Difference between revisions of "Oesophageal Dysautonomia"

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(Redirected page to Key-Gaskell Syndrome)
 
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#REDIRECT[[Key-Gaskell Syndrome]]
 
 
Part of a syndrome of generalised autonomic neuropathy. It has been observed throughout Western Europe and The United States.
 
 
 
==Signalment==
 
Historically reported  most frequently in cats but now also in dogs.
 
 
 
==Description==
 
* Degenerative lesions of the autonomic ganglia, spinal cord intermediate grey columns and sympathetic axons
 
* Aetiology still largely idiopathic
 
 
 
==Diagnosis==
 
===Clinical Signs===
 
Those of a generalised 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%, 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.
 

Latest revision as of 15:26, 30 July 2010