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Likelihood and outcome of esophageal perforation secondary to esophageal foreign body in dogs

Allyson A. StermanDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.

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Kelley M. Thieman MankinDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.

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Kathleen M. HamDepartment of Clinical Science, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

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Audrey K. CookDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.

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Abstract

OBJECTIVE To determine the likelihood and outcome of esophageal perforation secondary to an esophageal foreign body (EFB) in dogs.

DESIGN Retrospective observational study.

ANIMALS 125 dogs evaluated for EFB at 2 veterinary teaching hospitals from January 2005 through December 2013.

PROCEDURES Data were retrieved from the medical record of each dog regarding variables hypothesized to be associated with esophageal perforation, whether esophageal perforation was present, and survival to hospital discharge. Variables were examined for associations with various outcomes.

RESULTS Bones (55/125 [44%]) and fishhooks (37/125 [30%]) were the most common types of EFBs. Fifteen (12%) dogs had an esophageal perforation (10 with a fishhook EFB and 5 with a bone EFB). No association was identified between dog body weight and esophageal perforation. Esophageal perforation was more likely in dogs with a fishhook EFB (10/37 [27%]) versus other EFBs (5/88 [6%]; OR, 6.1; 95% confidence interval, 1.9 to 9.6). Median interval from fishhook or bone ingestion to initial evaluation was significantly longer for dogs with (12 and 96 hours, respectively) versus without (1 and 24 hours, respectively) perforation. Thirteen of 15 (87%) dogs with esophageal perforation survived to hospital discharge, including all 10 dogs with perforation secondary to fishhook ingestion. Eight survivors with esophageal perforation required no surgical intervention.

CONCLUSIONS AND CLINICAL RELEVANCE Esophageal perforation was uncommon in the evaluated dogs with an EFB, and no surgical intervention was required for a large proportion of them. Fishhooks and delay between EFB ingestion and initial evaluation were risk factors for perforation.

Abstract

OBJECTIVE To determine the likelihood and outcome of esophageal perforation secondary to an esophageal foreign body (EFB) in dogs.

DESIGN Retrospective observational study.

ANIMALS 125 dogs evaluated for EFB at 2 veterinary teaching hospitals from January 2005 through December 2013.

PROCEDURES Data were retrieved from the medical record of each dog regarding variables hypothesized to be associated with esophageal perforation, whether esophageal perforation was present, and survival to hospital discharge. Variables were examined for associations with various outcomes.

RESULTS Bones (55/125 [44%]) and fishhooks (37/125 [30%]) were the most common types of EFBs. Fifteen (12%) dogs had an esophageal perforation (10 with a fishhook EFB and 5 with a bone EFB). No association was identified between dog body weight and esophageal perforation. Esophageal perforation was more likely in dogs with a fishhook EFB (10/37 [27%]) versus other EFBs (5/88 [6%]; OR, 6.1; 95% confidence interval, 1.9 to 9.6). Median interval from fishhook or bone ingestion to initial evaluation was significantly longer for dogs with (12 and 96 hours, respectively) versus without (1 and 24 hours, respectively) perforation. Thirteen of 15 (87%) dogs with esophageal perforation survived to hospital discharge, including all 10 dogs with perforation secondary to fishhook ingestion. Eight survivors with esophageal perforation required no surgical intervention.

CONCLUSIONS AND CLINICAL RELEVANCE Esophageal perforation was uncommon in the evaluated dogs with an EFB, and no surgical intervention was required for a large proportion of them. Fishhooks and delay between EFB ingestion and initial evaluation were risk factors for perforation.

Contributor Notes

Address correspondence to Dr. Thieman Mankin (kthieman@cvm.tamu.edu).