Oesophageal Stricture

[Janspack]

My 16 month old Standard Poodle has had two obstructions in the past 2 months both needing major surgery.  I almost lost him recently after a 4 hour operation to remove a tennis ball and repair the damage done. With a lot of care and skill from my vets, he has made it through.

Unfortunately, it has left him with what we're hoping will be a temporary problem with swallowing his food.  Last weekend, he started choking when he ate and then he regurgitated the food. I was still feeding him wet food following the surgery. The vet saw him on Monday and diagnosed him with either oesophagitis (inflammation) or oesophageal stricture. (narrowing).  This has probably been caused by him regurgitating stomach acid when he was under anaesthetic and having reflux quite badly post surgery.

I have been trying to find more information and possibly a forum for help with this problem but without much luck so far.

I wondered if there is anyone on this forum who had dealt with anything like this of knows of a forum.  There is a Yahoo group for megaoesophagus but nothing for stricture which is the opposite problem.

At the moment, we're managing it by feeding him with his front feet on my lap (as I sit in my wheelchair) and that's helping by letting gravity aid the passage of the food down his oesophagus. He can't eat any dry food yet unless I soak it and make it very mushy.  Still feeding him 4 times a day to try to get weight back on him.

Would be grateful for any thoughts or experiences of dealing with this problem.

[Penel CIMDA moderator]

Oh Jan, what a nightmare.  Jo told me what had happened, how awful for you all.  I haven't heard of what you're describing.  Do they think that with time the problem might go away?

[Jo CIMDA]

Hi Jan

How is Spirit now?  Do you think he may have laryngeal paralysis? Are SP's genetically predisposed to this condition?  Watch out for aspirate pneumonia if he chokes back his food.  If you want to know more about LP I can put you in touch with someone who knows a great deal.  Just email me privately.


http://www.willows.uk.net/specialist-services/pet-health-information/soft-tissue/laryngeal-paralysis

As for MegaO, I can't think of anything other than what you are doing?  Does he have any problems with other muscles?

I do hope this spontaneously resolves very soon.

Jo

[Janspack]

Hi Penel,

Thanks, it was a dreadful time - the first obstruction was worrying enough as he took four days before he would eat then but this time it was almost a week and the vet was talking euthanasia.  I went to visit him on the Saturday and two hours later, he finally took some food.

With the elevated feeding he is doing better most of the time although still has the odd time when he regurgitates.  Vet will do some xrays if he doesn't improve in the next couple of weeks.

Hope all is well with you.

[Janspack]

Hi Jan

How is Spirit now?  Do you think he may have laryngeal paralysis? Are SP's genetically predisposed to this condition?  Watch out for aspirate pneumonia if he chokes back his food.  If you want to know more about LP I can put you in touch with someone who knows a great deal.  Just email me privately.


http://www.willows.uk.net/specialist-services/pet-health-information/soft-tissue/laryngeal-paralysis

As for MegaO, I can't think of anything other than what you are doing?  Does he have any problems with other muscles?

I do hope this spontaneously resolves very soon.

Jo

Hi Jo,

Have just replied to your email but before I saw this post.  I don't think it is LP as he has no problem with his bark and he isn't coughing at all in between eating. That was one of the first things I noticed when YoYo had LP. Hope it's not that as it was AP that I lost YoYo to. 

I've just been told on the mega-E list at Yahoo that oesophagitis is very painful and dogs with it don't eat so beginning to wonder if it could be that. Mind you, I suppose it could be different with different dogs. Spirit is eating very well - in fact seems ravenous the whole time despite getting 4 feeds a day. 

I haven't noticed any problems with other muscles at all.  Apart from the swallowing and perhaps still being a bit less active than he was, he doesn't seem to have any other problems.  Haven't checked his temperature (can't find my thermometer, I really shouldn't tidy up)  It was running at 103.6 when I saw the vet 2 weeks ago and had been around 103 - 104 since he was discharged. 

If there is no improvement after another couple of weeks, then I'll probably get him Xrayed as for MegaO they wouldn't have to give him an anaesthetic - something I really don't want to put him through again at the moment.

[Nuala]

Hi Jan,

My Irish Terrier suffers from a focal form of polymyositis with only the muscles in her head, oesophagus and pharynx affected.  Initially, we had a diagnosis of oesophagitis as she was regurgitating several times a day.  She had 3 barium swallows over a week to test for megaesophagus.  Tests 1 & 3 were done (our local GP vet) without sedation and were negative but Test 2 at a fancy (& expensive) vet hospital was done with sedation and the result was positive for megaesophagus.  This was despite our advising the vet hospital that our girl was very sensitive to sedation - our vet describes her as "a cheap drunk".  I know the normal protocol is to sedate for the barium swallow but there are studies which demonstrate that sedation can adversely affect the swallowing action and give a false positive for a megaesophagus diagnosis.  Just something to be aware of in advance.

After the megaesophagus fiasco, it took a while for us to get a correct diagnosis and in the meantime, we started to see muscle wastage in both the temporal and masseter muscles of the head.  Thankfully the myositis has not spread further and our girl has done very well on a combination of prednisolone and azathioprine although we are resigned to remaining on a maintenance dose of medication as even very slow attempts to reduce the meds to zero have resulted in relapses.  We help manage her problems by elevated feeding, 3 meals per day and an anti gulp bowl has really helped as this slows down the feeding process.

Good luck with Spirit
Nuala

[Jo CIMDA]

Hi Jan

I know you have been down this route before, and you are really hoping that it will spontaneously resolve, but it might be worth having him checked out soon.  If it is a myositis or primary MegaO, as you know,  the progression of the disease may be halted if treated with steroids early enough.  It's such a worry for you.

Jo

[Janspack]

Hi Nuala,

Thanks for the advice.  I read on one site that it was best to Xray for MegaO with the dog conscious as it could give a false positive if they are under anaesthetic.

I had a Standard Poodle with masticatory muscle myositis - Jo and Penel will remember him (BJ) - and his did progress to polymyositis and then we discovered he actually had lupus as he had several other AI problems as well. It was awful so I feel for you and your dog..

I am concerned it might not be oesophagitis as I understand that that is usually painful and they don't want to eat - Spirit is ravenous and eats four large meals a day!  I will be asking the vet to do more tests next week if he hasn't improved.  I need to know what we are dealing with and if he has megaO or perhaps a stricture. That would be the best diagnosis (stricture) because they can help that by dilating it out again.

[Janspack]

Hi Jan

I know you have been down this route before, and you are really hoping that it will spontaneously resolve, but it might be worth having him checked out soon.  If it is a myositis or primary MegaO, as you know,  the progression of the disease may be halted if treated with steroids early enough.  It's such a worry for you.

Jo

Hi Jo,

I have decided to ask Graham for more investigations if things haven't sorted themselves out by next week. He did say if it was going to resolve it should do in a couple of weeks (that was a week ago). 

Sometimes, he manages his feed without choking but other times, the same food gets stuck and he regurgitates.

As you know, I'm a person who wants to learn what we are dealing with so as best to get it treated/cured. I'm not to good at this wait and see business.

He and my other Standard are at the groomers today and the house seems so quiet without the two of them.   I always used to clip them myself but just can't manage it now sadly. They go to Plumpton Agricultural College as they do advanced grooming courses so it doesn't cost me anywhere near as much as a private groomer would.

I appreciate the advice and will keep you posted.

[Jo CIMDA]

Good luck Jan.  It's surely a good sign that he doesn't choke all the time.

I feel it is like teaching my grandmother how to suck eggs - if you get my meaning.

Jo

[Janspack]

Good luck Jan.  It's surely a good sign that he doesn't choke all the time.

I feel it is like teaching my grandmother how to suck eggs - if you get my meaning.

Jo

Not at all Jo, I always appreciate your input.  His eating seems to vary - had a good day yesterday but breakfast this morning was quite difficult. In general though, he's doing pretty well.  He seems completely fit again apart from that.