10y FS Shih Tzu that was originally presented for an esophageal foreign body (see endoscopic image below).
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We were able to dislodge the foreign body using endoscopy; however, the following image is the damage left behind, which is significant and circumferential.
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Within two weeks (which is the general timeline), the patient began regurgitating. Subsequent endoscopic evaluation revealed a severe stricture, whose lumen is estimated at 7-8mm (see right image).
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Subsequently, we utilized a 3-stage balloon that incrementally increases its diameter depending on the amount of fluid pressure deployed.
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The following image shows the desired result, which is a partial rent in the stricture.
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This dilation procedure increased the diameter to well beyond the diameter of the scope (8.9mm), allowing easy entry into the stomach.
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Benign esophageal strictures (BES) in dogs are most commonly secondary to esophagitis from either gastric acid reflux during anesthesia or an esophageal foreign body. They typically form 7-14 days after the event. The damage that occurs will not generally result in a stricture unless it is circumferential in nature.
The best preventative after a confirmed or suspected event has occurred is omeprazole (0.5-1mg/kg PO q12) +/- sucralfate (0.25-1g PO q8) for 10-14 days.
If a stricture does occur, balloon dilation (i.e. radial traction) vs. bougienage (longitudinal traction) are the treatments of choice. I prefer the balloon option, although studies indicate they are similar in safety and efficacy.
Sometimes one procedure is sufficient; however, many cases require 2 or more procedures since the stricture tends to reduce in size mildly after each procedure. If multiple procedures are performed, it is ideal to do them within 7-10 days of each other.
Hope ya’ll are well and staying busy. Please call me anytime if I can be of assistance.
– Kirk