Signalment and Hx
Patient is a 1.5 year old, female spayed, mix breed dog who was referred for esophagogram under fluoroscopy due to chronic, intermittent vomiting/ regurgitation. Patient had a history of dietary indiscretion.
Physical exam
On physical examination she was BAR. Her body condition score was adequate. The thoracic auscultation was unremarkable and she was slightly uncomfortable on palpation of the abdomen. She weighed 24 lbs.
Diagnostics prior to esophagogram
CBC - unremarkable.
Chemistry panel - unremarkable.
Abdominal radiographs- possible partial duodenal obstruction.
Abdominal CT scan- normal; no evidence of obstruction noted.
Esophagogram
Patient was awake in ventral recumbency on our hard top table while barium was administered orally during fluoroscopy. Afterwards, soft food mixed with barium was given. Finally, kibble with barium was given. The images were submitted to our board certified radiologist. Pertinent findings included:
Findings of esophagogram
During the evaluation of barium fluid and food passage, there is normal first and second esophageal wave transit into the stomach. Once the barium reached the cardia some of the barium moved into the fundus and some of the barium liquid and food refluxed to the caudal esophagus.No evidence of obstruction or persistent dilation seen
Conclusions
Gastroesophageal reflux
Follow Up
Patient is doing very well on medical management for gastroesophageal reflux.
Fluoroscopy in Veterinary Medicine
Fluoroscopy is a very useful tool in our diagnostic armament. Until recently it wasn't readily available but now through MPI it can be done in your practice and it’s very affordable. Fluoroscopy is used to diagnosed problems such as the one presented here (GERD), but it plays an important role in other esophageal problems such as PRAA, strictures and evaluating the swallow reflex, among others. In addition it can be used to diagnose tracheal collapse, evaluate the urethra and urinary bladder (retrograde urethrocystogram) and evaluate lesions with draining tracts (fistulograms).