Oesophagitis

Typical Signalment

Any age group can be affected
Young animals with congenital hiatal hernias
Cats are more prone to doxycycline-associated oesophagitis
Cats suffering from oesophageal stricture
Anaesthesia
Poor positioning during anaesthesia

Description

Oesophagitis in an inflammatory disorder of the oesophagus that usually involves the mucosa but can involve the deeper layers of the submucosa and muscularis. It can take the form of acute or chronic. The disease process occurs after disruption of one of the barrier defence mechanisms and can lead one or several of inflammation, ulceration and erosion of the underlying structures. The most common causes are:

chemical injury following swallowing
oesophageal foreign bodies
gastro-oesophageal reflux

Diagnosis

Clinical Signs

include:

regurgitation
salivation
neck extension during swallowing
odynophagia
food avoidance
aspiration pneumonia (wheezes, coughing)

Laboratory Tests

Generally unremarkable but may show:

leucocytosis
neutrophilia

Diagnostic Imaging

The oesophagus is generally normal on routine survey radiographs. Signs of aspiration pneumonia may be seen in ventral lung lobes. It can be better differentiated using barium-contrast studies which may show:

an irregular mucosal surface
narrowing
a dilated oesophagus
oesophageal hypomotility

To better diagnose oesophagitis, endoscopy with biopsies can be used. Severe oesophagitis will be seen with an oedematous mucosa that is hyperaemic, ulcerated and actively bleeding, whilst less severe cases may require several mucosal biopsies to diagnose the condition.

Treatment

Mild oesophagitis:

withdraw oral food for 2-3 days and manage as an outpatient.

More severe oesophagitis:

may need admitting to the hospital, Nil Per Os and animal may require enteral or parenteral nutritional support.

Drugs:

oral sucralfate suspension
gastric acid secretory inhibitors can be useful in cases of gastro-oesophageal reflux
broad spectrum antibiotics in animals with aspiration pneumonia

Prognosis

Mild oesophagitis has a good prognosis whereas ulcerative oesophagitis and animals suffering from aspiration pneumonia have a more guarded prognosis.