Objective—To determine outcome of bougienage for treatment of benign esophageal stricture (BES) in dogs and cats and identify risk factors for the condition.
Design—Retrospective case series.
Animals—20 dogs and 8 cats with BES.
Procedures—Medical records were reviewed for information on signalment, clinical features, and outcome. Long-term outcome information was obtained with a questionnaire.
Results—Esophageal bougienage was performed with dilators ranging from 5 to 15 mm in diameter; median numbers of bougienage procedures were 3 (dogs) and 4.5 (cats). A good outcome, defined as tolerance of solid food with regurgitation less than once a week, was achieved in 14 dogs and 6 cats. Complications were minimal, with nonfatal esophageal perforation occurring in 1 cat. Four dogs and 1 cat were euthanized or died because of esophageal disease. Dogs with BES were more likely to be female, have a recent history of general anesthesia, have received an antimicrobial orally, or have a history of vomiting than were dogs in a reference population. Cats with BES were more likely to have a recent history of general anesthesia, vomiting, or gastrointestinal tract trichobezoars than were cats in a reference population. Doxycycline-induced esophagitis was the suspected cause of BES in 3 cats. Although general anesthesia was associated with development of BES in 18 dogs and 5 cats, concurrent potential causes of esophageal injury were common.
Conclusions and Clinical Relevance—Results suggested that esophageal bougienage was a safe and effective treatment for most dogs and cats with BES, with outcomes similar to those reported for balloon dilation.
Objective—To determine prevalence, clinical features, and causes of epistaxis in dogs.
Design—Retrospective case series.
Animals—176 dogs with epistaxis.
Procedures—Medical records were reviewed for information related to signalment, clinical features, diagnosis, and outcome.
Results—132 (75%) dogs were initially examined by the hospital's emergency service; prevalence of epistaxis was 0.3%. Dogs with epistaxis were more likely to be old (≥ 6 years), male, and large (≥ 26 kg [58.5 lb]) than were dogs in a reference population. In 109 (62%) dogs with epistaxis, an underlying cause was identified; 115 underlying disorders were identified, with 90 classified as local and 25 classified as systemic. Local causes of epistaxis included nasal neoplasia (n = 35), trauma (33), idiopathic rhinitis (20), and periapical abscess (2). Systemic causes included thrombocytopenia (12), thrombocytopathia (7), coagulopathy (3), hypertension (2), and vasculitis (1). Dogs with local causes were more likely to have unilateral than bilateral epistaxis, but 11 of 21 (52%) dogs with systemic disorders also had unilateral epistaxis. Dogs with systemic disorders were more likely to have clinical signs of systemic disease. Duration of epistaxis (acute vs chronic), severity, and duration of hospitalization were similar for dogs with local versus systemic disorders.
Conclusions and Clinical Relevance—Results suggested that epistaxis was a common disorder in dogs and frequently regarded as an emergency. Local causes of epistaxis were predominant, but clinical features traditionally thought to be helpful in distinguishing local versus systemic causes could not be reliably used for this purpose.
Case Description—A 4-year-old spayed female mixed-breed dog with a history of allergic skin disease was examined because of regurgitation, coughing, and dysphagia that began 15 days after abdominal surgery for correction of gastric dilatation and volvulus.
Clinical Findings—Severe diffuse esophagitis, esophageal dysmotility, and a benign esophageal stricture at the level of the base of the heart were identified via contrast videofluoroscopy and esophagoscopy. Severe diffuse eosinophilic ulcerative esophagitis was confirmed by histologic examination of esophageal biopsy specimens and cytologic evaluation of specimens obtained by use of a cytology brush. Esophageal eosinophils were evident (14% to 50% of the inflammatory cell population and > 25 eosinophils/hpf).
Treatment and Outcome—No clinical or endoscopic improvement was evident after treatment with antireflux medications, including a proton-pump inhibitor, following an initial esophageal bougienage procedure. An excellent response characterized by resolution of dysphagia and regurgitation with marked improvement of the esophageal mucosa was evident following intralesional and systemic administration of glucocorticoids, 2 additional esophageal bougienage procedures, and feeding of an elimination diet.
Clinical Relevance—To our knowledge, the information reported here is the first description of eosinophilic esophagitis (EE) in a dog. Many similarities exist between the condition in the dog reported here and EE in humans. This clinical report highlights the need to consider EE as a differential diagnosis for esophagitis and esophageal strictures in dogs. When appropriate, esophageal biopsy or cytologic specimens should be obtained and examined to investigate the possibility of EE.
Objective—To determine whether basal serum or plasma cortisol concentration can be used as a screening test to rule out hypoadrenocorticism in dogs.
Design—Retrospective case-control study.
Animals—110 dogs with nonadrenal gland illnesses and 13 dogs with hypoadrenocorticism.
Procedures—Sensitivity and specificity of basal serum or plasma cortisol concentrations of either ≤ 1 μg/dL or ≤ 2 μg/dL to detect dogs with hypoadrenocorticism were estimated by use of the ACTH stimulation test as the gold standard.
Results—Basal cortisol concentrations of ≤ 1 μg/dL had excellent sensitivity (100%) and specificity (98.2%) for detecting dogs with hypoadrenocorticism. For basal cortisol concentrations of ≤ 2 μg/dL, sensitivity was 100% but specificity was 78.2%.
Conclusions and Clinical Relevance—On the basis of sensitivity and specificity, basal serum or plasma cortisol concentrations had high negative predictive values over a wide range of prevalence rates and can be used to rule out a diagnosis of hypoadrenocorticism. Dogs with basal cortisol concentrations > 2 μg/dL that are not receiving corticosteroids, mitotane, or ketoconazole are highly unlikely to have hypoadrenocorticism. However, if the basal cortisol concentration is ≤ 2 μg/dL, little to no information regarding adrenal gland function can be obtained and an ACTH stimulation test should be performed.