Regurgitation

Buy now to access the full article, existing subscribers login

Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Timecourse (incubation, duration), Diagnosis, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Monitoring, Subsequent management, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Kenneth Simpson BVMS PhD
Dr Kim Willoughby BVMS PhD MRCVS

Introduction

  • Retrograde flow of ingesta from the esophagus to the mouth, occasionally nose.
  • Regurgitation is a clinical sign NOT A DIAGNOSIS.
  • Cause : esophageal irritation, motility disorder or obstruction.
  • Signs : food returned with lack of abdominal effort, production of mucoid saliva between meals.
  • Diagnosis : signs, radiography, esophagoscopy.
  • Treatment : depends on cause but most cases also require treatment for esophagitis if regurgitation has been persistent.
  • Prognosis : depends on cause but can be good with appropriate treatment.

Diagnosis

Clinical signs

  • Depression.
  • Pain on palpation of cervical esophageal region.
  • Occasionally fluid can be heard sloshing in large megaesophagus on palpation.
  • Increased respiratory noise if secondary inhalation pneumonia  Pneumonia  or mediastinitis present (decreased if anterior mediastinal mass).
  • Weight loss if chronic.
  • Mass at thoracic inlet - reduced compressibililty of thoracic inlet.
  • Other signs referrable to primary disease.

Diagnosis

Differential diagnosis

  • Vomiting  Vomiting  .
  • Pharyngeal disease:
    • Pharyngeal achalasia.
    • Pharyngitis  Pharyngitis tonsillitis  .
    • Pharyngeal retching.
  • Dysphagia.

Sequelae

Prognosis

  • Depends on etiology.
  • Often good if underlying cause can be addressed.
  • Guarded prognosis should be given in cases with aspiration pneumonia.
  • Esophageal perforation carries a very poor prognosis.

Expected response to treatment

  • Improving demeanor.
  • Reduced frequency of regurgitation.
  • In most cases where improvement is going to occur, this will be within a matter of days.

Reasons for treatment failure

  • Severe/untreatable underlying pathology.
  • Failure to support patient adequately while nil per os .
  • Development of complications such as inhalation pneumonia or mediastinitis which may be fatal.
  • Stricture development post esophagitis or esophageal foreign body removal.

Sources

Publications

Refereed papers

  • Washabau R J & Hall J A (1997)Diagnosis and management of gastrointestinal motility disorders in dogs and cats.Comp Cont Ed Pract Vet19, 721-737.

Sample content only, to unlock the full article login or buy now

Loading...