg Case history The cat had been healthy until 3 weeks prior to admission, when he had been anaesthetized for a routine dental cleaning. Since then he had been regurgitating food and froth, but not bile. The regurgitated food appeared undigested. He was also retching. He was de-wormed regularly and vaccinated yearly. He had arthritis and he was treated with meloxicam for this condition. He was an indoor and outdoor cat, but had no known exposure to toxins. He was fed canned cat food and chicken, but had a poor appetite during the 3 weeks prior to presentation. He was able to prehend and swallow his food and could drink water, although he may have been drinking less than usual. His stools were normal in appearance and he was able to urinate and defecate normally. He was on no other medications or supplements. Physical examination The cat was bright and responsive. His body condition score was 4/9 and he was estimated to be about 5% dehydrated. Mucus membrane colour was pink and capillary refill time was less than 2 seconds. Thoracic auscultation revealed normal heart and lung sounds, with a heart rate of 190 beats per minute (bpm) and a respiratory rate of 30 breaths per minute. There was no evidence of abnormalities or pain on abdominal palpation. Rectal temperature was 38.0° C. Problem list and discussion of problems • Regurgitation Regurgitation usually indicates an oesophageal disorder. Differential diagnosis Oesophagitis • Obstructive oesophageal disorders • foreign body • stricture • neoplasia • peri-oesophageal masses Oesophageal neuromuscular disorders • Megaoesophagus, including systemic disorders affecting swallowing, such as myasthenia gravis and dysautonomia • Oesophageal motility abnormalities Case work-up The cat was admitted to the hospital for investigative procedures and rehydration with crystalloid fluids administered intravenously. Minimum data base Haematology and serum chemistry were performed and results were all within the reference ranges. Imaging Plain radiographs of the cat’s thorax were unremarkable. While a barium swallowing study could have been performed to further evaluate the oesophageal function, this test carries the risk of aspiration of the barium and in this case it was elected to perform endoscopy rather than the swallowing study. Clinical tip While thoracic radiographs are useful to evaluate the lungs and many other oesophageal disorders, strictures may not be visible on a plain radiograph and even liquid barium may pass through a stricture rapidly enough that it is not detected. Barium mixed with food may allow visualization of a narrowed area of the oesophagus at the point of the stricture, but may or may not show multiple areas of strictures if the food is regurgitated when it reaches the first area of stricture. Barium swallow studies, whether liquid or liquid mixed with food, do carry a risk of aspiration pneumonia, especially if the patient must be put in lateral recumbency to obtain the radiograph. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Swallowing and regurgitation Introduction to haematochezia and melaena Ingestion of glue by a dog Pancreatitis in a cat Stay updated, free articles. Join our Telegram channel Join Tags: Solutions Veternary Practice Small Animal Gastroentrology Sep 22, 2016 | Posted by admin in SMALL ANIMAL | Comments Off on Oesophageal stricture in a cat Full access? Get Clinical Tree
4 Oesophageal stricture in a cat Initial presentation Regurgitation Signalment: 9-year-old male neutered Siamese cat, body weight 3.5 kg Case history The cat had been healthy until 3 weeks prior to admission, when he had been anaesthetized for a routine dental cleaning. Since then he had been regurgitating food and froth, but not bile. The regurgitated food appeared undigested. He was also retching. He was de-wormed regularly and vaccinated yearly. He had arthritis and he was treated with meloxicam for this condition. He was an indoor and outdoor cat, but had no known exposure to toxins. He was fed canned cat food and chicken, but had a poor appetite during the 3 weeks prior to presentation. He was able to prehend and swallow his food and could drink water, although he may have been drinking less than usual. His stools were normal in appearance and he was able to urinate and defecate normally. He was on no other medications or supplements. Physical examination The cat was bright and responsive. His body condition score was 4/9 and he was estimated to be about 5% dehydrated. Mucus membrane colour was pink and capillary refill time was less than 2 seconds. Thoracic auscultation revealed normal heart and lung sounds, with a heart rate of 190 beats per minute (bpm) and a respiratory rate of 30 breaths per minute. There was no evidence of abnormalities or pain on abdominal palpation. Rectal temperature was 38.0° C. Problem list and discussion of problems • Regurgitation Regurgitation usually indicates an oesophageal disorder. Differential diagnosis Oesophagitis • Obstructive oesophageal disorders • foreign body • stricture • neoplasia • peri-oesophageal masses Oesophageal neuromuscular disorders • Megaoesophagus, including systemic disorders affecting swallowing, such as myasthenia gravis and dysautonomia • Oesophageal motility abnormalities Case work-up The cat was admitted to the hospital for investigative procedures and rehydration with crystalloid fluids administered intravenously. Minimum data base Haematology and serum chemistry were performed and results were all within the reference ranges. Imaging Plain radiographs of the cat’s thorax were unremarkable. While a barium swallowing study could have been performed to further evaluate the oesophageal function, this test carries the risk of aspiration of the barium and in this case it was elected to perform endoscopy rather than the swallowing study. Clinical tip While thoracic radiographs are useful to evaluate the lungs and many other oesophageal disorders, strictures may not be visible on a plain radiograph and even liquid barium may pass through a stricture rapidly enough that it is not detected. Barium mixed with food may allow visualization of a narrowed area of the oesophagus at the point of the stricture, but may or may not show multiple areas of strictures if the food is regurgitated when it reaches the first area of stricture. Barium swallow studies, whether liquid or liquid mixed with food, do carry a risk of aspiration pneumonia, especially if the patient must be put in lateral recumbency to obtain the radiograph. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Swallowing and regurgitation Introduction to haematochezia and melaena Ingestion of glue by a dog Pancreatitis in a cat Stay updated, free articles. Join our Telegram channel Join Tags: Solutions Veternary Practice Small Animal Gastroentrology Sep 22, 2016 | Posted by admin in SMALL ANIMAL | Comments Off on Oesophageal stricture in a cat Full access? Get Clinical Tree
