The current literature is reviewed in this paper regarding the application of diagnostic imaging in the evaluation of swallowing disorders of the dog. The applications of radiography, contrast radiography, and contrast videofluoroscopy are discussed with pertinent case examples provided for emphasis. The indications for image-guided interventions are also described.

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Imaging evaluation of dogs and cats with Dysphagia.

PLEASE NOTE THAT A MORE RECENT EDITION OF THIS TITLE IS AVAILABLE IN THE LIBRARYDysphagia and regurgitation are the two main clinical signs associated with swallowing disorders in dogs and cats. Dysphagia is defined as difficulty swallowing; regurgitation is defined as the passive evacuation of undigested food from the oesophagus. Differentiation between dysphagia and regurgitation may help to localize the anatomical site of the disease, as dysphagia is the most important clinical sign associated with diseases of the oral cavity and pharynx whilst regurgitation is the most important clinical sign associated with diseases of the oesophagus. In most swallowing disorders one of these clinical signs (dysphagia or regurgitation) tends to predominate, thereby providing a clue to the site of the lesion. In some animals, however, regurgitation and dysphagia may coexist, in which case other clinical signs may be useful in differentiating the site of the lesion. This chapter considers the clinical features, diagnosis and treatment of dysphagia and regurgitation.

Dysphagia and regurgitation

OBJECTIVE

To evaluate the use of rigid endoscopy in the management of oropharyngeal stick injuries.



METHODS

Retrospective analysis of case records between 2011 and 2013 from a large referral hospital. Data regarding signalment, clinical presentation, treatment options and final outcomes were recorded.



RESULTS

Nine dogs were identified with acute oropharyngeal stick injuries. There were seven males and two females and the dogs were of various breeds, ages (1 · 5 to 9 years) and weights (11 · 9 to 38 · 4 kg). The time from injury to referral was between 1 and 3 days (median: 2 days). All dogs were anaesthetised and the tracts explored using a 30° forward-oblique, 2 · 7-mm-diameter, 18-cm-length rigid endoscope with corresponding 14 · 5 Fr sheath. The endoscopy was performed under saline irrigation. Foreign material (>1 mm in size) was removed using grasping forceps fed through the sheath. Subsequently, the tracts were re-inspected and flushed with further saline to confirm that all foreign material had been removed. All dogs recovered uneventfully and had excellent outcomes with no cases representing with chronic manifestations of oropharyngeal stick injuries.



CLINICAL SIGNIFICANCE

Rigid endoscopy is an effective method for the diagnosis, assessment and, in certain cases, treatment of acute oropharyngeal stick injuries in dogs.

The use of rigid endoscopy in the management of acute oropharyngeal stick injuries.

A 5-month-old male Abyssinian presented with right hemiplegia. Cervical radiographs, haematology and serum biochemistry were normal. A foreign body was identified on computed tomography (CT) and magnetic resonance imaging (MRI). Removal of the foreign body was carried out via a dorsal approach between the occipital bone and the C1 vertebral body using intra-operative CT. No complications were encountered. Thirty days after surgery, the cat was ambulatory.

Spinal cord trauma in a cat caused by ingestion of a splinter.

General Oral Pathology

A 16 month old cat presented with a history of acute onset oral pain and hypersalivation. Oral examination revealed a wooden stick that protruded from the right sublingual region. Lateral cervical radiography showed retro pharyngeal gas lucencies. An 11 cm wooden stick was removed per os and the resulting tract was endoscopically explored. There were no post-operative complications and the cat remains disease free four months after presentation. In contrast to dogs, where oropharyngeal stick injuries are an uncommon albeit well recognised condition, there have been no previous case reports of oropharyngeal stick injuries in the cat. This case report describes the presentation, diagnosis and treatment of an oropharyngeal stick injury in a cat.

JM Williams

Papers

Oropharyngeal stick injury in a Bengal cat.