Esophageal Disease in Dogs
Dr. Bari Spielman
Certain diagnostic tests must be performed to make a definitive diagnosis of esophageal disease and exclude other disease processes that may cause similar symptoms. A complete history is especially important in these cases, as regurgitation – a common clinical sign seen with esophageal disease – is often referred to as vomiting by the pet owner. A thorough work-up begins with a broad general baseline of diagnostic tests and, in many cases, more specialized or advanced testing are indicated as well. It is important to note that an accurate diagnosis is necessary for an accurate treatment regime. A complete blood count (CBC) is most often within normal limits; however, with severe inflammation or infection or anemia associated with chronic (long-term) illness, one may expect to see an elevation in the white blood cell count, or decrease in the red blood cell count, respectively.
A biochemical profile is needed to rule out other systemic disorders that may predispose to certain esophageal diseases.
A urinalysis is part of any complete baseline work-up.
Chest X-rays are needed to evaluate the size and shape of the esophagus, assess for the presence of a foreign object or growth, evaluate the heart size, and assess the lungs for the possibility of secondary pneumonia.
An Esophagram, or barium swallow, is helpful in evaluating the esophageal mucosa (lining), detecting the presence of a stricture (narrowing) or dilation. This test can be performed in most hospitals, and is a fairly low risk procedure for the patient.
Dynamic contrast fluoroscopy, a type of radiographic evaluation, helps assess the function of the esophagus, evaluating movement of solids and liquids through the esophagus. Because of the type of instrumentation involved, it is often necessary to have the patient seen at a referral facility. While this procedure is not necessary in all cases, it can be invaluable in others.
Esophagoscopy is a procedure that allows visual inspection of the esophagus. In some cases, it may be the most useful tool in diagnosing certain esophageal diseases, in particular, foreign bodies, strictures, and esophagitis. One must be cautious, as this procedure necessitates general anesthesia. It is recommended that a specialist or an individual with some experience with endoscopy performs this procedure.
Antinuclear antibody titers may be run to confirm immune-mediated diseases associated with esophageal disease.
An ACTH stimulation test, acetylcholine receptor antibody titers, lead level, serum creatine kinase, thyroid function tests, electromyography or muscle biopsies may be recommended in those cases with megaesophagus.