Esophageal Diverticula In Dogs

Esophageal diverticula is a comparatively rare disease in which there is a muscular layer outpouching in the esophageal mucosa i.e protruding pocket-like dilatations in the esophageal lining. This esophageal pouch-like sac, called a diverticulum, will trap food and obstruct the systematic movement of the ingesta through the esophagus.

In general, diverticula can be classified into false and true diverticula. Outpouchings that involve all layers (mucosa, submucosa, and muscular) of the esophageal layer are called ‘True diverticula’ whereas ‘false diverticulum’ only involves the mucosa and/or submucosa.

Depending on the formation of the diverticula, it can be classified into congenital and acquired. Congenital diverticula have been attributed to abnormalities that happen in the esophagus during embryologic development itself. Acquired diverticula are subdivided into either pulsion or traction forms, depending upon the pathogenesis.

Pulsion diverticula: These are created from the contraction of periesophageal fibrous scar tissue when there is greater intraluminal pressure in an area of weakness and/or abnormal regional esophageal motility.

Traction diverticula: They occur due to the adhesions of the esophageal wall (for instance, mediastinal inflammation that grasps and drags the esophageal wall) located in the cranial and midthoracic esophagus creating a diverticulum.

• Retching
• Regurgitating food or water
• Excessive drooling
• Bad breath
• Refusing to eat
• Trouble swallowing/ Exaggerated or frequent swallowing
• Hacking sounds to try to clear the throat
• Aspiration pneumonia- cough, fever, nasal discharge, lethargy, and poor appetite

The Treatment depends upon the underlying cause and extent/severity of the problem.

Medications for medical conditions should be provided only as required.

Most intestinal ulcers can be healed successfully using acid-blocking and gastro-protectant medications.

Check with your vet for the minimal effective medication level. If vets suggest for medications be discontinued, they should be done immediately.

Prostaglandin E1 analog: These medications may be considered if NSAIDs are required long term. Misoprostol (Cytotec, Arthrotec) can decrease the harmful gastric effects of NSAIDs.

Supplements: Quercetin Chalcone, L-glutamine, and probiotics to achieve optimal gut health.

Surgery: Surgery may be necessary sometimes; if the Larger diverticula are causing pneumonia or breathing problems or the cause of problems are foreign bodies (in the case of the megaesophagus) or bronchoesophageal fistula. This will provide immediate respite and prevents further complications.

When your dog is in a vulnerable group due to a situation or condition, providing required medications and feeding a diet with supplements can be helpful.

• Change the food to a different texture or experiment with the food. Some animals do good with solid foods and some with liquid foods.
• Canned food can be rolled into small meatballs. The meatballs must be swallowed by the dog and this stimulates enough esophageal motility to easily pass through the esophagus.
• To ensure that the most nutrients are being absorbed, it is good to feed 3-4 small meals a day.

Herbs

Always discuss with the vet about these treatments before offering them to your dog.

Deglycyrrhizinated Licorice: 100 to 300 mg/daily depending on the size of the dog

Slippery elm: 100 milligrams per 10 pounds

Aloe vera: 1 ml per kilogram bodyweight

Echinacea: 1.0 g/10 kg body weight

Alfalfa: Small, medium dogs - 1 teaspoon daily; large dogs - 2 teaspoons daily

• Protect your dog from infections, ingestion of toxins, and hyperacidity
• Use pain relievers regularly for dogs with caution
• Use NSAIDsthat less likely to cause ulcer
• Avoid extreme exertion (sled dogs or other working dogs) as it can increase stomach acid that can overwhelm the mucosal barrier
• Change your dog's diet to control excess production of stomach acid

Small Dog Breeds

Esophageal diverticula is a comparatively rare disease in which there is a muscular layer outpouching in the esophageal mucosa i.e protruding pocket-like dilatations in the esophageal lining. This esophageal pouch-like sac, called a diverticulum, will trap food and obstruct the systematic movement of the ingesta through the esophagus.

In general, diverticula can be classified into false and true diverticula. Outpouchings that involve all layers (mucosa, submucosa, and muscularis) of the esophageal layer are called ‘True diverticula’ whereas ‘false diverticulum’ only involves the mucosa and/or submucosa.

Depending on the formation of the diverticula, it can be classified into congenital and acquired. Congenital diverticula have been attributed to abnormalities that happen in the esophagus during embryologic development itself. Acquired diverticula are subdivided into either pulsion or traction forms, depending upon the pathogenesis.

Pulsion diverticula: These are created from the contraction of periesophageal fibrous scar tissue when there is greater intraluminal pressure in an area of weakness and/or abnormal regional esophageal motility.

Traction diverticula: They occur due to the adhesions of the esophageal wall (for instance, mediastinal inflammation that grasps and drags the esophageal wall) located in the cranial and midthoracic esophagus creating a diverticulum.

Classification based on location:

Pharyngeal diverticula (Zenker): This is considered pulsion and false diverticula. Zenker's often occurs in the hypopharynx immediately proximal to Killian's triangle, which is an area Surrounded by the pharyngeal constrictor muscles (inferior) and cricopharyngeus muscles.

A mid-esophageal diverticulum: True and traction diverticulum. This is usually caused above and below the level of the trachea bifurcation due to mediastinal inflammation.

Epiphrenic diverticula: This is a form of pulsion and false diverticula. They may also develop as a result of anomalies of the vascular ring in the cranial esophagus or enhanced lower esophageal sphincter pressure (achalasia) and it is associated with a concomitant esophageal motor disorder.

Right away transport your pet to the closest vet clinic, if you suspect drug poisoning or when your dog is showing any signs of distress.

• Regurgitating food or water
• Hacking sounds to try to clear the throat

• Bland diet: boiled chicken, cooked rice, tofu, low-fat cottage cheese, boiled hamburger, canned tuna etc.
• Provide easily digestible lean cuts of meat. - (boiled and drained off excess fat).
• semi-moist pet food with boiled chicken or Meat-flavored baby food.
• Low fat, plain yogurt.
• Avoid hard treats, kibble, and biscuits.
• High-fiber foods: whole grain bread, rice, cereal, green beans, peas, Beet Pulp.

When there is an underlying reason for your pet’s esophageal diverticula, such as a disease, infection, or cancer, then your vet may recommend further diagnosis as that condition must be treated in addition to the esophageal diverticula itself.