Oesophageal Dysautonomia
 |
This article is still under construction. |
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.