Protocol for Anaesthesia in Chelonians. Plasma Protein Electrophoresis. Reproductive Surgery in Female Asian Pythons. Reptile Anesthesia. Reptile Infectious Diseases. Treatment of Shell Necrosis in Orlitia borneensis. Understanding the Reptile Environment.
Understanding of Disease Ecology. Feline Medicine. Approach to Jaundiced Cat. Feline Infectious Peritonitis. Feline Medicine Emergency Cases. Feline Pancreatitis. Feline Traumatic Spinal Cord Diseases. Feline Vestibular Disease. Management of Anesthetic Complications.
Metabolic Causes in Feline Neurologic Diseases. Neurological Examination in Cats. Sedation vs. General Anesthesia for Kitty. Taming Feline Arthritis. Role of Stress in Feline Medicine. Treating Feline Inflammatory Liver Disease. Challenges of Feline Anesthesia. Global Nutrition. Chronic GI Disease. Dermatological Disorders. Feline Cystitis. Feline Diabetes Mellitus. Feline Liver Disorders. Nutrition in the Critical Care Patient. Nutritional Support for Joint Surgery Patient.
Why Nutrition in the General Practice. Global Pain Council. Adjunctive Modalities. Analgesic Tools in Small Animal Anesthesia. Local Anesthesia. Future Therapies for Chronic Pain. Hereditary Diseases. Management of Canine Hip Dysplasia. How I Treat. Chronic Large-Bowel Diarrheas. Ultrasonic Rollercoaster Through Abdomen. Axial Skeletal Radiology.
Clinical Application of MRI. Pitfalls in Thoracic Radiology. In Search of Foreign Bodies. Veterinary Computed Tomography. Radiographs vs. Computed Tomography. Im Possibilities of Thoracic Ultrasonography. Diagnostic Imaging of the Heart. Interpret the Pulmonary Radiography. Ultrasonography of Unusual Body Parts. Infectious Disease. Canine Monocytic Ehrlichiosis. Chronic Cough in Dog. Infectious Disease Update.
Diagnostic Techniques for Infectious Diseases. Blood Transfusion Transmission of Infectious Diseases. Integrated Medicine. Acupuncture for Neck Pain. How Do Herbs Work? Popular Thai Culinary Herbs.
Using Gold in Veterinary Medicine. Veterinary Herbal Medicine. Internal Medicine. Acute Canine Leptospirosis. Acute Respiratory Infections. Biliary Tract Abnormalities. Chronic Hepatic Diseases of the Dog. Chronic Respiratory Diseases. Chronic Small Intestinal Diseases. Diabetes Mellitus Update. Endocrine Abnormalities. Extracorporeal Blood Purification Techniques. Feline Acromegaly. Glomerulonephritis Treatment. Hemodialysis vs. Peritoneal Dialysis. Hemostatic Disorders in Renal Diseases.
Managing Immune-Mediated Diseases. Nutritional Management of Renal Diseases. Protein-Losing Enteropathies. Respiratory Neoplasia. Respiratory Therapeutics. Canine Hyperadrenocorticism. Urolith in Thailand Vs Global Perspective. Nurse Technician. Acute Kidney Injury. Chemotherapy Drugs. Clinical Approach to Arrhythmias. Conservative Treatment for Fractures. Pet-Related Zoonotic Diseases. Emergency Procedures to Save Patients' Lives. General Principles of Joint Radiology.
How Can I Help in Arthroscopy? Perform a Safe Gastrointestinal Surgery. Introduction to Rabbit Dental Disease. Managing Anorexic Cats. Oral Examination, Radiography, Diagnosis.
Pain Diffusion Catheters. Patient Monitoring. Reducing Stress for Animals in Veterinary Clinic. Reptile Physical Examination.
Seizure Management. Use of Checklists in Vet Surgery. UFOs in the Body. Use of Drains. Water Quality Explained. Advanced Surgical Oncology. Imaging the Oncology Patient. Biopsy Techniques. Canine Soft Tissue Sarcoma. Cats Are Not Small Dogs. Feline Lymphoma. Mast Cell Tumors. Management of Chemotherapy Side Effects. Molecular Markers in Canine Lymphoma. Perspectives on Canine Hemangiosarcoma. Thoracic Wall Tumors in Dogs. Treatment of Bone Cancer Pain in Dogs.
When Standard Cancer Treatments Fail. One Care Management. Effective Communication. Measuring Client Satisfaction. Reputation Management. Time to Own Your Examination Room. One Health. Idiopathic Pulmonary Fibrosis. Zoonotic Infection: Canine Leishmaniosis. Abnormal Adnexa.
Corneal Ulcers. Ocular Emergencies I. Ocular Emergencies II. Complete Ophthalmic Examination. Uveitis - Simple. Visual Loss. Oral Abstracts. Epidemiological Analysis of Dog Behaviour Problems.
Serum 3-Bromotyrosine Concentrations. Incidence of Diabetes in Insured Swedish Cats. Photodynamic Hyperthermal Chemotherapy. Cranial Cruciate Ligament Disease.
Elbow Dysplasia in the Dog. Thankfully, in most cases, it isn't severe and can be treated successfully and easily. Pet owners usually become aware that their dog has esophagitis because they become reluctant or unable to eat or drink.
There are other symptoms and there is a lot more going on, but it doesn't exactly get out a megaphone to alert you to its presence.
While easily confused, these two symptoms are actually two very different things. You should know the difference as regurgitation usually comes from acid while vomiting can come from a wider variety of stomach problems. Of course, vomiting can also be a symptom of acid reflux and esophagitis. That sounds really twisty turny, but being able to tell the difference can help you and the dog's vet better understand what's going on with your dog. There will be visible belly involvement and what comes out will probably be partially digested.
Regurgitation is essentially burping up acid, food, and sometimes water from the esophagus. There will not be visible belly involvement and what comes out will be stomach acid, undigested food, and sometimes water.
There will be no warning prior to the regurgitation in the form of nausea or stool issues. Puppies are slightly more likely than other dogs to have acid reflux because their esophageal sphincter muscle isn't as developed, allowing stomach acid into the esophagus and damaging it.
A hiatal hernia is when part of the stomach enters the chest cavity. This interferes with the normal functioning of the stomach and lungs and can lead to symptoms of esophagitis as well as difficulty breathing. If your dog has this combination of symptoms, be sure to tell your vet so they can be more likely to make the proper diagnosis.
There is a type of esophagitis that is not caused by irritation as we normally picture it. Eosinophilic esophagitis comes from an excessive amount of white blood cells in the mucous lining of the esophagus. It is not very well understood as it has only recently been discovered, but it is believed to be a response to food allergies.
The symptoms are similar to that of any other kind of esophagitis. Pondering potential causes and triggers may help point you and the vet toward the idea of this kind of esophagitis. The bottom of the threat level begins when something irritates the esophagus, such as stomach acid, a pill, a foreign body, or the effects of a disease at an early stage. The cause can be treated and the esophagus can repair itself or it will take only a little effort to repair the damage. If the problem continues for a length of time, it can cause damage to the esophagus that may make the dog unwilling to eat or drink or have damaged the esophagus enough that more extensive treatments will be needed to repair the tissue.
The worst cases involve permanent damage to the esophagus, infections, and aspiration pneumonia. Aspiration pneumonia is a very serious situation where food, water, or stomach acid enters the lungs because the dog's throat doesn't function as it should. Thankfully, the more dangerous forms of esophagitis are fairly rare. This is because the most common reason for a dog to have esophagitis is acid reflux, and you will probably be getting the dog help for that before it gets so bad it could become that serious.
But do make sure that you take the dog to the vet to be evaluated as soon as you suspect acid reflux to ensure it doesn't get that bad and also to make sure that the proper treatments are given to the dog. If you have acid reflux, think of all the times you're suffering but there are probably no signs that another person could see or would notice. If it's bad enough you may hold your chest or be seen burping up something.
We rely on our awareness of our symptoms and our ability to tell others what's going on to let people know we are suffering. Dogs can't do this. That is why dogs may have acid reflux and esophagitis for other reasons for a long time before anyone realizes it. The symptoms may also be intermittent, making it even more confusing.
If you do suspect your dog has acid reflux or esophagitis, make notes of their intermittent symptoms so you can make a record that is easier for you and the vet to evaluate. You may be able to detect a pattern that points to an allergen or other trigger. It may also help you realize that your dog needs treatment sooner than you might would if you rely on memory alone.
When you take the dog to the vet, be sure to tell them as many details as you can imagine being relevant, symptoms, odd behavior you notice, and potential triggering factors.
It's better to err on the side of giving too much information than not sharing something that you didn't realize would be helpful. You have to determine the cause of the esophagitis before you can treat it. If the dog has cancer or another disease, then just trying to change their diet or lifestyle isn't going to help. Thinking it's worse than it is and treating for that won't do anything for the dog either, except possibly make them worse, if all they have is acid reflux. A final diagnosis may require endoscopy or surgery.
Once you firmly establish that a patient is regurgitating, you must pinpoint the particular esophageal disorder. Esophageal diseases can be congenital or acquired. They may be due to weakness e. Although clinical signs of congenital esophageal disease typically appear when patients are young, the disease may not be diagnosed in some patients until they are several years old. Distinguishing esophageal weakness from esophageal obstruction is usually best done with radiography.
Plain radiographs may be sufficient, but contrast radiography with oral barium administration is much more definitive and helps prevent diagnostic errors. Always obtain plain radiographs before contrast radiographs because, in many cases, plain radiographs are definitive or show that endoscopy is the best next step instead of contrast radiography e.
Congenital esophageal weakness and congenital obstruction e. Keep in mind that vascular ring anomalies may be first diagnosed in older pets1 i. It can be easy to confuse segmental esophageal weakness proximal to the heart with a vascular ring anomaly causing obstruction.
Sometimes this mistake is not recognized until the time of surgery. It is also worth noting that while surgery is indicated for vascular ring anomalies and the condition of most patients improves substantially with surgery,2 occasionally patients do not benefit from surgery.
Acquired esophageal weakness is also well-understood and has been discussed in detail elsewhere,3 but I want to emphasize two points. First, always look for a cause e. Treating the underlying cause of a megaesophagus results in a much better prognosis than simply altering the feeding practices and hoping that aspiration does not result.
Second, aspiration pneumonia is the main cause of morbidity and mortality in patients with esophageal disease, especially in those with esophageal weakness. Aspiration may occur weeks or months before regurgitation is first noticed. Your index of suspicion for esophageal weakness should be high in patients with recurrent pneumonia or chronic cough even without a history of regurgitation, vomiting, or dysphagia. In these cases, esophageal function should be assessed by fluoroscopic barium contrast esophagograms so proper treatment of underlying esophageal weakness can be attempted.
Remember, canine pneumonias are generally not spread from dog to dog unless caused by Bordetella bronchiseptica , so always look for the cause, most commonly either fungal infection or aspiration. Esophageal foreign bodies are not common but are seen frequently enough that practitioners must be adept at diagnosing them, otherwise the consequences can be catastrophic e. The key to suspecting esophageal foreign bodies is to recognize that the acute vomiting reported by a client is actually acute regurgitation.
In such cases, immediately obtain thoracic radiographs. Most esophageal foreign bodies do not show up as obvious esophageal lesions on plain radiographs.
Instead, they often appear as ill-defined, soft tissue opacities that look as if they could be in the pulmonary parenchyma. Whenever a suspected pulmonary mass is detected radiographically, consider whether it could be an esophageal mass.
If there is any possibility the mass is esophageal, your next step should be to perform contrast radiography or endoscopy which is usually preferred. In general, endoscopic manipulation is the best way to resolve most cases of esophageal foreign objects.
If endoscopy is anticipated, avoid contrast esophagograms, because barium tends to obscure the visual field and makes endoscopic removal more difficult. Contrast films are rarely needed to detect esophageal perforation.
Discovering a pneumothorax or pleural fluid on plain radiographs should make you strongly suspect an esophageal perforation. Obtain pleural fluid for cytologic examination to diagnose sepsis. Rigid endoscopy is often more effective than flexible endoscopy for removing esophageal foreign bodies.
Rigid endoscopes allow the use of rigid forceps, which permit a much stronger grip on the object and more delicate and precise manipulation of the object to free it from any ulcers or craters it has created.
Carefully placing the edge of the rigid endoscope against a lodged bone may allow the rigid forceps to break off pieces of the bone or even to break it in two, without further injuring the esophagus. This maneuver is especially helpful when the bone has eroded deep ulcers into the esophagus and cannot be removed otherwise. A foreign body can be partially drawn into the rigid endoscope, facilitating its removal from the esophagus.
This is especially valuable if you are attempting to remove sharp-edged objects or trying to pull objects through the cricopharyngeal area. Likewise, most fishhooks, even treble hooks, can be removed endoscopically. The limiting factors in removing such hooks are the size of the barb i. In these cases, surgical removal is warranted.
After removing a foreign object, immediately reexamine the esophagus endoscopically to assess the degree of esophagitis. Also obtain a thoracic radiograph to check for evidence of pneumothorax, which would indicate perforation has occurred. While perforation generally requires referral for surgery, a small perforation might heal spontaneously if pleural contamination is avoided.
If a minor perforation has occurred, placing a gastrostomy tube endoscopically may allow the perforation to heal. The gastrostomy tube prevents food, water, and medications from traversing the esophagus. Depending on the amount of esophageal damage, it may be advisable to treat the patient for esophagitis i. Esophagitis is probably more common than practitioners think. Diagnosing it is problematic, because a the clinical signs vary tremendously, depending on its severity; b it can be hard to definitively diagnose radiographically; c endoscopy is the best method of diagnosis, but not all practitioners have access to endoscopy; and d it may not always be on practitioners' lists of differential diagnoses.
Common causes of esophagitis include ingestion of caustic substances including prescribed medications , excessive vomiting of acidic gastric contents, acid reflux, and trauma from foreign objects previously discussed.
Common caustic substances responsible for esophagitis include oral administration of tetracycline and doxycycline monohydrate.
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