Why eat dog food when you can eat…

10y FS Shih Tzu that was originally presented for an esophageal foreign body (see endoscopic image below).

We were able to dislodge the foreign body using endoscopy; however, the following image is the damage left behind, which is significant and circumferential.

Within two weeks (which is the general timeline), the patient began regurgitating. Subsequent endoscopic evaluation revealed a severe stricture, whose lumen is estimated at 7-8mm (see right image).

Subsequently, we utilized a 3-stage balloon that incrementally increases its diameter depending on the amount of fluid pressure deployed.

The following image shows the desired result, which is a partial rent in the stricture.

This dilation procedure increased the diameter to well beyond the diameter of the scope (8.9mm), allowing easy entry into the stomach.

Benign esophageal strictures (BES) in dogs are most commonly secondary to esophagitis from either gastric acid reflux during anesthesia or an esophageal foreign body. They typically form 7-14 days after the event. The damage that occurs will not generally result in a stricture unless it is circumferential in nature.

The best preventative after a confirmed or suspected event has occurred is omeprazole (0.5-1mg/kg PO q12) +/- sucralfate (0.25-1g PO q8) for 10-14 days.

If a stricture does occur, balloon dilation (i.e. radial traction) vs. bougienage (longitudinal traction) are the treatments of choice. I prefer the balloon option, although studies indicate they are similar in safety and efficacy.

Sometimes one procedure is sufficient; however, many cases require 2 or more procedures since the stricture tends to reduce in size mildly after each procedure. If multiple procedures are performed, it is ideal to do them within 7-10 days of each other.

Hope ya’ll are well and staying busy. Please call me anytime if I can be of assistance.

– Kirk

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