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Cricopharyngeal Achalasia

By: Dr. Nicholas Trout

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Cricopharyngeal achalasia is a swallowing disorder that prevents food from passing normally from the pharynx into the esophagus. The condition is rare and the exact cause is unknown, but is probably a neurological abnormality. It is reported to be more common in cocker spaniels and springer spaniels.

Signs of a swallowing disorder are usually seen initially in the puppy at the time of weaning. When eating solid food the puppy shows repeated attempts to swallow the same mouthful, until eventually it is swallowed, regurgitated or aspirated into the airway.

Most affected puppies have a voracious appetite but are thin from the inability to get adequate nutrition. The disorder puts them at high risk for aspiration pneumonia, which is pneumonia caused by inhaling food particles into the lungs.

The disease is important because it is one of the few swallowing disorders that can be cured with surgery.

What to Watch For

  • A recently weaned puppy who struggles to swallow food and eat properly
  • A puppy that is thin despite a healthy appetite

    Diagnosis

    Your veterinarian will want to investigate for cricopharyngeal achalasia in any puppy with difficulty swallowing and will observe the pup while eating and drinking to determine if the problem truly originates in the back of the throat, the pharynx. In addition, your veterinarian will probably recommend the following:

  • Chest X-rays to evaluate for aspiration pneumonia

  • Fluoroscopy. Moving X-ray images of the pharynx and esophagus while swallowing a barium coated meal provides a definitive diagnosis of cricopharyngeal achalasia.

  • Bloodwork is usually normal unless the animal has developed a significant pneumonia.

    Treatment

    Surgery offers an excellent possibility of curing the problem. A muscle that is not functioning properly at the junction of the pharynx and esophagus is cut, so that it no longer impedes movement of food from the throat down to the stomach.

    Home Care and Prevention

    Dogs will initially be fed a gruel, a mixture or dry or canned food and water that is easier to swallow. Over a period of several days this can be changed over to a normal food consistency.

    If pneumonia has developed, your pet will be discharged on a course of antibiotics, and these should be administered for the full time, even if your pet appears to be well. Follow-up X-rays will be necessary to ensure that the pneumonia is resolving.

    It is not possible to prevent this disease as it is a congenital defect, a disorder the animal is born with. Early recognition of a swallowing problem offers your pet the best chance for a prompt diagnosis before malnutrition and pneumonia set in.

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