• 1.

    Jergens A. Diseases of the esophagus. In: Ettinger S, Feldman E, eds. Textbook of veterinary internal medicine. 6th ed. St Louis: Elsevier Saunders, 2005;12981309.

    • Search Google Scholar
    • Export Citation
  • 2.

    Sellon RK, Willard MD. Esophagitis and esophageal strictures. Vet Clin North Am Small Anim Pract 2003;33:945967.

  • 3.

    Straus E, Johnson GF, Yalow RS. Canine Zollinger-Ellison syndrome. Gastroenterology 1977;72:380381.

  • 4.

    Patton CS, Hake R, Newton J, et al.Esophagitis due to Pythium insidiosum infection in two dogs. J Vet Intern Med 1996;10:139142.

  • 5.

    Mylonakis ME, Rallis T, Koutinas AF. Canine spirocercosis. Compend Contin Educ Pract Vet 2008;30:111116.

  • 6.

    Kim D, Lifschitz C, Bonis P. Eosinophilic esophagitis. In: Rose B, Rush J, eds. Up To Date Web site. Available at: www.uptodate.com. Accessed Oct 27, 2008.

    • Search Google Scholar
    • Export Citation
  • 7.

    Blanchard C, Rothenberg ME. Basic pathogenesis of eosinophilic esophagitis. Gastrointest Endosc Clin N Am 2008;18:133143.

  • 8.

    Landres RT, Kuster GG, Strum WB. Eosinophilic esophagitis in a patient with vigorous achalasia. Gastroenterology 1978;74:12981301.

  • 9.

    Shiflett DW, Gilliam JH, Wu WC, et al.Multiple esophageal webs. Gastroenterology 1979;77:556559.

  • 10.

    Noel RJ, Putnam PE, Rothenberg ME. Eosinophilic esophagitis. N Engl J Med 2004;351:940941.

  • 11.

    Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004;113:1128.

  • 12.

    Furuta GT, Liacouras CA, Collins MH, et al.Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology 2007;133:13421363.

    • Search Google Scholar
    • Export Citation
  • 13.

    Spechler SJ, Genta RM, Souza RF. Thoughts on the complex relationship between gastroesophageal reflux disease and eosinophilic esophagitis. Am J Gastroenterol 2007;102:13011306.

    • Search Google Scholar
    • Export Citation
  • 14.

    Croese J, Fairley SK, Masson JW, et al.Clinical and endoscopic features of eosinophilic esophagitis in adults. Gastrointest Endosc 2003;58:516522.

    • Search Google Scholar
    • Export Citation
  • 15.

    Müller S, Pühl S, Vieth M, et al.Analysis of symptoms and endoscopic findings in 117 patients with histological diagnoses of eosinophilic esophagitis. Endoscopy 2007;39:339344.

    • Search Google Scholar
    • Export Citation
  • 16.

    Fox VL. Eosinophilic esophagitis: endoscopic findings. Gastrointest Endosc Clin N Am 2008;18:4557.

  • 17.

    Straumann A, Rossi L, Simon HU, et al.Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis? Gastrointest Endosc 2003;57:407412.

    • Search Google Scholar
    • Export Citation
  • 18.

    Parfitt JR, Gregor JC, Suskin NG, et al.Eosinophilic esophagitis in adults: distinguishing features from gastroesophageal reflux disease: a study of 41 patients. Mod Pathol 2006;19:9096.

    • Search Google Scholar
    • Export Citation
  • 19.

    Geisinger KR, Cassidy KT, Nardi R, et al.The histologic development of acid-induced esophagitis in the cat. Mod Pathol 1990;3:619624.

  • 20.

    Poorkhalkali N, Rich HG, Jacobson I, et al.Chronic oesophagitis in the cat. Scand J Gastroenterol 2001;36:904909.

  • 21.

    Van Nieuwenhove Y, Willems G. Gastroesophageal reflux triggers proliferative activity of the submucosal glands in the canine esophagus. Dis Esophagus 1998;11:8993.

    • Search Google Scholar
    • Export Citation
  • 22.

    Schulze-Delrieu K, Mitros FA, Shirazi S. Inflammatory and structural changes in the opossum esophagus after resection of the cardia. Gastroenterology 1982;82:276283.

    • Search Google Scholar
    • Export Citation
  • 23.

    Gonsalves N, Policarpio-Nicolas M, Zhang Q, et al.Histopathologic variability and endoscopic correlates in adults with eosinophilic esophagitis. Gastrointest Endosc 2006;64:313319.

    • Search Google Scholar
    • Export Citation
  • 24.

    Spergel JM, Andrews T, Brown-Whitehorn TF, et al.Treatment of eosinophilic esophagitis with specific food elimination diet directed by a combination of skin prick and patch tests. Ann Allergy Asthma Immunol 2005;95:336343.

    • Search Google Scholar
    • Export Citation
  • 25.

    Konikoff MR, Noel RJ, Blanchard C, et al.A randomized, double-blind, placebo-controlled trial of fluticasone propionate for pediatric eosinophilic esophagitis. Gastroenterology 2006;131:13811391.

    • Search Google Scholar
    • Export Citation

Eosinophilic esophagitis in a dog

Michael J. Mazzei DVM1, Sally A. Bissett BVSc, MVSc, DACVIM2, K. Marcia Murphy DVM, DACVD3, Stuart Hunter BVSc, DACVP4, and Jennifer A. Neel DVM, DACVP5
View More View Less
  • 1 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.
  • | 2 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.
  • | 3 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.
  • | 4 Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.
  • | 5 Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

Abstract

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.

Abstract

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.

Contributor Notes

Dr. Mazzei's present address is Arboretum View Animal Hospital, 2551 Warrenville Rd, Downers Grove, IL 60515.

Address correspondence to Dr. Bissett.