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Megaesophagus
Introduction
- Generalized and diffuse dilation of esophagus preventing normal forward propulsion of ingesta.
- Cause: primary neuromuscular disease - congenital or acquired. Feline dysautonomia Feline dysautonomia is the most common cause of acquired feline megaesophagus recognized; most are idiopathic.
- Signs: regurgitation, repeated swallowing attempts, poor body condition and secondary respiratory sounds.
- Diagnosis: contrast radiography.
- Treatment: dependent on cause.
- Prognosis: guarded for resolution but management may alleviate signs.
Presenting signs
- Persistent regurgitation Regurgitation.
- Repeated swallowing attempts.
- Poor body condition.
- Coughing.
- Drooling saliva.
Age predisposition
- At weaning (congenital).
- 4 months (acquired).
Special risks
- Contrast radiography: force feeding barium risks barium aspiration → bronchopneumonia Pneumonia.
Pathogenesis
Etiology
- Congenital: absence of normal motility preventing normal forward propulsion of ingesta, persistent right aortic arch and strictures with dilation cranial to lesion.
- Acquired: neuromuscular disease, eg feline dysautonomia Feline dysautonomia, myasthenia gravis Myasthenia gravis, lead poisoning Lead toxicity, systemic muscular diseases such as polymyositis and polymyopathy.
- Pyloric dyssynergia due to abnormal pyloric function - most commonly seen in Siamese Siamese cats.
- Idiopathic.
Specific
- Neuromuscular disease, eg feline dysautonomia/myasthenia gravis.
- Congenital or acquired myopathy Myopathies.
- Persistent right aortic arch Vascular ring anomaly.
- Nasopharyngeal polyp Nasopharyngeal polyp.
- Pyloric dyssynergia Pyloric stenosis.
Pathophysiology
- Absence of normal motility → failure of esophagus to propel ingesta forward → pooling of ingesta in dilated esophagus → regurgitation → possible aspiration of vomitus → bronchopneumonia.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Schneider J, Ames M, DiCicco M et al (2015) Recovery of normal oesphageal function in a kitten with diffuse megaoesphagus and an occult lower oesphgageal stritcure. J Feline Med Surg 17 (6), 557-561 PubMed.
- Frowde P E, Battersby I A, Whitley N T et al (2011) Oesophageal disease in 33 cats. J Feline Med Surg 13 (8), 564-569 PubMed.
- Byron J K, Shadwick S R, Bennett A R (2010) Megaoesophagus in a 6-month-old cat secondary to a nasopharyngeal polyp. J Feline Med Surg 12 (4), 322-324 PubMed.
- Martínez N I, Cook W, Troy G C et al (2001) Intermittent gastro esophageal intussusception in a cat with idiopathic megaesophagus. JAAHA 37 (3), 234-237 PubMed.
- Moses L, Harpster N K, Beck K A et al (2000) Esophageal motility dysfunction in cats - a study of 44 cases. JAAHA 36 (4), 309-312 PubMed.
- Guilford W G (1990) Megaesophagus in the dog and cat. Seminars in Vet Med and Surg 5 (1), 37-45 PubMed.