Dysphagia in Dogs

Digg

Del.icio.us

Stumble

Dysphagia (Difficult Swallowing) in Dogs

By: Dr. Bari Spielman

Section: Overview

Dysphagia is the medical term used to describe difficulty in swallowing. Dysphagia has many different causes, some of which are treatable and some are not. Diagnosing and treating the problem early can help increase the chances of a positive outcome.

Dysphagia may be a mild problem in some animals, or it may cause extreme distress in some patients. With longstanding dysphagia the dog may loose a lot of weight due to its inability to eat and swallow (despite a normal appetite). Dysphagia may represent a transient local problem, or a severe, systemic illness. The recognition of dysphagia in your dog warrants an immediate examination by your veterinarian to determine the cause and institute appropriate therapy.

General Causes

Disorders of the nerves of the head (cranial nerves), especially diseases of the nerves to the tongue (hypoglossal nerve) or muscles of

chewing (trigeminal nerve)

Inflammation of the muscles of chewing (masticatory muscle myositis)

Weakness of the muscles of chewing from diseases such as myasthenia gravis (an immune disorder of the nervous/muscular system), muscular dystrophies (inherited abnormalities of muscle), etc.

Paralysis of the muscles of chewing from rabies, tick paralysis, or botulism (rare)

Trauma to the jaw, tongue, and other structures of the mouth

Inflammation of the tongue (glossitis), gums (gingivigitis), mouth (stomatitis), or pharynx (pharyngitis)

Dental diseases

Foreign bodies in the mouth or pharynx

Masses or cysts in the mouth or pharynx

Airway diseases that affect the back of the mouth and throat

Cricopharyngeal achalasia, which is an incoordination in the movement of food stuffs from the back of the mouth through the pharynx and into the esophagus

What to Watch For

Drooling, sometimes with blood in the saliva

Gagging

Dropping food from the mouth or the collection of food along one side of the mouth

Repeated attempts at swallowing

Coughing

Regurgitation of food

Change in appetite

Weight loss

Pain around the head, mouth and or neck area

Physical deformities of the head and neck

Possible nasal discharge

Possible foul odor from the mouth

Signs of muscle weakness elsewhere in the body

Diagnostic Tests

A thorough examination is very important, as some causes of dysphagia may be detectable on the examination. In addition your veterinarian may recommend the following additional tests:

A complete oral examination under sedation

Complete blood count (CBC)

Biochemical profile and urinalysis

Radiographs (X-rays) of the mouth, skull (with teeth) and neck

Chest x-rays if the animal is coughing

Specialized diagnostic tests may be indicated in selected cases and may include the following:

Ultrasound of the pharynx (throat)

Pharyngoscopy (evaluation of the throat with an endoscope)

Fluoroscopic barium swallow (food material filled with barium is observed being swallowed under a video x-ray machine)

Blood tests for myasthenia gravis, to detect inflammation of the muscles responsible for chewing and for other immune disorders

Certain hormonal assays

Electrodiagnostic tests that detect muscle and nerve function

Possible biopsy and cytology of any abnormal masses, cysts or muscles

Treatment

Treatment of dysphagia is quite variable depending upon the cause. Some animals require supportive care while their primary disease is being treated or is resolving. Supportive care may include the following:

Nutritional support is of paramount importance. A change in food consistency or the position of the patient during feeding may be recommended in some cases. A feeding tube that bypasses the mouth and throat may be indicated, such as a gastrostomy (stomach) tube. Occasionally, parenteral (intravenous) feeding may be indicated, depending on the primary disease process.

Antibiotics may be recommended to combat or prevent bacterial infections.

Specific treatments may include the following:

Surgical correction of any fractures of the jaw and palate, surgical repair of lacerations, and removal of any oral foreign bodies, cysts and masses

Removal of diseased teeth and application of specific remedies for dental disease

Surgical correction of upper airway abnormalities

Medications for myasthenia gravis and certain hormonal problems

Corticosteroids for inflammation of the muscles or tissues of the mouth

Home Care

Administer any prescribed medications and dietary recommendations as directed by your veterinarian. If your pet is not improving, and/or if additional clinical signs develop, contact your veterinarian. Animals with weakness or paralysis of the muscles or nerves to the head may take several weeks to return to normal, once appropriate therapy has been instituted. Consistent nursing care at home is very important to their recovery.