Esophageal Disease in Cats

Esophageal disease in cats refers to a number of conditions affecting the throat, or esophagus, of your cat. Esophageal diseases can be congenital (inherited) or acquired through illness or injury. Esophageal disease impacts your cat’s ability to eat, swallow and, in some cases, breathe appropriately. Esophageal disease is a serious condition, and one that is easily confused with general stomach upset. If your cat is experiencing symptoms of esophageal disease you should seek veterinary assistance as soon as possible.

Symptoms of esophageal disease in your cat will typically involve the ability to eat or swallow. In some cases when injury is the underlying cause, obvious perforation or injury will be present due to open wounds or protrusions under your cat’s skin. In less obvious cases, signs to watch for include:

• Regurgitation
• Difficulty or painful swallowing
• Exaggerated swallowing
• Weight loss due to inability to digest food
• General Lethargy

Esophageal disease is a general description of dysfunction of the esophagus and can be caused by a number of specific conditions. The most common of these include:

• Foreign objects in the esophagus
• Strictures or narrowing of the esophagus
• Esophageal diverticula (pouch like expansions of the wall of the esophagus)
• Megaesophagus (lack of motility of the esophagus)
• Vascular ring abnormalities
• Esophagitis or an irritation of the esophagus

Diagnosis of esophageal disease in your cat will begin with an initial exam by your vet and will include a complete analysis of your cat’s medical history and a review of symptoms. One of the key aspects of Esophageal disease is that the signature regurgitation can often mimic vomiting. In order to definitively diagnose your cat with esophageal disease, your veterinarian will need to rule out digestive upset as a cause of the symptoms.

In order to assist your vet, you should pay close attention to the material your cat is regurgitating. Regurgitated food will often come up more quickly after eating than vomit and will appear undigested. However, the conclusive difference between regurgitated food and vomit is the presence, or lack thereof, of color to the liquid or mucus. Since regurgitated food does not have a chance to reach the stomach, the fluid will be clear. Vomit will typically be food accompanied by bile, which is yellowish in color. 

Once you have confirmed your cat is suffering from esophageal disease, your veterinarian will need to determine the exact condition or disease. To do this, your vet will want to obtain a clear picture of the esophagus of your cat. One method for doing this is called an endoscopy. In this procedure, a tube with a small camera is placed down your cat’s throat, allowing the veterinarian to video images of the esophagus. This is particularly helpful if an injury, perforation or foreign object is suspected. Endoscopy will require your cat be anesthetized so that the tube can safely be inserted into their throat.

Another diagnostic tool is imaging with the use of barium. Since barium appears as a contrasting color on an x-ray, your cat can be orally administered this harmless chalky white fluid, which will coat the throat and pool in any pockets or restrictive areas. Your vet will then take x-rays to determine whether the barium is passing normally through the esophagus. Your cat will typically be able to remain alert  for this procedure.

Treatment of esophageal disease will depend on the exact condition causing the defect. If a foreign body is found, such as a twig, bone fragment, or other item, your veterinarian will carefully remove the item using similar tools to those used in the endoscopy. The vet will then inspect the lining of the esophagus to determine whether there has been any perforation or injury. 

Treatment for megaesophagus is largely supportive in nature. Your cat should be given frequent smaller meals and, if possible, should be fed from a position that requires them to stand upright with their neck in a raised position. Since this can be difficult in cats, an alternative method for aiding the flow of food through the esophagus to the stomach is holding your cat on your shoulder after a meal or scratching their throat for an extended period of time to encourage an elongated esophagus position. 

Some conditions may resolve on their own such as esophageal strictures or esophagitis, and your vet may prescribe careful observation and supportive care to monitor these conditions as part of supportive care.

The prognosis for cats suffering from esophageal disease is good to excellent, depending on the underlying condition. In some cats, esophageal disease may be a lifelong condition that requires management via small meals and support after meals. In general, careful management of esophageal disease and following your veterinarian’s advice regarding management and regular follow up visits will allow your cat to live a long and healthy life.