Signs of problems with the esophagus include difficulty swallowing and regurgitation (return of food or fluid before it has reached the stomach). Congenital abnormalities of the esophagus are discussed earlier in this chapter (see Digestive Disorders of Cats: Esophagus).
Inflammation of the Esophagus (Esophagitis)
Inflammation of the esophagus (esophagitis) is usually caused by foreign objects or acid reflux. Other causes include certain drugs, eating an irritating or caustic substance, or cancer. Calicivirus in cats may also cause esophagitis. Mild inflammation may produce no visible signs and often requires no treatment. If the problem is caused by acid reflux (a cause of heartburn in people), drugs that reduce stomach acid can provide relief. Your veterinarian may recommend feeding your pet a diet of soft food, low in fat and fiber, in small, frequent meals. If esophagitis is severe, a feeding tube may need to be surgically placed into the stomach, bypassing the esophagus to allow it to rest. Antibiotics are sometimes prescribed to prevent bacterial infection.
Foreign Objects in the Esophagus
Cats are generally pickier eaters than dogs, but occasionally they will get foreign objects lodged in the esophagus. Bones are the most common, but other objects such as needles, string, thread, fishhooks, and wood may also become stuck. Signs include excessive drooling, gagging, regurgitation, and repeated attempts to swallow. Many foreign objects can be seen on x-rays. If a foreign object is found in the esophagus, a veterinarian will need to remove it as soon as possible. Surgery is necessary if the esophagus has been perforated or the foreign object cannot be removed using endoscopy. In these cases, the outlook for recovery is usually poor.
Esophageal stricture is a narrowing of the esophagus. It may develop after trauma (for example, ingestion of a foreign object, caustic substance, or certain drugs), inflammation of the esophagus, gastro-esophageal reflux (gastric acid flowing back into the esophagus), or tumor invasion. Signs include vomiting, excessive drooling, difficulty swallowing, and pain. Examining the esophagus using fluoroscopy and endoscopy are the preferred methods for diagnosis. This enables the veterinarian to actually see the number, location, and types of strictures. Endoscopy may also allow the veterinarian to correct the stricture at the time of examination.
Treatment with a balloon catheter has been successful. The catheter is a tube that is placed in the esophagus and then advanced to where the stricture occurs. The tip of the catheter is then inflated like a balloon, which stretches the esophagus and relieves the stricture. Other methods, including surgery, have been less successful.
Diverticula are pouch-like expansions (dilations) of the esophageal wall. They can be inherited or acquired; however, they are rare in cats. There are 2 types of acquired diverticula: pulsion and traction. Pulsion diverticula are caused by an increase in pressure inside the esophagus or deep esophageal inflammation, which leads to a rupture (hernia) of the inner lining. Traction diverticula are caused by inflammation in the chest cavity close to the esophagus. Fibrous tissue is formed and then contracts, pulling the esophageal wall outward (see Digestive Disorders of Dogs: Esophageal Diverticula).
Last full review/revision July 2011 by Dana G. Allen, DVM, MSc, DACVIM; Sharon Campbell, DVM, MS, DACVIM; Ben H. Colmery, DVM, DAVDC; James G. Fox, DVM, MS, DACLAM; Carlton L. Gyles, DVM, PhD, FCAHS; Walter Ingwersen, DVM, DVSc, DACVIM; Lisa E. Moore, DVM, DACVIM; Sofie Muylle, DVM, PhD; Sharon Patton, MS, PhD; Andrew S. Peregrine, BVMS, PhD, DVM, DEVPC; Stanley I. Rubin, DVM, MS, DACVIM; H. Carolien Rutgers, DVM, MS, DACVIM, DECVIM-CA, DSAM, MRCVS; Jörg M. Steiner, DrMedVet, PhD, DACVIM, DECVIM-CA; Thomas W. Swerczek, DVM, PhD