Esophageal Obstruction in Dogs

An esophagus, the tube-like hose that transmits food from a dog's mouth to its diaphragm muscle to its stomach, completes this process in approximately five seconds. Unfortunately, that rapid time span makes it just as easy for foreign objects (balls, bones, paper, rocks and tissue) to get lodged as well, leading to vomiting or regurgitation.

There's no doubt about it, dogs eat weird and unusual things, sometimes with frequency. When a dog ingests something large, too large to pass through the throat (esophagus), there's a chance that the esophagus can become blocked. This will result in serious swelling and blockage, you will notice signs of pain right away, and should act with urgency to seek proper medical attention.

Before an animal vomits something up or out, there are other symptoms pet owners can be aware of, including:

• Abdominal contractions (looks like dry heaving)
• Anorexia
• Depression
• Drooling
• Fever
• Lip licking
• Pacing
• Pawing at its face
• Salivation

Regurgitation and vomiting will be the most obvious signs though. However, pet owners should not assume that it will happen as soon as they eat. While it can happen within a few minutes, regurgitation or vomiting could be hours or days later.

Types

Three common areas, which are more narrow than other areas, where foreign objects get stuck in the esophagus include:

• Base of the heart
• Diaphragm
• Lower neck near chest cavity

While liquid foods may have a fighting chance of passing through, chunky foods will not get far as long as the object is firmly lodged in these areas.

Unlike other illnesses, esophageal obstruction in dogs is due to swallowing foreign objects. If the item cannot get to the stomach and come out through the bowels, it is usually stuck somewhere in the esophagus, leading to regurgitation or vomiting.

Sharp objects are even more dangerous because they can lead to punctures or affect the esophageal muscle walls for regular eating.

Pneumonia can become risky if the muscle walls are closed.

A veterinarian may inquire about the color of the bile to determine the pH level.

• pH of 5 or less is a sign of gastric acid and vomiting
• ph of 6 or higher is a sign of regurgitation

While a pet owner may commonly mistake vomiting for regurgitation, the appearance of bile after food has been in a dilated esophagus may have the same fluid appearance, specifically if it has had time to set in water or saliva.

If the dog vomits or regurgitates while in the examination room, that bile will be examined as well. Plain thoracic radiographs or fluoroscopy procedures may also be used to determine whether the dog is vomiting or regurgitating.

If the vomiting is due to gastrointestinal diseases, a blood count and serum chemistry profile will be used to examine the abdomen. If the situation is more serious, an endoscopy or surgery may be needed.

Under anesthesia*, the surgeon's goal will be to remove any and all foreign objects from the esophagus. It can be removed either through the mouth or pushed out through the stomach using an endoscope and forceps.

If neither exit route works, then surgery is the alternative. The chest cavity and esophagus will be surgically opened to remove the foreign objects.

• Midline incision - Foreign objects in the bottom of the neck

• Right side of chest incision - Foreign objects in the base of the heart

• Left or right side of chest incision - Foreign objects in front of the diaphragm

Outside of these three incisions, some medical professionals may choose to surgically open the abdomen near the midline area to pull the foreign object into the stomach area.

*Although rare, it is a mild possibility that death may occur from anesthesia. Monitoring devices used for blood pressure, electrocardiogram (EKG), expiratory carbon dioxide levels, inspiratory or pulse oximetry) a surgeon should immediately be alerted of any complications while the surgery is being completed.

In the best case scenario, the foreign object will be removed, and the dog will usually heal within a few days. However, if the item cannot be pulled out or pushed out, there is the possibility of infections during surgery. This is why antibiotics are mandatory during surgery and a certain amount of days later. If an infection happens anyway, it will usually show up within two to five days.

Signs of infection include:

• Esophagitis (inflammation that may damage esophagus tissues)
• Fever
• Foul odor near surgical wounds
• Heartburn
• Lethargy
• Pain near surgical wounds (outside of mild sensitivity)
• Pus near surgical wounds
• Regurgitation
• Swelling near surgical wounds

Seroma formation, or fluid accumulation, may require draining if problems occur but it can usually resolve on its own.

For additional regurgitation after surgery, a catheter will be used to widen (i.e., dilate) the esophagus to make sure no additional foreign objects are inside and to check on the healing process.

Swelling should diminish within a few days if there are no additional complications.