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Part of a syndrome of generalised autonomic neuropathy. It has been observed throughout Western Europe and The United States.
==Signalment==
Reported historically most frequently in cats but now also in dogs.
==Description==
* Degenerative lesions of the autonomic ganglia, apinal cord intermediate grey columns and sympathetic axons
* Aetiology still largely idiopathic
==Diagnosis==
===Clinical Signs===
Those of a gneralised autonomic dysfuntion of the gastrointestinal and urinary tracts. Those associated with the oesophagus include:
* Regurgitation
* Megaoesophagus
* Oesophageal hypotmotility
The most frequent clinical signs associated with the syndrome are depression, anorexia, constipation, regurgitation or vomiting and incontinence (faecal and urinary) less frequently.
===Physical Examination===
Findings associated with the GI system include:
* Dry mucous membranes
* Intestinal distension
===Radiography===
====Plain Radiography====
Oesophageal dilatation may be observed.
====Contrast Radiography====
Oesophageal hypomotility may be evident on barium contrast study.
==Differential Diagnosis==
There are few differentials on presentation of the many manifestations of the disease. However, early in the course of disease other causes of megaoesophagus need to be considered.
==Treatment==
===Supportive===
Including elevated feeding, gastrostomy tube feedings or total paranteral nutrition.
===Parasympathomimetic Drugs===
Some dogs may show minor improvement on initiation of for example, bethanechol, metoclopramide.
==Prognosis==
Guarded to poor. Recovery rates in the cat are reported as 20-40% may recover, however this may take 2-12 months. In the dog recovery rates are lower. Despite recovery many are also left with residual impairment including intermittent regurgitation.