Cricopharyngeal Achalasia

Cricopharyngeal Achalasia

By: Dr. Nicholas Trout

Section: Follow-up

  • Your dog may require hospitalization for several days, if a state of dehydration existed, or the need to give intravenous antibiotics.

  • The incision and either stitches or staples will lie on the underside of the neck. This area must be examined daily for signs of swelling, redness or discharge. Given the location of the incision, use of an Elizabethan collar is normally not recommended.

  • Initially, food should be given in a liquidized form. A soupy gruel should be fed for the first couple of days following surgery to make sure he is swallowing normally. If all goes well then the diet can gradually revert to normal food consistency, usually by the end of the first week.

  • Bones and chew toys should be avoided for the first couple of weeks following the procedure.

  • Oral antibiotics will continue at home, perhaps for an additional four to six weeks, depending on the severity of the pneumonia.
    In some cases your veterinarian may demonstrate the use of percussion, that is, patting the chest with a cupped hand over various lung fields to encourage mucus to be coughed up by your dog.

    If the swallowing disorder fails to resolve this may be due to one of several complications:

  • The muscle was inadequately cut or removed, or the procedure only performed on one side, so the obstructive effect persists.

  • Scarring has occurred and restored some continuity to the constricting muscle band.

  • Other forms of pharyngeal dysphagia are present concurrent with the cricopharyngeal achalasia.

    The first two problems can be corrected surgically. In the third case, the surgery will actually have made the problem worse, and there is usually no good treatment alternative.

    Sutures or staples can be removed in 10 to 14 days following surgery.

    Prevention In-depth

    This is not a disease that can be prevented because it is a rare congenital problem. In many cases, dogs with swallowing disorders will be noticed by the breeder at the time of weaning and not be available for sale as pets.

    Because the exact cause of the disorder is unknown, it would be unwise to breed from a sire or dam whose offspring have developed cricopharyngeal achalasia.

    Early and accurate diagnosis offers the best prognosis for your dog as malnutrition, dehydration and especially aspiration pneumonia, can significantly impact the risk for anesthesia and subsequent surgical success.

    The diagnosis of cricopharyngeal achalasia requires fluoroscopy, not normally available outside of universities and larger veterinary institutions, and the study needs to be evaluated by an experienced radiologist.

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