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Case report: resolution of esophageal stricture by foley catheter guided by video endoscopy in a 3-month-old filly
Rivera Vasquez, Gonzalo; Muñoz...
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Introduction
Esophageal disorders are uncommon and mainly in adult horses, the most common being esophageal obstruction, which can present as a complication with esophageal stricture, which are normally acquired by external or internal trauma(1). However, they are not common in foals(2).
Clinic History
A 3-month-old filly was presented to the Clinica Veterinaria Equina Patagonia Spa, Chillán, who 10 days before had had milk reflux from both nostrils, being treated for esophageal obstruction with a nasogastric tube. Treatment with temporary effect and recurrence in 3 times. In addition, it had respiratory distress and weakness.
Relevant Clinical Signs
Bilateral nasal reflux, pneumonia, and body condition 3/9, heart rate: 100 beast/minute, respiratory rate: 60 breaths/minute and temperature 39,5º Celsius.
Evidence
Aspiration pneumonia and fever.
Esophageal stricture in the proximal third with ulcerative lesion, without contraction, and gastric ulcer of the glandular mucosa, diagnosed by video endoscopy.
Contrast radiograph shows a narrowing of the lumen in the proximal third of the esophagus.
Treatment And Management
Under general anesthesia, the esophagus was dilated by insufflation of a 14G Foley catheter. The Foley catheter was directed to the stenosed site by means of video endoscopy and insufflated with 5 ml of water for 90 seconds. Repeated procedure for 5 consecutive days. Ulcers were treated with sucralfate (MulcatelTM 20 mg/kg, BID, oral) and omeprazole (EquigastrimTM 2 mg/kg/d, oral) and aspiration pneumonia with ceftiofur (CobactamTM mg/kg every 24 hours for 10 days). The resolution was successful and without recurrence up to 30 months of age.
Discussion
The ulcer was caused by the nasogastric probing. There is only one record of successful resolution of esophageal stricture by Foley catheter dilation in foals, a low-cost alternative, with much greater success than with esophagostomy and with fewer complications(3, 4).
References
- Bezdekova B, Janalik P. Oesophageal disorders in horses: retrospective study of 39 cases, Equine Vet Educ. 2018; 30(2):94-9.
- Nijdam P, Elmas C, Fugazzola MC. Treatment of an esophageal stricture in a 1-month-old miniature Shetland colt, Case Rep Vet Med. 2017;3069419.
- Chidlow HB, Robbins EG, Slovis NM. Balloon dilation to treat oesophageal strictures in five foals, Equine Vet Educ. 2017; 29(11):609-16.
- Mira J, Posada S, Castillo C, Velez M. Dilation of a proximal esophageal stricture by endoscopically and radiologically guided balloon in a Falabella foal, Rev Med Vet. 2015;(31):85-95.
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About
Affiliation of the authors at the time of publication
1 Universidad De Concepcion, Ciencias Clinicas, Chillán, Chile ; 2 universidad De Concepcion, Ciencias Clinicas, Concepción, Chile
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