Esophagitis in Cats
Esophagitis is the term applied to inflammation of the esophagus -- the muscular tube that carries food down from the mouth cavity to the stomach. Gastrointestinal reflux, or acid reflux, is the most common cause of esophagitis in cats. Acid reflux is the result of stomach acids passing into the esophageal canal, causing irritation to the tissue lining of the esophagus.
Young cats born with congenital esophageal abnormalities are at an increased risk for esophagitis. Older cats that are being treated with anesthesia for surgery, or for other reasons, may also develop this condition. One of the most important complications of esophagitis is aspiration pneumonia, by which a cat that is not able to swallow food properly may end up with food material entering into the lungs.
Symptoms and Types
- Regurgitation (return of food or other contents from the esophagus or stomach back through the mouth)
- Increased swallowing motions
- Increased secretions coming out of mouth
- Pain while swallowing
- Difficulty in swallowing
- Cat may cry while swallowing food or after swallowing due to pain in the esophagus
- Cat may extends its head and neck during swallowing
- Inability to ingest food
- Reluctance to move or lie down
- Poor appetite
- Weight loss
- Cat may feel pain if you touch its neck or esophagus
- More pronounced symptoms if pneumonia develops
- Reflux of gastric and/or intestinal contents (backward flow of fluids toward the esophagus)
- Accidental ingestion of irritant chemicals
- After surgery involving the esophagus -- often due to passing of the feeding tube through the esophagus
- Chronic vomiting
- Foreign body remaining in esophagus
- Animal retaining ingested pills or capsules in esophagus
Your veterinarian will examine your cat thoroughly after taking a full history from you. You will need to give your veterinarian as much information as you can about your cat's health, including the onset of symptoms, and any possible incidents that might have preceded this condition.
Routine laboratory testing will include a complete blood count, biochemistry profile, and a urinalysis, though these tests usually return as normal in such patients. However, in cases of pneumonia, changes related to the infection may be seen in laboratory results. Radiographic studies, including X-ray or ultrasound imaging, may help in the diagnosis of esophagitis. An advanced type of radiography called barium contrast radiography may reveal changes in the esophagus due to inflammation. In barium contrast radiography, barium sulfate is administered orally to the cat. The particles are suspended in the esophagus, making the esophageal canal easier to visualize on X-ray.
Endoscopy is also an option for diagnosis in these patients and is often a more reliable procedure for diagnosis of esophagitis. Endoscopy is an internal diagnostic tool which uses an endoscope, a rigid but flexible tube equipped with a camera and methods for retrieving tissue samples, that can be inserted into a hollow cavity, such as the esophagus. Using this method, your veterinarian can look directly into the esophagus in order to visually inspect it, to take pictures, and to take a sample for biopsy.
Endoscopy may also be used to remove a foreign body, if required.
If your cat is found to have a case of mild esophagitis it may be treated as an outpatient and will not likely need to be admitted into hospital. However, if your cat is suffering from complications like pneumonia, it will need to be admitted into hospital for intensive care and treatment. Fluids will be required for patients suffering from dehydration, and oxygen will be supplemented until your cat's breathing has improved and it is out of danger. Antibiotics are often required to treat pneumonia in affected patients, but this is not always the case.
If gastrointestinal reflux is the cause of the esophagitis, your veterinarian will treat the cause and the symptoms to reduce their amount and frequency, and also to prevent the esophagus from narrowing in response to the stress and trauma.
Living and Management
Your veterinarian may recommend withholding water and food for a few days. While your cat is recovering, there are various methods for giving nutrition, including intravenous nutrition.
When your cat is able to ingest food again, a soft, palatable and highly nutritious food is recommended. Follow up progress checkups are an important part of after care, and endoscopy examinations are usually performed to verify that the esophagus is healing properly. The prognosis for affected animals is good if the esophagitis is recognized and treated promptly and aggressively. However, if the condition has progressed to the point that the esophagus has formed a stricture (narrowing), the prognosis is usually very poor.