1. If a tick is found, withhold food and water and seek veterinary attention immediately as anti-venom is required. [See also section on paralysis tick].
  2. All cases of regurgitation should be investigated by a veterinarian. Because these animals are at an increased risk of aspiration pneumonia, veterinary attention should be sought immediately.
  3. In cases where megaoesophagus is diagnosed, home care includes:
    • Feeding a high-calorie diet divided into small portions fed throughout the day
    • Feed small meatballs made of canned food
    • Feeding the animal in an upright position (the Bailey chair has been designed for this purpose)
    • Limit activity after feeding

WHAT IS IT?

Regurgitation is the passive expulsion of undigested food or liquid from the oesophagus or food-pipe. It should be distinguished from vomiting, which is an active process, preceded by nausea.

CLINICAL SIGNS

Regurgitation must be distinguished from vomiting.

  • Regurgitation is passive
  • Food brought up is undigested
  • It may be covered in mucus or saliva
  • It may be shaped like the oesophagus (sausage shaped)

Other signs depend on the underlying cause but may include

  • Hypersalivation
  • Coughing
  • Difficulty breathing (dyspnoea)
  • Difficulty picking up food (dysphagia)
  • Weakness (due to underlying disease)
  • Weight loss
  • Fever
  • Nasal discharge
  • Paralysis
  • In the case of tick paralysis, an engorged tick may be found on the animal’s body.

CAUSES

Regurgitation is caused by dysfunction or obstruction of the oesophagus or pharynx. Causes include:

  • A foreign body (for example, a bone)
  • Inflammation or ulceration of the pharynx or oesophagus (may be secondary to burns, medication or generalised disease)
  • Megaoesophagus, a condition where the muscle tone of the oesophagus is reduced or lost and the oesophagus expands, accumulating food and fluid.
  • Anatomical abnormalities such as an out pocketing in the oesophagus (diverticulum) or hiatal hernia
  • Neuromuscular disorders such as botulism, tetanus, Coonhound paralysis, Myasthenia gravis or tick paralysis
  • Immune disorders such as lupus
  • Endocrine disorders such as hypothyroidism
  • Some cancers such as thymoma

Animals with disorders causing regurgitation are at a high risk of aspiration pneumonia.

TREATMENT

Veterinary care depends on the underlying cause. Aside from a physical examination, your veterinarian may perform blood tests, x-rays (to assess the oesophagus and lungs), advanced imaging such as swallowing studies, endoscopy and fluoroscopy, and specific tests for particular conditions such as myasthenia gravis.

Antacids and gastroprotectants may be prescribed, as may drugs which increase the muscle tone of the oesophagus.

REFERENCES

Beatty J, Swift N, Foster D & Barrs V (2006) Suspected clindamycin-associated oesophageal injury in cats: five cases. Journal of Feline Medicine and Surgery 8:412-419.

Gaynor AR, Shofer FS & Washabau RJ (1997) Risk factors for acquired megaoesophagus in dogs. Journal of the American Veterinary Medical Association 211:1406-1412.

Johnson BM, DeNovo RC & Mears EA (2009) Canine megaoesphagus. In Kirk’s Current Veterinary Therapy XIV eds. Bonagura & Twedt, pp 486-492.