CHOKE IN DOGDEFINITION: The esophagus is the tubular, muscular organ that extends from the pharynx to the stomach and functions to transmit ingested material to the stomach. Esophageal disease is any disease that effects the esophagus.

Causes:· Megaesophagus is decreased or absent esophageal movement that often results in dilatation, or stretching beyond normal size. It may be congenital (existing from birth) or acquired later in life.

· Vascular ring anomaly is strangulation (compression) of the esophagus within several structures, causing a partial megaesophagus.

· Esophagitis is an inflammation of the esophagus.

· Esophageal foreign bodies are any objects present or remaining within the esophagus.

·Esophageal stricture is an abnormal narrowing of the esophagus.

·Esophageal diverticula are pouch-like dilatations of the esophageal wall.

· Esophageal neoplasia is cancer of the esophagus.

Oesophageal foreign bodies These are typically associated with inability to eat and regurgitation (rather than vomiting). Usually this is a problem in dogs rather than cats, and they tend to reach the veterinarian for investigation a few days after ingestion. The commonest foreign body is an inappropriate bone gobbled up (without chewing) by a greedy dog. Chicken bones are rarely a problem as they are too soft. Vertebrae are big offenders because of their irregular shape. Most of these require endoscopic intervention to effect a favourable outcome, typically at a centre with facilities for endoscopy and purposedesigned bone retrieval forceps.

. Fish hook caught in the caudal thoracic oesophagus of a dog. Photo courtesy of Dr Terry King. Nasopharyngeal foreign bodies Bones, blades of grass, plant awns, berries, pills, plastic toys, bits of fish (especially fish heads) or meat can all cause problems if they become lodged in the nasopharynx. This usually occurs after vomiting following the initial deposition and subsequently gives rise to stertor, inspiratory dyspnoea, snoring and halitosis. If the foreign body is not obvious to the human eye, then, endoscopy or a vigorous flush with saline will aid diagnosis. The differential diagnosis for nasopharyngeal disease has been published in a recent article in the Compendium. Gastrointestinal foreign bodies (GIFB) Classic GIFBs in dogs include mango pips, peach and apricot stones, tennis ball remnants (somewhat radioopaque) and metallic foreign bodies (washers, fish hooks, bottle tops, coins). (Bones very rarely cause problems once they reach the stomach, although excess ingestion may result in constipation if the dog is not accustomed to eating a bone rich diet.)

Tennis ball remnant causing intestinal obstruction in a dog. Photo courtesy of Dr Terry King. GIFBs may cause irritation of the stomach and thus vomiting, and occasionally they obstruct gastric outflow through the pylorus. Intestinal foreign bodies give rise to signs of obstruction with or without perforation and peritonitis (initially localised, eventually generalised).Two recent additions to the list of GIFBs in dogs are the TAMPON and the SKEWEAnimals that are systemically ill benefit from IV fluid therapy (eg, lactated Ringer’s or normal saline). Restoring vascular volume is vital to improve tissue perfusion. There is no difference in survival for animals undergoing small- versus large-intestinal surgery. The overall mortality rate for intestinal surgery is reported to be 12%. Large-intestinal surgery tends to be associated with longer surgery and recovery times. Animals requiring both resection and anastomosis and enterotomy are less likely to survive. Those with concurrent peritonitis reportedly have a mortality rate of up to 31%. Animals requiring more than one procedure tend to have higher mortality rates. Surgery and multiple enterotomies are necessary in most cats for the removal of linear foreign objects, yet many recover well. Peritonitis and death associated with linear foreign objects is much more common in dogs than in cats. R (SATAY) STICK.

Contemporary hazards to dogs - tampons and satay sticks (with tasty ‘bait’). Tampons, for obvious reasons, are especially attractive to dogs and cause an especially nasty syndrome due to severe plication of the gut from the attached, anchored string. This problem is more apparent in these politically correct times, because flushing tampons down the toilet is actively discouraged. Although this topic may initially appear unseemly, owners need to be made aware of this NEW danger common to many households.

Plication and perforation of the small bowel following ingestion of a tampon. Photo courtesy of Dr Terry King. Satay sticks are a novel manifestation of multiculturalism in Australian society. Instead of dogs merely getting pancreatitis from eating the fatty sausages after a BBQ, or getting Heinz body haemolytic anaemia after eating the left-over onions, a new syndrome has emerged due to ingestion of wooden skewers (typically with some tasty shish kebab still attached). These sharp linear foreign bodies usually make it to the stomach without damaging the pharynx or oesophagus, but exit the gut at points of anatomic tortuosity, such as the duodenal flexure or ileocaecocolic junction, giving rise to peritonitis. They often eventually exit the body via the left paralumbar fossa region where they can cause local irritation and infection. Date palm seeds/pips seem to be an increasingly common cause of partial intestinal obstruction in certain regions of Sydney. They may lodge in the pylorus or small intestine, and being radiolucent, can be hard to detect with radiography and even utilising expert ultrasonography. Sometimes these pips pass spontaneously, having caused a few days of partial intestinal obstruction /irritation, while in other cases surgery is equired to effect a cure. The value of lubricants has not been establishedTREATMENT: Animals that are systemically ill benefit from IV fluid therapy (eg, lactated Ringer’s or normal saline). Restoring vascular volume is vital to improve tissue perfusion. There is no difference in survival for animals undergoing small- versus large-intestinal surgery. The overall mortality rate for intestinal surgery is reported to be 12%. Large-intestinal surgery tends to be associated with longer surgery and recovery times. Animals requiring both resection and anastomosis and enterotomy are less likely to survive. Those with concurrent peritonitis reportedly have a mortality rate of up to 31%. Animals requiring more than one procedure tend to

have higher mortality rates. Surgery and multiple enterotomies are necessary in most cats for the removal of linear foreign objects, yet many recover well. Peritonitis and death associated with linear foreign objects is much more common in dogs than in cats. REFERENCES:http://www.pgf.edu.au/per_47.cfmhttp://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/23308.htm