Swallowing Difficulties in Dogs

• Gagging
• Retching
• Regurgitation
• Multiple attempts to swallow
• Excessive drooling
• Ravenous appetite
• Packed food stored in the cheeks
• Impacted food in the pharynx
• Coughing
• Aspiration
• Pneumonia due to aspiration

Types

Dogs may have difficulty with any of the phases of swallowing.

• Oral dysphagia - difficulty with the first stage of swallowing, moving food to the back of the mouth.

• Oropharyngeal dysphagia - difficulty with the pharyngeal phase of swallowing,

• Cricopharyngeal dysphagia - difficulty moving the bolus from the pharynx to the esophagus.

• Esophageal dysfunction - the bolus is unable to move through the esophagus normally.

Causes of dysphagia can be structural or functional. Physical obstructions, including pain, can present a problem, or the muscles which control swallowing may be weak, uncoordinated, or defective. Some common causes include:

• Inflammation from gastroesophageal reflux
• Foreign object lodged in the pharynx or esophagus
• Abscess or enlarged lymph nodes

• Esophageal stricture - a narrowing of the esophageal muscles as a result of repeated or long-term inflammation.

• Fracture of the mandible
• Dental pain
• Cyst under the tongue (sialocele)
• Tumor Infections such as toxoplasma and neospora
• Botulism or tick paralysis

Congenital esophagus abnormalities, usually present at birth, but some may develop later; many are found more often in certain breeds, although they may appear in any dog

• Cricopharyngeal achalasia - condition in which the esophageal muscles are abnormally constricted and don’t allow proper swallowing, more common in Golden Retrievers, and Cocker or Springer Spaniels

• Cricopharyngeal asynchrony - lack of proper synchronization in these same muscles

• Vascular ring entrapment - condition in which the esophagus and trachea are partially trapped, more common among German Shepherds, Boston Terriers, and Irish Setters

• Megaesophagus - condition in which the esophagus is enlarged, more common among Chinese Shar-Peis, Fox Terriers, German Shepherds, Great Danes, Irish Setters, Labrador Retrievers, Miniature Schnauzers, and Newfoundlands

• Esophageal diverticula - pouch-like structure on the esophagus

• Hiatal hernia- hernia between the stomach and the esophagus, more common in Chinese Shar-Peis and English Boxers

Any degenerative nerve or muscle disease

• Polymyositis/Inflammatory myopathy - idiopathic inflammatory muscle disease in which immune cells infiltrate muscles causing weakness, more common in Boxers

• Muscular dystrophy - non-inflammatory muscle degeneration disease

Your dog’s symptoms can sometimes indicate which part of the swallowing phase is creating a problem. If the difficulty is in the oral phase, food will likely remain in the mouth. Gagging, retching and multiple attempts to swallow will usually indicate a problem with bolus entering or leaving the pharynx, while regurgitation, coughing, and aspiration suggest problems with movement along the esophagus.

The veterinarian will discuss your dog’s symptoms with you. He will then perform a thorough physical examination followed by a clinical feeding test. He will evaluate each stage of swallowing as much as possible during the examination, and check for inflammation. Unless the cause is obvious, X-rays will be taken to determine if there is a physical obstruction. Contrast dyes may be added to your dog’s food so that the vet can determine where the bolus is getting stuck. If the problem appears to be neurological or related to muscle weakness, further testing will be needed to evaluate tissue degeneration.

If there are complicating problems like aspiration pneumonia, this will require immediate treatment. Your dog may need fluids and additional oxygen, and may spend several days in a veterinary hospital to recover.

Other treatments will depend on the cause. Foreign bodies can sometimes be easily removed. If they are more deeply lodged, surgery may be required. Surgery may also be required if an esophageal stricture has developed, and many congenital physical abnormalities can also be corrected with surgery. This will likely be minor surgery, but there is always a certain amount of risk. Your dog will spend several days in the hospital, and may be on a special diet during recovery.

Some conditions can be treated with medication. Infections may clear up with antibiotics. If the issue is acid reflux causing inflammation, antacids along with diet modification may be able to fix this problem. Medications which are causing acid reflux or are getting stuck in the throat may need to be changed or administered differently. Some muscular and neurological conditions can also be treated or at least reduced with medication. If the problem is due to a serious degenerative condition your dog may eventually need to be euthanized.