Inflammation of the Esophagus in Cats

Early detection and aggressive treatment of the condition increases the likelihood of a positive prognosis. If left untreated, the esophagus may narrow. This is a much more serious condition with a very poor likelihood of survival. Cats displaying possible symptoms of esophagitis should be examined by a veterinarian as soon as possible.

Inflammation of the esophagus (esophagitis) in cats is a condition that causes difficulty in swallowing. It is commonly caused by exposure to stomach acid (gastrointestinal reflux) that causes irritation to the area. Esophageal inflammation may progress to aspiration pneumonia, a potentially serious condition that occurs when food is inhaled into the lungs.

If the inflammation is mild, affected cats may not display any symptoms and medical treatment will not be necessary. In other cases, cats may display one or more of the following symptoms:

• Regurgitation
• Difficulty swallowing 
• Repeated swallowing motions
• Drooling
• Gagging
• Pain or crying out while swallowing
• Extending head or neck while swallowing
• Decreased appetite
• Weight loss
• Inability to digest food 
• Reluctance to lie down
• Fatigue 
• Coughing
• Fever
• Development of pneumonia 

Types

Esophageal inflammation in young kittens is typically recognized when they begin to eat solid foods. This is likely to be caused one of three primary types of congenital (inherited) disorders:

• Congenital megaesophagus: Abnormal esophageal nerve development (most common in Siamese breeds)
• Vascular ring entrapment: Restriction caused by abnormal blood vessels in the esophagus
• Cricopharyngeal achalasia: Difficulty swallowing due to the failure of muscles in the throat to relax

There are several possible underlying causes for the condition, including:

• Congenital abnormality 
• Complications from anesthesia (usually occurs in older cats)
• Reflux
• Foreign object or pill caught in esophagus
• Ingestion of irritating chemicals
• Ingestion of certain drugs
• Chronic vomiting
• Cancer

The treating veterinarian will begin by reviewing the cat’s detailed health history and discussing information regarding severity and onset of symptoms as well as any other possible causes or incidents that have preceded the condition. A standard set of lab tests will be ordered to rule out other conditions. This will likely include a complete blood count (CBC), biochemistry profile, and urinalysis. When esophagitis is the cause of the condition, it is likely that the lab tests will return normal results. If the condition has developed into pneumonia, blood tests may indicate a higher than usual white blood cell count, indicating the presence of an infection. 

Visual diagnosis may be made through the use of X-rays, ultrasound, barium contrast radiography, fluoroscopy, or endoscopy. The vet may also use endoscopy to extract a tissue sample that will be sent out for a biopsy.

Treatment recommendations and prognosis will depend greatly on the severity and underlying cause of the condition.

Outpatient Treatment

If the condition is not critical, affected cats can usually be treated on an outpatient basis. When the cause is acid reflux, prescription medications may be prescribed and dietary changes recommended in order to reduce stomach acid. 

If a foreign body is present in the esophagus, it may be removed with an endoscopy. Common items that are removed include bones, string, needles, and other objects.

Hospitalization

If a cat has presented with pneumonia, hospitalization and more intense treatment may be necessary. Fluids will likely be needed to address dehydration and possible electrolyte imbalances. Oxygen may be used to assist cats that are experiencing difficulty breathing and antibiotics may also be prescribed to treat or avoid infections.

It may be recommended that food and water be withheld for several days to allow the esophagus to heal. Nutrition and hydration will likely need to be administered intravenously or through a feeding tube surgically placed in the stomach.

If items are lodged in the esophagus and cannot be removed with endoscopy, or if the condition has caused the esophagus to perforate, surgery will likely be required. In this situation, the prognosis for survival is often poor. 

Balloon Catheter Procedure

Some cats may be candidates for balloon catheter treatment. This occurs when a balloon catheter is placed in the esophagus and inflated to help relieve strictures. There is a higher chance of success with this procedure than with surgical treatments.

Surgical Treatment

Surgical treatment is not usually recommended as the chance of recovery is generally very poor. An exception occurs when congenital disorders are discovered early in life. In this case, corrective surgery may be a viable option. The earlier that treatment occurs, the more likely it is to be effective. If left untreated, inherited conditions are likely to result in permanent esophageal damage.

As they recover, affected cats will need to be fed a highly nutritious diet consisting of soft foods in order to avoid further irritating the esophagus. Additional dietary recommendations may include feeding small, frequent meals that are low in fiber and fat. Regular follow-up appointments will be needed and it is likely that an endoscopy will be performed each time to ensure proper healing and recovery.