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Risk factors and prognostic indicators for surgical outcome of dogs with esophageal foreign body obstructions

Brigitte A. BrissonDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

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Shannon H. WainbergDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

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Sarah MalekDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

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Stephanie ReabelDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

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Alice DefargesDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

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William C. SearsDepartment of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

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Abstract

OBJECTIVE To determine risk factors for surgical intervention, complications, and outcome in dogs with an esophageal foreign body (EFB).

DESIGN Retrospective observational study.

ANIMALS 224 incidents of EFB in 223 dogs evaluated at a veterinary teaching hospital from 1995 through 2014.

PROCEDURES Hospital records were reviewed to collect data regarding signalment, history, clinical signs, EFB type and location, procedures, complications, and outcomes. Breed distributions were compared between dogs with EFB and the entire canine patient population during the study period. Variables were tested for associations with each other and with outcomes.

RESULTS Terrier breeds were most common (71/233 [30.5%]). Duration of EFB entrapment, body weight, anorexia, lethargy, rectal temperature, and esophageal perforation were associated with the need for surgical intervention. Older age, longer duration of EFB entrapment, and perforation were associated with a poorer prognosis. Endoscopic retrieval or advancement into the stomach was successful for 183 of 219 (83.6%) EFBs, and 16 of 143 (11.2%) entrapments resulted in postprocedural esophageal stricture. Overall median duration of hospitalization was brief (1 day), and the need for surgical intervention was associated with a longer duration. Overall mortality rate was 5.4% (12/223); 90 of 102 (88.2%) dogs with a median follow-up period of 27 months after EFB treatment had an excellent outcome.

CONCLUSIONS AND CLINICAL RELEVANCE Study findings suggested that endoscopic EFB retrieval remains the initial treatment option of choice for affected dogs, provided that esophageal perforation does not necessitate surgical intervention. Although esophageal stricture formation was the most common complication, the overall rate of this outcome was low.

Abstract

OBJECTIVE To determine risk factors for surgical intervention, complications, and outcome in dogs with an esophageal foreign body (EFB).

DESIGN Retrospective observational study.

ANIMALS 224 incidents of EFB in 223 dogs evaluated at a veterinary teaching hospital from 1995 through 2014.

PROCEDURES Hospital records were reviewed to collect data regarding signalment, history, clinical signs, EFB type and location, procedures, complications, and outcomes. Breed distributions were compared between dogs with EFB and the entire canine patient population during the study period. Variables were tested for associations with each other and with outcomes.

RESULTS Terrier breeds were most common (71/233 [30.5%]). Duration of EFB entrapment, body weight, anorexia, lethargy, rectal temperature, and esophageal perforation were associated with the need for surgical intervention. Older age, longer duration of EFB entrapment, and perforation were associated with a poorer prognosis. Endoscopic retrieval or advancement into the stomach was successful for 183 of 219 (83.6%) EFBs, and 16 of 143 (11.2%) entrapments resulted in postprocedural esophageal stricture. Overall median duration of hospitalization was brief (1 day), and the need for surgical intervention was associated with a longer duration. Overall mortality rate was 5.4% (12/223); 90 of 102 (88.2%) dogs with a median follow-up period of 27 months after EFB treatment had an excellent outcome.

CONCLUSIONS AND CLINICAL RELEVANCE Study findings suggested that endoscopic EFB retrieval remains the initial treatment option of choice for affected dogs, provided that esophageal perforation does not necessitate surgical intervention. Although esophageal stricture formation was the most common complication, the overall rate of this outcome was low.

Contributor Notes

Dr. Malek's present address is Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

Address corresponding to Dr. Brisson (bbrisson@uoguelph.ca).