Understanding Esophagitis in Dogs
Esophagitis means inflammation and irritation of the esophagus—the muscular tube connecting your dog's mouth to its stomach. While it might sound simple, this condition can cause significant discomfort and even serious complications if left untreated.
What Causes Esophagitis?
The lining of the esophagus is delicate. When it's damaged by various factors, inflammation sets in. Common causes include:
- Gastroesophageal reflux (acid reflux): This frequently happens during or after anesthesia but can also occur with chronic vomiting.
- Ingestion of caustic or abrasive substances: Dogs sometimes swallow cleaning chemicals or sharp objects like bones or sticks.
- Irritating medications: Pills such as doxycycline, tetracycline, and clindamycin may harm the esophageal lining if they linger there.
- Foreign bodies: Toys or other objects stuck in the esophagus can cause direct injury.
- Infections: Parasitic, bacterial, or viral agents occasionally play a role.
- Trauma: Direct injury from accidents or medical procedures may trigger inflammation.
Brachycephalic (short-nosed) breeds face higher risks due to their anatomy. Hiatal hernias (where part of the stomach protrudes into the chest), congenital abnormalities, and tumors are additional contributors.
Recognizing Symptoms
The signs of esophagitis can be subtle or dramatic. Watch for:
- Regurgitation—passive expulsion of undigested food/liquid
- Pain or reluctance when swallowing (dysphagia)
- Excessive drooling or licking lips/air
- Coughing/gagging after eating or drinking
- Poor appetite and weight loss
- Poor posture (neck extended while swallowing)
- Lethargy, repeated swallowing attempts
- Bad breath (halitosis)
- Reluctance to move or lie down
- Fever—especially if aspiration pneumonia develops
Mild cases might only show subtle discomfort. Severe esophagitis may leave a dog refusing food, water—even saliva—due to pain.
How Is Esophagitis Diagnosed?
Your veterinarian will start with a detailed history and physical exam. Routine bloodwork often appears normal unless infection is present. Imaging like thoracic x-rays and barium contrast studies can reveal structural changes but aren't always definitive. Fluoroscopy helps assess swallowing function.
The gold standard for diagnosis is endoscopy (esophagoscopy). Here, a tiny camera visualizes the esophageal lining directly—identifying redness, swelling, ulcers, foreign bodies, strictures—and allows for biopsy if needed.
Treatment Options for Esophagitis
Treatment depends on severity and underlying cause:
- Mild cases: Supportive care and rest may suffice.
- Nutritional support: Soft, bland diets in small frequent meals help reduce further irritation; severe cases might require feeding tubes to bypass the esophagus entirely.
- Medications:
- Acid suppressors: Proton pump inhibitors (omeprazole) or H2 blockers (famotidine) reduce acid exposure.
- Mucosal protectants: Sucralfate coats ulcerated tissue to aid healing.
- Prokinetic drugs: Cisapride or metoclopramide improve motility and sphincter tone.
- Pain control: Systemic analgesics ease discomfort so dogs will eat and drink again.
Treatment duration varies: mild cases may recover within a week; severe/chronic cases could need several weeks. If aspiration pneumonia occurs—when food/fluid enters the lungs—antibiotics and oxygen support become necessary. Hospitalization is sometimes required for complicated cases.
If strictures form (scarring/narrowing), procedures like balloon dilation or bougienage are used; rare surgical intervention may be needed for refractory cases. Foreign bodies are removed surgically or endoscopically as appropriate. Corticosteroids for stricture prevention remain controversial and aren't routinely recommended.
Pitfalls & Complications
Dangers associated with untreated or severe esophagitis include:
- Esophageal strictures: Scarring that narrows passage for food/liquid
- Megaesophagus: Loss of motility/dilation of the tube itself
- Aspiration pneumonia: Food/fluid inhaled into lungs causing infection/inflammation
- Laceration/perforation: Rare but possible with sharp foreign objects
The Outlook: Prognosis & Prevention Tips
If recognized early and treated appropriately, most mild-to-moderate cases improve well. Prognosis worsens with perforation, severe strictures, tumors—or if diagnosis/treatment is delayed long enough for irreversible damage to occur.
You can help prevent esophagitis by treating vomiting promptly and keeping caustic substances out of reach. For at-risk dogs (those undergoing anesthesia/chronic vomiting), acid-suppressing medication before procedures may help reduce risk. Always give pills with water/food so they reach the stomach quickly instead of lingering in the esophagus where they could cause harm.
