Have you ever drank a hot beverage too quickly or swallowed a pill and felt as though it was stuck in your throat? If yes, then you can imagine what it’s like to have esophagitis (i.e., inflammation of the esophagus). When you eat, food mixes with saliva and passes through the esophagus on the way to the stomach. Esophagitis occurs when this food pipe is inflamed.
Esophagitis in dogs has many causes, like chewing foreign materials like toys or sticks, or ingesting chemicals (or drugs) that irritate the lining of the esophagus. If your dog shows signs of this condition, you can work with your veterinarian to confirm the diagnosis and explore treatment options.
Causes of Esophagitis
Esophagitis in dogs can be an acute condition caused by a recent event, like swallowing a foreign object. It can also be a chronic condition that results from stomach acid coming back up into the esophagus. There are three ways the esophagus can become inflamed: chemical, thermal, and mechanical damage.
“Sometimes people have been known to give their dogs a liquid like hydrogen peroxide to induce vomiting if they’ve eaten something dangerous, and we have to get it out right away,” says Dr. Amy Attas, VMD of New York-based practice City Pets. “That will really irritate the esophagus.” Other chemical causes include certain oral antibiotics, like tetracycline and doxycycline, which can irritate the esophagus. Even some anti-inflammatory drugs can lead to inflammation.
Another common chemical cause is being anesthetized. “When animals are under general anesthesia, often they’re placed on their backs, and in that position, we can get some gastric reflux coming from the stomach into the esophagus,” Dr. Attas explains.
Eating something too hot (temperature-wise) can result in thermal damage to the mucosal cells that line the esophagus, according to Dr. Attas. Lastly, mechanical damage can happen from swallowing something rough or sharp, like a stick.
Signs of Esophageal Problems in Dogs
“Sometimes esophagitis is a silent problem, but other times it has symptoms that people don’t realize reflect esophagitis,” Dr. Attas says. Symptoms include drooling, coughing, constant licking, vomiting, stretching their neck, or refusing to eat. Along with these signs, your vet would consider your dog’s history, including the following questions:
- Have they been under general anesthesia recently?
- What medications are they taking?
- Have they vomited or regurgitated recently?
- Have they chewed on or ingested a foreign body?
- Has your dog been licking their paws after coming into contact with a strong cleaning solution?
- Is your dog licking or swallowing excessively?
- Is their breed prone to esophageal problems?
Any breed can get esophagitis, especially if they’ve been under anesthesia or tend to be an aggressive chewer. However, brachycephalic breeds like the Pug, Bulldog, French Bulldog, and Pekingese are more likely to have gastric reflux disease and esophagitis, according to Dr. Attas. “They have to put a little extra effort to get air through their tiny nostrils and beyond their overlong soft palate,” she says. This increased intrathoracic pressure can cause stomach acid to go back up into the esophagus. In addition, small sacs in their airways, called saccules, can become enlarged and everted, thus restricting their breathing.
Diagnosing Esophagitis in Dogs
Typically, you’re not going to find esophagitis on routine X-rays or blood tests, Dr. Attas says. The vet will perform these tests to rule out other esophageal problems like an esophageal ulcer, mass, or tumor. They may also order special X-rays, called contrast X-rays, where the patient is given food containing a radioopaque substance to see if the esophagus looks normal with food in it.
“One of the best ways to do this is with a moving X-ray called fluoroscopy,” she says. “The dog is awake on the X-ray table, and you can watch the food go through the esophagus.” Fluoroscopy allows you to see whether the walls of the esophagus look thick in a particular area or if the inside of the esophagus, called the lumen, looks narrow.
“The diagnosis is made based on clinical signs,” she says. For example, your dog might be uncomfortable in a certain position or cry out while swallowing. Another sign is being reluctant to eat even though they seem hungry. If these signs are present, your vet may recommend imaging tests to get a full picture of what’s going on inside the esophagus.
One of these tests is an esophagoscopy, which involves putting “a fiberoptic tube, with a camera on the end, through the back of the mouth and into the esophagus,” Dr. Attas says. “An inflamed esophagus is red, roughened, swollen, and bleeds easily if you touch it.” If esophagitis is untreated, it can narrow the esophagus, making it difficult for food to pass through to the stomach. A vet would often perform most of these tests at specialty services.
Treatment and Prognosis
There are two different classes of drugs for treating esophagitis: histamine antagonists and protein pump inhibitors (PPIs). “Histamine antagonists work by blocking some of the production of gastric acid,” Dr. Attas says. Dogs with an acute case of esophagitis might lick the air repeatedly or strain their neck after vomiting. “I would want to put that dog on Pepcid because it works really quickly,” she says.
Conversely, if a dog has a chronic gastric reflux disorder, her advice would be to put them on a PPI because these drugs are much better at inhibiting gastric acid secretion and protecting against gastric acid damage. “But they won’t help in an acute situation because it does take time for them to be effective,” she adds.
Another treatment option for a severe case of esophagitis is a mucosal protectant like sucralfate. This treatment involves drinking a liquid chalk solution. The downside of a mucosal protectant is the chalky taste. In addition, because it’s so effective at coating the lining of the esophagus, “you have to give this medication at a different time from when you give other medications because it blocks the stomach receptors so well that other medications don’t get absorbed,” she explains.
The prognosis for mild to moderate cases of esophagitis tends to be good. So, if you notice any changes in your dog’s appetite, or they’re having difficulty swallowing or tend to regurgitate after eating, it’s a good idea to consult with your veterinarian about treatment options.
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