Skip to main content
menu sluit menu
Home Home
Login
Main navigation
  • Library
  • Calendar
  • e-Learning
  • News
    • Veterinary News In this section you find veterinary news
    • Recent Additions All content that was recently added to the IVIS library
  • Get involved
    • Donate Support IVIS, make a donation today
    • Media kit Promote your e-learning & events on IVIS
    • Add your e-learning & events to the IVIS calendar
    • Publish on IVIS Publish your work with us
  • About
    • Mission Our Mission Statement
    • What we do More info about IVIS and what we do
    • Who we are More info about the IVIS team
    • Authors See list of all IVIS authors and editors
  • Contact
User tools menu
User tools menu
Main navigation
  • Library
  • Calendar
  • e-Learning
  • News
    • Veterinary News In this section you find veterinary news
    • Recent Additions All content that was recently added to the IVIS library
  • Get involved
    • Donate Support IVIS, make a donation today
    • Media kit Promote your e-learning & events on IVIS
    • Add your e-learning & events to the IVIS calendar
    • Publish on IVIS Publish your work with us
  • About
    • Mission Our Mission Statement
    • What we do More info about IVIS and what we do
    • Who we are More info about the IVIS team
    • Authors See list of all IVIS authors and editors
  • Contact
Follow IVIS
  • Twitter
  • Facebook
Support IVIS

Breadcrumb

  1. Home
  2. Library
  3. Encyclopedia of Canine Clinical Nutrition
  4. Oropharyngeal and Esophageal Diseases
Encyclopedia of Canine Clinical Nutrition
Back to Table of Contents
Add to My Library
Close
Would you like to add this to your library?

Get access to all handy features included in the IVIS website

  • Get unlimited access to books, proceedings and journals.
  • Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
  • Bookmark your favorite articles in My Library for future reading.
  • Save future meetings and courses in My Calendar and My e-Learning.
  • Ask authors questions and read what others have to say.
Sign in Register
Comments
Print this article
Share:
  • Facebook
  • LinkedIn
  • Mail
  • Twitter

Oropharyngeal and Esophageal Diseases

Author(s):
German A.J. and
Zentek J.
In: Encyclopedia of Canine Clinical Nutrition by Pibot P. et al.
Updated:
JAN 08, 2008
Languages:
  • DE
  • EN
  • ES
  • FR
  • IT
Back to Table of Contents
Add to My Library
Close
Would you like to add this to your library?

Get access to all handy features included in the IVIS website

  • Get unlimited access to books, proceedings and journals.
  • Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
  • Bookmark your favorite articles in My Library for future reading.
  • Save future meetings and courses in My Calendar and My e-Learning.
  • Ask authors questions and read what others have to say.
Sign in Register
Print this article
SHARE:
  • Facebook
  • LinkedIn
  • Mail
  • Twitter
    Read

    2. Oropharyngeal and Esophageal Diseases

    Swallowing Disorders and Diseases of the Esophagus

    Clinical Signs Associated with Swallowing Disorders

    Dysphagia is defined as difficult or painful swallowing (odynophagia) and can result from conditions of the oral cavity, pharynx and esophagus. The complete swallowing sequence involves oropharyngeal, esophageal and gastro-esophageal phases. The oropharyngeal phase can be further subdivided into oral, pharyngeal and cricopharyngeal stages. Abnormalities of any of these stages can result in dysphagia. Disorders are usually functional or morphological; most functional disorders are the result of failure, spasm or incoordination of the normal neuromuscular activity. Regurgitation is almost effortless expulsion of food from either the oropharynx or esophagus. This should be differentiated from vomiting (Table 1).

    Table 1. Differentiation of Regurgitation from Vomiting

    Regurgitation

    Vomiting

    • Passive event
    • No abdominal effort
    • Not preceded by prodromal signs
    • But may drool saliva
    • Can be associated with:
    • Undigested food covered by mucus/saliva
    • Neutral pH
    • Solids but not liquids if stricture or pointed foreign body
    • Fresh blood if ulcerated
    • Bolus in neck
    • Pain on swallowing
    • Timing
    • Immediate or soon after swallowing
    • Delayed if dilated esophagus or diverticulum present
    • Reflex act with a coordinated reflex
    • Abdominal heaves
    • Retroperistalsis
    • Reflex closure of glottis
    • Preceded by prodromal signs
    • Nausea
    • Unease
    • Anorexia
    • Hypersalivation
    • Swallowing
    • Retching
    • Can be associated with:
    • Acid pH (<5)
    • Bile
    • Partially digested food
    • Digested or fresh blood
    • Timing
    • Variable but rarely immediate

    The main clinical signs associated with swallowing disorders are listed in Table 2.

    Table 2. Signs of Swallowing Disorders

    Primary Signs

    Secondary Signs

    Dysphagia

    Odynophagia

    Regurgitation

    Polypnea may be present

    Malnutrition

    Dehydration

    Anorexia (pain, obstruction) or polyphagia (starvation)

    Regurgitation

    • Reflux pharyngitis, rhinitis
    • Nasal discharge

    Aspiration pneumonia

    • Cough, dyspnea

    Tracheal compression

    • Cough, dyspnea

    Diagnosis of Esophageal Disease

    For animals presenting with esophageal disease, a staged approach to diagnosis is usually required.

    Signalment and History

    Breed, gender and age can all provide clues as to the likely diagnosis. In this regard, young dogs are more likely to suffer from congenital diseases. A thorough history is essential, in order to establish the pattern of clinical signs, in terms of duration, progression, frequency and severity. Further clues as to the underlying etiology may be evident e.g., ingestion of a foreign body.

    Physical Examination

    Physical examination is often normal although, if regurgitation is severe, body condition may be poor. Diseases of the oral cavity can often be directly visualized, but the pharynx and cricopharynx cannot be examined without sedation or general anesthesia. If the cervical esophagus is dilated, this can often be palpated or visualized.

    Further Diagnostic Investigations

    History and physical examination confirms signs consistent with a swallowing disorder, and may give a clue as to the exact region involved (Table 3). However, a definitive diagnosis can rarely be established at this stage and additional procedures are required.

    Table 3. Differentiation of Oropharyngeal from Esophageal Dysphagia

    Clinical Sign

    Oropharynx

    Esophagus

    Dysphagia

    Always present

    Sometimes present (with esophagitis or obstruction)

    Regurgitation

    Present

    Present

    Hypersalivation

    Usually present

    Absent (except in case of foreign object), n.b. pseudoptyalism

    Gagging

    Often present

    Usually absent

    Ability to drink

    Abnormal

    Normal

    Ability to form a solid bolus

    Abnormal

    Normal

    Dropping of food from mouth

    Yes

    No

    Time of food ejection

    Immediate

    Immediate in cranial obstruction

    Character of food ejected

    Undigested

    Undigested

    Odynophagia

    Occasionally seen

    Frequent, particularly with esophagitis due to foreign body

    Number of swallowing attempts

    Multiple

    Single to multiple

    Associated signs

    Nasal discharge

    Dyspnea, cough

    Reluctance to eat

    May be present

    May be present

    Radiography (Direct or Indirect Signs)

    Survey radiographs. Many swallowing disorders can be detected with plain radiography. A gas-filled esophagus can be seen with megaesophagus, sometimes evident as a tracheal stripe sign. Most foreign bodies (especially bone material) are also evident with plain radiography.

    Barium Esophagram ± Fluoroscopy

    In some cases contrast radiography is required, although this is unnecessary (and can even be dangerous e.g., inhalation of barium) if a diagnosis is evident on the plain radiograph. Barium mixed with food is preferable for esophageal studies; iodine-based contrast agents should be used if perforation is suspected. If available, fluoroscopic analysis is preferable because it provides dynamic information on oral cavity, pharyngeal and esophageal function. All swallowing phases can be examined and characterized.

    Endoscopy

    This is not essential for many esophageal diseases e.g., megaesophagus, but is the method of choice for most other conditions. This procedure is also essential for diagnosis of all organic causes (e.g., esophagitis - Figure 6 -, gastro-esophagal reflux, stenosis, esophagal neoplasia). Flexible endoscopy is preferable to rigid endoscopy for viewing the esophagus. Endoscopy can also be therapeutic e.g., foreign body removal, esophageal stricture dilation, and placement of percutaneous esophagostomy tubes.

    Esophagial mucosa: secondary inflammatory aspect lesions in the presence of gastroesophageal reflux
    Figure 6. Esophagial mucosa: secondary inflammatory aspect lesions in the presence of gastroesophageal reflux. Cardial incontinence is present. (© V. Freiche).

    Specific Swallowing Disorders

    The major swallowing disorders are listed in Table 4.

    Table 4. Major Diseases of the Oropharynx and Esophagus

    Oropharynx

    Esophagus

    Oropharyngeal neuromuscular dysphagia

    Cricopharyngeal achalasia

    Oropharyngeal neuromuscular granuloma

    Oropharyngeal trauma

    • Physical injury
    • Burns
    • Foreign bodies

    Oropharyngeal inflammation (various etiologies!)

    • Glossitis
    • Stomatitis
    • Pharyngitis

    Megaesophagus

    Esophagitis

    Esophageal stricture

    Esophageal foreign body

    Vascular ring anomalies

    Hiatal hernia

    Gastro-esophageal intussusception

    Esophageal neoplasia

    Esophageal fistula

    Esophageal diverticulum

    Gastroesophageal reflux

    Oropharyngeal Neuromuscular Dysfunction

    These can result in disruption of any of the oropharyngeal stages of swallowing (oral, pharyngeal or cricopharyngeal). Cricopharyngeal dysmotility can result either from failure of the cricopharynx to contract (chalasia) or relax (achalasia). The etiology of these disorders is poorly understood, but some cases are associated with neurological (brain stem disease, peripheral neuropathies), neuromuscular (myasthenia gravis, polymyositis) or metabolic (hypothyroidism) derangements. Cricopharyngeal achalasia is described in young dogs as a congenital failure.

    Most of these disorders are treated medically. If a specific cause can be documented this should be treated. Otherwise treatment is usually supportive e.g., nutritional support (via gastrostomy tube) or postural feeding. If cricopharyngeal achalasia is present, this can be managed surgically e.g., by cricopharyngeal myotomy. Given that in many cases, an underlying disorder is not found, the prognosis is usually guarded.

    Megaesophagus and Esophageal Dysmotility

    Megaesophagus refers to esophageal global dilatation and dysfunction/paralysis, and has numerous possible causes (Table 5). Pathogenesis is characterized by failure of progressive peristaltic waves. Esophageal dysmotility is the term used to describe defective esophageal motility without overt dilation of the esophagus (e.g., visible on radiography). The same diseases that cause megaesophagus are also responsible for esophageal dysmotility. Megaesophagus can be primary or secondary. The most important cause of acquired megaoeosphagus is myasthenia gravis (MG). In focal MG, megaosophagus may be the only clinical sign. The main clinical sign of megaesophagus is regurgitation (without pain), and a dilated cervical esophagus may be seen. Secondary signs (pyrexia, coughing, dyspnea, weight loss) may also be present and are usually due to nasal reflux, inhalation pneumonia, and malnutrition.

    Table 5. Major Causes of Megaesophagus

    Primary / Idiopathic

    Secondary

    Congenital e.g.,

    - Great Dane,

    - German Shepherd,

    - Irish Setter (associated with pyloric stenosis)

    Acquired

    Focal or general myasthenia gravis

    Other neurological disorders

    - Polymyositis

    - Polyneuropathies

    - Dysautonomia

    - Bilateral vagal nerve damage

    - Brain stem disease

    • Trauma
    • Neoplasia
    • Vascular disease
    • Botulism
    • Distemper
    • Dysautonomia
    • Tetanus

    - Systemic lupus erythematosus (SLE)

    Toxicity

    - Lead

    - Thallium

    - Anticholinesterase

    - Acrylamide

    Various

    - Mediastinitis

    - Hypoadrenocorticism

    - Pituitary dwarfism

    - Esophagitis

    - Hiatal hernia

    - Hypothyroidism (controversial)

    There is no effective medical or surgical therapy for idiopathic megaesophagus and all methods are supportive (see below). For secondary megaesophagus, treatment involves treating the underlying cause. Examples include using steroid replacement for hypoadrenocorticism, and using a combination of anticholinesterases (e.g., pyridostigmine) and immunosuppressive medication (glucocorticoids, azathioprine, mycophenolate or cyclosporin) to treat MG.

    There is always a danger of aspiration and subsequent pneumonia and, therefore, prognosis is guarded. However, some idiopathic cases in young dogs recover spontaneously, whilst recovery of function occasionally occurs in secondary megaesophagus if the underlying cause is treated.

    Esophagitis and Esophageal Ulceration

    Esophagitis is defined as inflammation of the esophagus, and has a number of potential causes (Table 6). Ulceration (and subsequent stricture formation) can develop if esophagitis is severe.

    Table 6. Major Causes of Esophagitis

    Gastro-esophageal Reflux

    Ingestion of Irritant Substances/Material

    General anesthesia +++

    Hiatal hernia

    Persistent vomiting: rare

    Natural reflux esophagitis (defective lower esophageal sphincter function)

    - Obesity

    - Upper airway obstruction (laryngeal paralysis)

    Caustics

    Hot liquids

    Irritants

    Foreign bodies

    Drugs e.g., NSAIDs, antibacterials (doxycycline)

    Clinical signs of esophagitis include chronic vomiting/regurgitation, hypersalivation and anorexia due to the pain associated with swallowing. Endoscopy is advisable and the stomach and the duodenum should be examined if chronic vomiting is present.

    Treatment is symptomatic. In addition to nutritional support (see below), attention must be given to providing adequate fluid therapy. Recommended drug therapy includes the use of broad-spectrum antibacterials, analgesics, mucosal protectants (sucralfate), gastric acid blockers (e.g., H2antagonists such as ranitidine, famotidine, or proton pump inhibitors such as omeprazole), and motility modifiers e.g., metoclopramide.

    Esophageal Obstruction

    Esophageal obstruction can be intraluminal, intramural or extramural, and can be partial or complete (Table 7). If the obstruction is long-standing, the esophagus cranial to the obstruction can become dilated and hypomotile. Other complications of esophageal obstruction include esophagitis and esophageal rupture leading to mediastinitis (not often described in dogs).

    Table 7. Major causes of Esophageal Obstruction

    Intraluminal

    Mural

    Extramural

    Esophageal foreign body

    - Bones

    - Needles

    - Wood

    - Fish-hooks

    Esophageal stricture

    - Foreign body

    - Caustic material

    - Esophagitis

    - Gastric reflux

    - Drug therapy e.g., antibacterials, non-steroidals etc

    Esophageal neoplasia

    - Leiomyoma, leiomyosarcoma

    - Carcinoma

    - Fibrosarcoma

    - Osteosarcoma (associated with Spirocerca lupi infection)

    - Papilloma (rare)

    Thoracic neoplasia

    - Thymoma

    - Lymphoma

    - Other

    Enlarged bronchial lymph nodes

    - Neoplastic

    - Infectious (e.g., granulomatous diseases)

    Cardiac disease

    - Congestive cardiac failure causing enlarged left atrium

    - Vascular ring anomalies

    Persistent right aortic arch

    Double aortic arch

    Anomalous origin of the subclavian

    Anomalous origin of intercostal arteries

    Aberrant ductus arteriosis (PDA).

    Other thoracic and mediastinal diseases

    Esophageal strictures are the result of luminal narrowing caused by fibrosis. The fibrosis develops in the healing phase after esophageal ulceration, which is in turn caused by foreign bodies, ingestion of caustic material, esophageal burns (from ingestion of hot foodstuffs), diseases that cause esophagitis, gastric reflux (most common after general anaesthesia), and drug therapy (e.g.,  doxycycline). The diagnostic approach described above is applicable to esophageal strictures, with esophageal contrast studies and endoscopy most applicable.

    Treatment involves widening dilation of the stricture, either by balloon dilation or bougienage. Nutritional support is often required during the period of therapeutic dilations (see below).

    Esophageal foreign bodies are relatively common in dogs and types include bones, needles, wood and fish-hooks. Foreign bodies occur most commonly in young animals, and Terrier breeds (e.g., West Highland White Terrier) are predisposed. Clinical signs are usually acute in onset and include dysphagia, regurgitation, ptyalism and anorexia (if the presence of the foreign body causes pain).

    If obstruction is incomplete, ingestion of liquids but not solids is tolerated and there may be a delay before the animal is presented to the veterinarian. If perforation is present, mediastinitis can develop leading to signs of depression and pyrexia. A combination of plain radiography and esophagoscopy are suitable to make the diagnosis. Contrast studies are rarely required; barium may mask the foreign body and it should be avoided if perforation is suspected.

    The majority of esophageal foreign bodies can be removed, perorally, under endoscopic guidance. On rare occasions, surgical esophagostomy is required to remove the foreign body, but this should be a last resort. Again nutritional support may be required during the convalescent phase (see below). If lesions are severe, a percutaneous gastrostomy tube (PEG) must be placed.

    Vascular ring anomalies (VRA) are congenital malformations of the aortic arches, and constrict the esophagus at the level of the heart base. The esophagus cranial to the obstruction can then become dilated and aperistaltic. VRA are most common in Irish Setters and German Shepherds (e.g., same as for idiopathic megaesophagus).

    Clinical signs include acute onset of regurgitation and poor weight gain, and are usually first noted at the timing of weaning (e.g., when solids are administered for the first time). Contrast radiographic studies are the best methods of diagnosis.

    Surgical management is the treatment of choice, but success depends upon how longstanding the problem is. The more delayed the presentation, the greater the size of the associated esophageal dilatation and the less likely the signs are to resolve. Given that these animals are often poorly grown, nutritional support is required to improve condition prior to surgery (see below). The prognosis is guarded; these patients are at poor surgical risk due to malnutrition and the potential for aspiration pneumonia. Further, the esophageal cranial dilatation may persist despite correction of the VRA.

    Hiatal Hernia

    A hiatal hernia is a herniation of part or all of the gastresophageal junction and stomach through the esophageal hiatus of the diaphragm into the thorax. The condition can sometimes be exacerbated by increased inspiratory effort due to upper airway obstruction (e.g., laryngeal paralysis). The most severe, but thankfully rare, form is the gastro-esophageal intussusception, which occurs in young dogs with a breed predisposition for Shar-pei dogs. Clinical signs include acute onset of vomiting, regurgitation and dyspnea, leading to shock and death. Paraesophageal hernia involves herniation of the stomach parallel to the esophagus. Sliding hiatal hernia often presents in an intermittent fashion.

    Shar-pei puppies present a breed predisposition for gastro-esophageal intussusception
    Shar-pei puppies present a breed predisposition for gastro-esophageal intussusception. (© Badeau). To view click on figure

    Fluoroscopy or endoscopy may be required to demonstrate the problem but, unless the hernia develops during visualization, it is often missed. Repeated evaluation may be required. This type of hernia may cause reflux esophagitis intermittent regurgitation and vomiting.

    Many hernias can be successfully managed medically with modification of feeding behavior (small frequent meals, upright feeding) and drugs to treat associated reflux esophagitis. Surgical management is required for intussusception or persistent herniation.

    Esophageal Neoplasia

    Esophageal neoplasia is a rare cause of progressive regurgitation, often with blood. It has been reported to be associated with hypertrophic osteopathy (Marie's disease). The most common types of neoplasia in dogs include smooth muscle tumors, carcinoma, fibrosarcoma, and osteosarcoma (which is associated with Spirocerca lupi infection especially in South America, Africa or La Reunion Island). Esophageal neoplasia is invariably malignant, treatment options are limited and prognosis is grave (because the diagnosis is usually made too late).

    Feeding from a height helps swallowing in esophageal disease
    Feeding from a height helps swallowing in esophageal disease. (© Royal Canin).

    Esophageal Diverticula

    Esophageal diverticula are focal dilatations of the esophageal wall, and can either be congenital or can arise secondary to other esophageal diseases. Two types are described:

    • Pulsion Diverticula - These occur cranial to an esophageal lesion e.g., vascular ring anomalies.
    • Traction Diverticula - These develop as a result of inflammation and fibrosis within the esophagus, which distracts the esophagus causing a diverticulum.

    Diverticula must be differentiated from esophageal redundancy e.g., kinking of the esophagus seen in young brachycephalic breeds and Shar-pei dogs. Diagnosis is made with radiography (+/- barium studies). Small diverticula rarely cause a problem, and conservative treatment is appropriate (e.g., soft diet fed from an upright position). Larger (multilobulated) diverticula are more problematic and may require surgery, although prognosis is poor.

    Swallowing disorders and esophageal diseases are a significant problem for the affected individual, however, they occur less frequently in practice compared to the disorders of the gastrointestinal tract. Acute and chronic diseases of the stomach, the small and large intestine are of major practical significance and require thorough clinical workup of the patient to avoid misleading diagnosis and treatment.

    Nutritional Management of Swallowing Disorders

    Feeding from a Height - Food and water bowls can be placed in a high place. Small dogs can be fed "over-the shoulder". These patients can also be held vertical for a short while after feeding to encourage passage of food to stomach ([Guilford & Matz 2003]). In patients that tolerate liquids poorly, fluid requirements can be fulfilled with ice cubes.

    Alter Food Consistency - The optimum type of food varies between cases. For some, liquidized high quality diets are best, for others, wet food or moisturized dry food is suitable. Diet viscosity should also be considered.
    Diets may be applied either by syringe or as small solid boluses depending on the underlying disease or the preference of the patient or of the owner.

    Ensure Adequate Nutrient Intake - Patients with swallowing disorders need to be fed for shorter or longer times and depending on the duration of the disease the intake of fluid, energy and nutrients has to be balanced.
    Ideally, the diet should deliver all required nutrients in a reasonable volume. To maintain the energy balance of the patient, high fat diets are preferred because these diets provide high energy density so that the patients' energy requirements can be met in a smaller volume of food.

    Assisted Feeding e.g., Gastrostomy Tube - see Chapter 14 - For many diseases (e.g., esophageal stricture and esophageal ulceration), a period of assisted feeding is required whilst the primary disease is treated. Short to medium term assisted feeding can sometimes be of benefit in patients with megaesophagus, since it enables improvements in body condition and gives the patient time to adjust to alterations in oral feeding (Marks et al. 2000; Devitt et al. 2000; Sanderson et al. 2000).
    Many owners readily accept to feed their dogs with feeding tubes.

    Back to Table of Contents
    Add to My Library
    Close
    Would you like to add this to your library?

    Get access to all handy features included in the IVIS website

    • Get unlimited access to books, proceedings and journals.
    • Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
    • Bookmark your favorite articles in My Library for future reading.
    • Save future meetings and courses in My Calendar and My e-Learning.
    • Ask authors questions and read what others have to say.
    Sign in Register
    Print this article
    References

    1. Baillon ML, Marshall-Jones ZV, Butterwick RF. Effect of probiotic Lactobacillus acidophilus strain DSM 13241 in healthy adult dogs. Am J Vet Res 2004; 65(3).  - PubMed -

    ...
    Show all
    Comments (0)

    Ask the author

    0 comments
    Submit
    Close
    Would to like to further discuss this item?

    Get access to all handy features included in the IVIS website

    • Get unlimited access to books, proceedings and journals.
    • Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
    • Bookmark your favorite articles in My Library for future reading.
    • Save future meetings and courses in My Calendar and My e-Learning.
    • Ask authors questions and read what others have to say.
    Sign in Register
    About

    How to reference this publication (Harvard system)?

    German, A. and Zentek, J. (2008) “Oropharyngeal and Esophageal Diseases”, Encyclopedia of Canine Clinical Nutrition. Available at: https://www.ivis.org/library/encyclopedia-of-canine-clinical-nutrition/oropharyngeal-and-esophageal-diseases (Accessed: 28 January 2023).

    Affiliation of the authors at the time of publication

    1Faculty of Veterinary Sciences, University of Liverpool, United Kingdom. 2Faculty of Veterinary Medicine, University of Berlin, Germany.

    Author(s)

    • German

      German A.J.

      Professor of Small Animal Medicine
      BVSc(Hons) PhD CertSAM DipECVIM-CA MRCVS
      Department of Veterinary Clinical Sciences, Small Animal Teaching Hospital , University of Liverpool
      Read more about this author
    • Zentek J.

      Professor of Animal Nutrition and Dietetics
      DVM Prof. specialist degree in Animal Nutrition Dipl ECVN
      Faculty of Veterinary Medicine, Berlin University
      Read more about this author

    Copyright Statement

    © All text and images in this publication are copyright protected and cannot be reproduced or copied in any way.
    Related Content

    Readers also viewed these publications

    • Journal Issue

      Veterinary Evidence - Vol 8 N°1, Jan-Mar 2023

      In: Veterinary Evidence
      JAN 28, 2023
    • Journal Issue

      Veterinary Evidence - Vol 7 N°4, Oct-Dec 2022

      In: Veterinary Evidence
      JAN 16, 2023
    • Proceeding

      SFT - Theriogenology Annual Conference - Bellevue, 2022

      By: Society for Theriogenology
      JAN 10, 2023
    • Journal Issue

      Urgencias y cuidados intensivos - Argos N°244, Diciembre 2022

      In: Argos
      DEC 31, 2022
    • Proceeding

      ISCFR-EVSSAR Symposium - Italy 2022

      By: International Symposium on Canine and Feline Reproduction
      DEC 02, 2022
    • Journal Issue

      Patología endocrina - Argos N°243, Noviembre 2022

      In: Argos
      NOV 27, 2022
    • Journal Issue

      Traumatología y neurología - Argos Nº242, Octubre 2022

      In: Argos
      NOV 10, 2022
    • Chapter

      Tibia and Tarsus

      In: Current Techniques in Small Animal Surgery (5th Edition)
      NOV 07, 2022
    • Chapter

      Femur and Stifle Joint

      In: Current Techniques in Small Animal Surgery (5th Edition)
      OCT 28, 2022
    • Journal Issue

      Medicina felina - Argos Nº241, Septiembre 2022

      In: Argos
      OCT 24, 2022
    • Chapter

      Sacroiliac Joint, Pelvis, and Hip Joint

      In: Current Techniques in Small Animal Surgery (5th Edition)
      OCT 17, 2022
    • Journal Issue

      Veterinary Evidence - Vol 7 N°2, Apr-Jun 2022

      In: Veterinary Evidence
      OCT 07, 2022
    • Journal Issue

      Veterinary Evidence - Vol 7 N°3, Jul-Sep 2022

      In: Veterinary Evidence
      OCT 04, 2022
    • Chapter

      Amputation of the Forelimb

      In: Current Techniques in Small Animal Surgery (5th Edition)
      OCT 02, 2022
    • Journal Issue

      Israel Journal of Veterinary Medicine - Vol. 77(3), Sep. 2022

      In: Israel Journal of Veterinary Medicine
      SEP 30, 2022
    • Chapter

      Carpus, Metacarpus, and Phalanges

      In: Current Techniques in Small Animal Surgery (5th Edition)
      SEP 26, 2022
    • Chapter

      Radius and Ulna

      In: Current Techniques in Small Animal Surgery (5th Edition)
      SEP 16, 2022
    • Chapter

      Humerus and Elbow Joint

      In: Current Techniques in Small Animal Surgery (5th Edition)
      SEP 10, 2022
    • Chapter

      Scapula and Shoulder Joint

      In: Current Techniques in Small Animal Surgery (5th Edition)
      SEP 05, 2022
    • Chapter

      Bone Grafts and Implants

      In: Current Techniques in Small Animal Surgery (5th Edition)
      SEP 03, 2022
    • Chapter

      External Skeletal Fixation

      In: Current Techniques in Small Animal Surgery (5th Edition)
      AUG 28, 2022
    • Chapter

      Plate-Rod Fixation

      In: Current Techniques in Small Animal Surgery (5th Edition)
      AUG 18, 2022
    • Chapter

      Fixation with Screws and Bone Plates

      In: Current Techniques in Small Animal Surgery (5th Edition)
      AUG 15, 2022
    • Journal Issue

      Israel Journal of Veterinary Medicine - Vol. 77(2), Jun. 2022

      In: Israel Journal of Veterinary Medicine
      AUG 12, 2022
    • Chapter

      Interlocking Nailing of Canine and Feline Fractures

      In: Current Techniques in Small Animal Surgery (5th Edition)
      AUG 11, 2022
    • Load more
    Back To Top
    Become a member of IVIS and get access to all our resources
    Create an account
    Sign in
    Leading the way in providing veterinary information
    About IVIS
    • Mission
    • What we do
    • Who we are
    Need help?
    • Contact
    Follow IVIS
    • Twitter
    • Facebook
    International Veterinary Information Service (IVIS) is a not-for-profit organization established to provide information to veterinarians, veterinary students, technicians and animal health professionals worldwide using Internet technology.
    Support IVIS
    © 2023 International Veterinary Information Service
    • Disclaimer
    • Privacy Policy