Balloon dilatation is the most commonly used therapy for esophageal strictures. The objective of this study was to assess outcome and complications of balloon dilatation and/or stenting for treatment of acquired esophageal strictures in dogs and cats.

Medical records were reviewed from animals presented with esophageal strictures that underwent endoscopic balloon dilatation or stenting. All cases were managed by the same clinician (VF). Values are expressed as percentage and median [interquartile range].

Twenty-four cases (19 dogs and 5 cats) were included. The median age was 6 years [2.7; 10.7] for dogs and 1 year [0.4; 4] for cats. Strictures resulted from recent anesthesia in 11 cases (45.8%). Other causes included foreign body (29%), toxic ingestion (10.4%), acute vomiting (6.2%) and one benign neoplasia (4.2%). Clinical signs reported by owners were regurgitation (24/24), vomiting (11/24), dysphagia (13/23), dysorexia or anorexia (10/22), ptyalism (6/23) and cough (6/24). Median duration of clinical signs prior to endoscopy was 15 days [10; 26]. Thirty-two strictures were identified at initial esophagoscopy. Seventeen animals had one stricture, six had two strictures and one had three strictures. Seven strictures (29.2%) were located within the cervical esophagus, 10 of 32 (41.6%) were in the mid-esophagus, and 15 of 32 (62.5%) were in the distal esophagus. The median stricture diameter was 4 mm [3; 8]. Annular strictures were observed in 21 of 32 stenosis (65.6%).

Balloon dilatation procedures were performed for 19/24 animals using a dilatator (Olympus®) with an inflated diameter of 10 to 12 mm. Median numbers of dilatation were 2 [1; 3]. Clinical improvement was noted for 15 cases. Perforation of the esophagus was the only complication (1/19). Stenting was considered for 6 animals (Boston Scientific® "Ultraflex" half covered stent in 2 cases and "Symphony" nitinol uncovered stent in 4 cases). Stent placement was considered for the last 4 refractory cases and as first-line treatment for 2 cases. Clinical improvement was observed in 5 of 6 cases. Complications included discomfort (1/6) and stent migration (1/6). Long-term follow up was available for 17 animals, median survival time was 730 days [100.7; 1368.7].

The limited number of cases precluded statistical analysis to determine the best treatment option. To the author's opinion, balloon dilatation remains a good first-line therapeutic modality. Esophageal stenting appears safe and effective for refractory cases or ductal strictures but needs to be compared to balloon dilatation in a prospective study on a more substantial number of cases.

Disclosures

No disclosures to report.