Swallowing Difficulties in Dogs

Any condition which inhibits the movement of food from the mouth to the stomach can pose a problem for your dog. Chewed food, referred to as bolus, is pushed to the back of the tongue where the swallowing reflex will propel it through the pharynx and esophagus. Continued action of the throat muscles pushes the bolus down the esophagus into the stomach. Swallowing difficulties, known as dysphagia, can be caused by many neurological and muscular conditions, as well as physical obstruction, pain, and inflammation. Short term problems will not pose a serious issue for your dog, although there may be an increased risk of choking. Chronic conditions will cause weight loss and nutritional deficiency and may be a sign of a serious degenerative condition. Dysphagia is more common in young dogs since many causes are congenital and will present themselves when puppies start to eat solid food.

Difficulties with the swallowing process in dogs can result from obstruction or from weakness and lack of coordination in the muscles. Veterinarians define this condition as dysphagia. Although not immediately life-threatening, in the long term it can lead to serious health problems.

• 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, antibiotics 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, for example. 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 better managed with medication. If the problem is due to a serious degenerative condition your dog may eventually need to be euthanized.

Many dogs will make a complete recovery from short-term problems and some long-term problems can be effectively corrected with surgery. If the problem is not correctable, diet modifications can sometimes help. Very small mouthfuls of food will make it easier for your dog to swallow, and maintaining an upright position can alleviate some problems. You may need to monitor your dog during feeding time. A liquid diet may also be prescribed by the veterinarian. Your dog will likely recover and live a fulfilling life with dysphagia, but it will depend on the underlying condition which causes it.

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