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Treatment

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.

Prevention

• Proper preparation prior to anesthesia (12-hour pre-operative fast)
• Avoid certain drugs prior to anesthesia, if possible
• If gastroesophageal reflux is present, avoid late-night feedings, as they tend to decrease the ability of the muscle between the stomach and esophagus to remain closed during sleep
• Protect your cat from ingesting caustic substances and foreign bodies

Living and Management

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.