Esophageal Diverticula in Cats

Esophageal diverticula may mimic many other common and harmless conditions in your cat, such as hairballs or the occasional upset stomach. While one episode of regurgitation or vomiting may be minor, it is important to seek veterinary care for your cat if the symptoms of esophageal diverticula become recurrent, or happen repeatedly.

The esophagus of your cat is the narrow, sensitive tube that connects your cat’s throat to the stomach, carrying food and water to be digested and turned into nutrients. Esophageal diverticula are pouch-like sacs that form inappropriately in your cat’s esophagus. These pouches can vary in size and can cause a variety of side effects and secondary conditions related to digestion and affect your cat’s overall health. 

Esophageal diverticula can cause food to become trapped in the sacs, creating a number of issues. Signs your cat may be suffering from this condition include:

• Frequent regurgitation after eating
• Vomiting
• Lethargy
• Weight loss
• Gagging
• Difficulty swallowing
• Aspiration pneumonia

Types

Two main types of esophageal diverticula exist. 

Pulsion Diverticula 

These type of esophageal diverticula tend to begin in the lower part of the esophagus and occur when increased pressure on the esophagus leads to inflammation which creates outward, or pulsating, pressure.

Traction Diverticula 

This type of esophageal diverticula involves inflammation of the tissues on the outside and surrounding the esophagus. When this inflammation occurs, fibrous tissues are produced that then contract, creating outward pull on the wall.

Esophageal diverticula may be genetic (inherited) or acquired, meaning a condition that has some underlying cause or that occurs over time. 

Common causes of each type of esophageal diverticula include:

• Foreign body lodged in esophagus
• Inherited condition
• Side effect of megaesophagus, which prevents normal movement of food through esophagus into the stomach
• Disorders that occur in the embryonic stage as your cat’s esophageal wall is developing

Diagnosis of esophageal diverticula will begin with a thorough physical exam of your cat in your veterinarian’s office. Your vet will need a complete medical and physical history of your cat’s symptoms. Owners should attempt to completely document your cat’s symptoms, paying particular attention to the timing of bouts of vomiting, approximate onset of symptoms and whether the severity of symptoms has increased or lessened over time or with different feeding locations or schedules. You should also let your vet know if your cat is allowed outdoors or may have recently experienced any trauma or potentially ingested any foreign bodies.

After considering the information you provide and examining your cat for any outwardly visible clues, your vet will order a series of internal imaging tests in order to get an accurate and detailed look at your cat’s internal structures. This may be done through x-rays, MRI or ultrasounds. The preferred method of imaging for throat issues is contrast x-rays using barium. 

Barium reflects back the x-rays so that the resulting images reveal internal structures and any abnormal areas or damage. Barium is a harmless substance and is administered to your cat via a small, needleless syringe. The thick liquid is then swallowed by your cat, coating the lining and pockets in the esophagus. Your vet will quickly follow up with standard x-rays, which will now have the esophagus more clearly delineated, allowing them to identify the location, size and shape of diverticula.

Treatment of esophageal diverticula in your cat will depend on the severity and cause of the condition. Small diverticula may resolve on their own with proper feeding and care. Your vet will prescribe a bland, soft food diet that should be fed to your cat while they are in an upright position. This will keep your cat’s esophagus extended and prevent food from becoming trapped in the sacs, also providing time to heal.

In severe cases or when the condition is present from birth or the sacs are very large, surgical correction will be needed. Surgery will require your cat to undergo anesthesia and your vet will then make small incisions into your cat’s neck area. They will then carefully use sutures to close any protrusions or remove the sacs entirely. Your cat will need to be hospitalized for several days and will also be given antibiotics and supportive care to help prevent infection post-surgery.

With the appropriate follow up care, cats have a good prognosis for making a full recovery from esophageal diverticula. If your cat has undergone surgery to correct the condition, you will need to provide a quiet spot away from other pets and small children, once they have been given the okay to return home. Your cat will need follow-up visits to confirm the condition has been thoroughly healed and to remove any sutures. Given proper treatment, your cat will live a long and healthy life.