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#REDIRECT[[Key-Gaskell Syndrome]]
 
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Part of a syndrome of generalised autonomic neuropathy. It has been observed throughout Western Europe and The United States.
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==Signalment==
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Historically reported  most frequently in cats but now also in dogs.
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==Description==
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* Degenerative lesions of the autonomic ganglia, spinal cord intermediate grey columns and sympathetic axons
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* Aetiology still largely idiopathic
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==Diagnosis==
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===Clinical Signs===
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Those of a generalised autonomic dysfuntion of the gastrointestinal and urinary tracts. Those associated with the oesophagus include:
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* Regurgitation
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* Megaoesophagus
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* Oesophageal hypotmotility
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The most frequent clinical signs associated with the syndrome are depression, anorexia, constipation, regurgitation or vomiting and incontinence (faecal and urinary) less frequently.
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===Physical Examination===
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Findings associated with the GI system include:
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* Dry mucous membranes
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* Intestinal distension
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===Radiography===
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====Plain Radiography====
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Oesophageal dilatation may be observed.
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====Contrast Radiography====
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Oesophageal hypomotility may be evident on barium contrast study.
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==Differential Diagnosis==
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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.
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==Treatment==
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===Supportive===
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Including elevated feeding, gastrostomy tube feedings or total paranteral nutrition.
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===Parasympathomimetic Drugs===
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Some dogs may show minor improvement on initiation of for example, bethanechol, metoclopramide.
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==Prognosis==
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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.
 
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