The esophagus is the tubular organ that runs from the throat to the stomach; an esophageal stricture is an abnormal narrowing of the internal open space of the esophagus. There is no apparent genetic factor involved, and it occurs in cats at any age.
Your veterinarian will want to rule out many of the possible diseases or conditions that might cause these symptoms. For example, if your cat has just been weaned, an abnormality called vascular ring anomaly may be the problem. In order to arrive at a definite diagnosis, your doctor may conduct a barium-contrast X-ray, which uses a radiopaque fluid in the esophageal passage, so that the passage of the liquid shows on the X-ray image, revealing abnormalities in the passage. An X-ray may reveal a foreign body caught in the esophagus. An insertable visual diagnostic tool called an endoscope can also be useful for visually examining the esophagus in closer detail. Your doctor will also be looking for tumors and masses.
Your cat may be kept in the hospital initially. Once hydration needs are addressed and the affected portion of the esophagus is dilated, you may be able to take your cat home. If your cat has aspiration pneumonia and/or inflammation of the esophagus, it may need to remain under medical supervision longer. Intravenous fluids may be needed for correcting hydration status and medications may be given by injection following dilation procedures to facilitate healing. Oxygen may be necessary for patients with severe aspiration pneumonia.
Also, cats that have severe inflammation of the esophagus, and those that have had dilation procedures will not be able to take food through the mouth. A temporary feeding tube may be placed at the time of esophageal dilation as a means of providing continual nutritional support. When you do restart feeding your cat by mouth you will need to give bland, liquid foods that are easily digestible. Your veterinarian will advise you on the most appropriate foods to help your cat through the recovery process.
A barium contrast X-ray, a method which uses a radiopaque liquid in order to trace a passageway and to define abnormalities within, or endoscopy, using an insertable tubular instrument for visually examining the interior of the esophagus, will need to be repeated every two to four weeks until clinical signs have been resolved, and adequate esophageal lumen size (the inner space of the esophagus) has been achieved.
A life-threatening complication of esophageal stricture dilation, called esophageal tear or perforation, usually occurs at the time of dilation. This complication has been observed after several days to weeks have passed, so you will need to observe your cat for signs of this. Also, remain observant for symptoms of aspiration pneumonia due to food, liquid, or objects being pulled into the lungs, because the risk remains high. Generally, the longer the stricture, the more guarded the prognosis. With esophageal strictures due to scarring, the prognosis is generally fair to guarded. Many strictures will recur despite repeated esophageal dilation; improvement without cure is a more realistic goal.
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