Stomatitis Pharyngitis Oesophagitis and Oesophageal Obstruction In Dog

Stomatitis, Pharyngitis, Oesophagitis and Oesophageal Obstruction In Dog and Cats (VCM -604) Dr. Pallav Shekhar Asstt. Prof Veterinary Medicine, BVC

Stomatitis • Stomatitis is a condition characterized by the irritation and inflammation of the soft tissues inside your pet's mouth. • In the majority of cases, stomatitis causes ulcers to form on the soft tissue, including the lips, tongue, gums and back of the throat.

• Stomatitis means “inflammation of the mouth” and is commonly known as chronic ulcerative paradental stomatitis (CUPS). • It’s a widely recognized condition in cats, • It can affect dogs of any breed as well. • Maltese, Greyhound, Cavalier King Charles Spaniel and Scottish Terrier.

• Gingiva (gingivitis) • Non-gingival tissues of the periodontium (periodontitis) • Lip (cheilitis) • Oral mucosa (stomatitis) • Mucosa of the dorsal or ventral tongue surface (glossitis) • Mucosa forming the lateral walls of the pharynx (faucitis), • Mucosa of the palate (palatitis), palatine tonsil (tonsillitis), • or mucosa of the pharynx (pharyngitis).

Stomatitis is inflammation of the mucous lining of any of the structures in the mouth • Periodontal disease, including gingivitis and periodontitis, is the most common oral problem in small animals.

• Gingivitis is a gingival inflammatory response to the presence of bacterial plaque on an adjacent tooth surface. • Periodontitis is inflammation of non-gingival tissues of the periodontium (namely periodontal ligament and alveolar bone).

Other Factors • • Autoimmune disease, immune deficiency Chemical agents Infectious disease Trauma Metabolic disease Infectious agents that have been associated with oral inflammation, glossitis, stomatitis, and oral ulcerations include feline herpesvirus, feline calicivirus, feline leukemia virus, feline immunodeficiency virus, canine distemper virus, Bartonella henselae, and certain Leptospira serovars. Uremia can cause stomatitis and oral ulcers.

Clinical signs • Halitosis • Drooling with thick, ropey saliva and • difficulty eating and opening their mouths

Diagnosis • Clinical signs • Typical oral lesions after excluding other etiologies such as uremic stomatitis, caustic stomatitis, or specific infectious agents. • The characteristic “kissing ulcers” or "kissing lesions, ". • An immune profile should be done, and a biopsy considered for histopathology. • Radiography

Treatment • ABST- Antibiotic • Topical chlorhexidine gluconate rinses or gels and possibly oral antibiotic treatment with metronidazole should also be used. • NSAID • Topical anti-inflammatory preparations to modulate the inflammatory response may provide comfort. • Removal of foreign body • Removal of necrotic tissue • Fluid and Electrolyte therapy

OESOPHAGITIS • It is Inflammation of esophagus. It is accompanied by spasm & obstruction, Pain on swallow & palpation, Regurgitation of blood stained, slimy material.

Etiology • Ingestion of chemical or physical irritant, Stomatitis & pharyngitis, Laceration of the mucosa by foreign body or stomach tube

Etiology • Foreign bodies • Gastroesophageal reflux • Certain drugs (e. g, doxycycline). Gastroesophageal reflux is usually associated with anesthesia, drugs that decrease lower esophageal sphincter tone (e. g, atropine, acepromazine), and acute or chronic vomiting. Other causes of esophagitis include ingestion of an irritating or caustic substance, neoplasia, and Spirocerca lupi infection

• Feeding tubes that traverse the gastroesophageal junction may result in gastroesophageal reflux. • Calicivirus in cats may also cause esophagitis.

Zollinger-Ellison Syndrome in Three Dogs R. P. Happé , I. Van Der Gaag , C. B. H. W. Lamers, . . . First Published March 1, 1980 Research Article Find in Pub. Med https: //doi. org/10. 1177/030098588001700206 Hiatial Hernia in the dog and cat: A retrospective study of 16 cases R. M. Bright, J. E. Sackman, C. De. Novo and C. Toal* Departments of Urban Practice and *Rural Practice, Univer- sity of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee 379011071, USA Journal of Small Animal Practice (1990) 31, 244 -25

Clinical Findings: • Acute Stage: Salivation, Swallow with severe pain. • Regurgitation & coughing with pain having much mucous & some fresh blood. • Vigorous contraction of the cervical and abdominal muscles. • On palpation in jugular furrow causes pain and swelling.

• • Diagnosis: On the basis of clinical symptoms Contrast radiograph Endoscopy

Treatment • • • Decreasing gastric acidity Increasing lower esophageal sphincter tone Increasing the rate of gastric emptying Providing pain control. In most cases, H 2 -receptor antagonists (eg, ranitidine, famotidine) are sufficient to decrease gastric acid production.

• In severe cases of esophagitis, a proton pump inhibitor (eg, omeprazole) is preferred. • Cisapride and metoclopramide increase lower esophageal tone and the rate of gastric emptying. • Cisapride is more potent than metoclopramide.

• A sucralfate slurry may also be administered orally for esophageal cytoprotection. • Soft food, low in fat and fiber, should be fed in small, frequent meals. • Systemic analgesics may be used for pain relief. • Gastrostomy tube placement

ESOPHAGEAL OBSTRUCTION • It is the condition where there is obstruction of esophagus. • It could be complete or partial by food mass, foreign bodies, inanimate object and depending upon obstruction, various signs are manifested.

Etiology: • Bones, vertebrae, soft toys, stones, pieces of wood, balls • Bones are the most common foreign body • Needles, fishhooks, wood, rawhide, and dental chew treats may also become lodged in the esophagus. • Cats- toys food mass.

Predilection site • Thoracic inlet over the heart base, Or • The caudal esophagus just cranial to the diaphragm. • Occasionally, an object may lodge in other locations such as the upper esophageal sphincter.

Pathogenesis • Ingestion of object leads to physical obstruction hence peristalsis gets struck at that site leading to inability to swallow, followed by regurgitation through mouth or nostrils.

Clinical signs • Ptyalism, gagging, dysphagia, regurgitation, and repeated attempts to swallow • Restless, constantly shakes head in order to expel obstructing mass • Dog is excited and is many a times nonresponsive to owner that is confused with rabies

Complications • Perforation of the cervical esophagus. • Local abscessation or subcutaneous emphysema • Pleuritis, mediastinitis, pyothorax, pneumothorax, bronchoesophageal fistula formation. • Esophageal stricture, and esophageal diverticulum. • Esophageal stricture formation is the most common complication associated with an esophageal foreign body. • Aspiration pneumonia may also be seen secondary to the regurgitation.

Diagnosis: • History • Symptoms • Palpation: Palpation on the course of esophagus is many times helpful for diagnosis. If obstructing mass is palpated then it is obstruction. • Passage of stomach tube/ probe: • Plain or Contrast radiograph

Radiological Examination: Plain? Barium meal ? ? Other Contrast media? ? ?

Treatment • Endoscopy: • Foley catheter: • Push in stomach • Surgery • Antibiotic and analgesic for 3 -5 days is given • Animal is maintained on soft palatable diet.

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