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Esophageal foreign body in a dog | VETgirl Veterinary Continuing Education Video

Today’s VETgirl online veterinary continuing education video is on the dangers of esophageal foreign bodies. In this video, an 8-month-old, male neutered, pug was referred for an esophageal foreign body that was presumed to be lodged in the esophagus for a week’s duration. The owners knew that this dog stole some rib bones and started to eat them one week prior. The owners pulled 1 bone out of the Pug’s mouth but didn’t realize that he had swallowed another one rib whole. The owners brought the dog immediately to their referring veterinarian for dysphagia and lip smacking. Unfortunately, the owners declined radiographs at this initial presentation. However, one week later, when clinical signs continued, the owners represented to the veterinary clinic. During this week, the dog could still eat small pieces of deli meat and drink water, and was relatively hydrated and stable on presentation. Radiographs revealed an esophageal foreign body (in the form of a rib bone), at which time the dog was referred for endoscopy.

Esophageal foreign bodies are a less common type of obstruction seen in small animal medicine, but they are an emergency that must be rapidly diagnosed and treated. They are often difficult to diagnose due to mild clinical signs and physical examination findings and subtle radiographic findings. Esophageal foreign bodies are often seen in dogs that are “greedy” and that wolf down treats or bones right away. Common causes for esophageal foreign bodies include treats such as rawhides, bones, fishing hooks, and needles. Larger objects such as treats or bones tend to get stuck at the location of the heart base or in the caudal esophagus (near the heart base and diaphragm). Sharper objects such as bone fragments, needles, or fishing hooks may adhere to the wall of the esophagus and get stuck anywhere along the length of the esophagus. Common clinical signs seen with esophageal foreign bodies include acute dysphagia, pawing at the mouth, acute “frantic” agitation, hypersalivation, gagging, coughing, and regurgitation. Treatment requires anesthesia and endoscopy to remove the foreign body or to push it into the stomach (for surgical removal later, or to pass on its own).

Thankfully, most patients recover well once the foreign body can be removed by endoscopy and can be slowly reintroduced to soft food 12-24 hours after the procedure. However, complications can be seen including esophageal necrosis, development of pneumothorax secondary to esophageal perforation, aspiration pneumonia, severe esophageal strictures, and death. Other treatments included analgesics (like opioids or tramadol), gastroprotectants (such as sucralfate, famotidine, and omeprazole), antiemetics, and sometimes antibiotics (particularly if there is a secondary aspiration pneumonia). When in doubt, don’t use NSAIDs due to the potential of being ulcerogenic. Lastly, in rare, severe cases, a low-dose, anti-inflammatory, tapering dose of steroids may be needed in cases of moderate to severe esophagitis to decrease the risk of esophageal stricture. Care should be taken to rule out the presence of aspiration pneumonia prior to the use of steroids. Check out our VETgirl podcast on esophageal foreign bodies for more information.

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