Esophageal Perforation Associated with a Foreign Body in a Dog
Background: The esophagus is a tubular organ that connects the laryngopharynx to the stomach. This organ has three points of narrowing: the thoracic inlet, the base of the heart, and the diaphragmatic hiatus; these are common sites of obstruction by foreign bodies. Clinical signs of esophageal obstructions include sialorrhea, dysphagia, regurgitation, dehydration, and depression. The diagnosis is based on clinical examination, anamnesis, and complementary imaging. The treatment requires the removal of the foreign body. Herein, we report a case of esophageal perforation associated with a foreign body in a Spitz German treated at the Veterinary Hospital of the Federal Rural University of Pernambuco.
Case: A 2-year-old female German Spitz was referred to the Veterinary Hospital of the Federal Rural University of Pernambuco (HV-UFRPE); she presented with recurrent drooling and emesis. According to the instructor, approximately five days after a party at the residence, the animal began to exhibit clinical signs. She was examined at a veterinary clinic, where she remained hospitalized for three days, without clinical improvement. She was then taken to the HV-UFRPE for further assessment. Upon physical examination, sialorrhea, hypercormed conjunctival mucosa, hyperthermia (41ºC), and regurgitation were observed. Imaging tests (simple radiography and ultrasonography), blood count, and a serum biochemistry panel (urea, creatinine, alanine aminotransferase, alkaline phosphatase, total protein, and albumin) were requested. The radiographic examination revealed a pulmonary interstitial pattern and pleural effusion. Analysis of the thoracic fluid yielded results consistent with a septic exudate. No significant changes were observed on total abdominal ultrasonography. The hemogram showed thrombocytosis, leukocytosis with absolute neutrophilia, as well as relative and absolute monocytosis. Esophagoscopy was offered, but the test was not performed and the patient died 24 h after its, being heading for necropsy. On necropsy, diffuse fibrinous pleuropneumonia filling the thorax was observed. The heart showed concentric hypertrophy of the left ventricle. The esophagus was obstructed by a food object, causing a necrotic, ulcerative esophagitis with perforation. In the abdominal cavity, hepatic and renal congestion were observed along with early-phase gestation (first trimester). Other organs lacked significant changes, and the cause of death was attributed to septic shock secondary to esophageal perforation. Tissue samples from the heart, lungs, and esophagus were obtained for histopathological examination. Diagnoses included cardiomyocyte hypertrophy and heart congestion, subacute interstitial pneumonia, diffuse chronic pulmonary edema, and necrotizing ulcerative esophagitis.
Discussion: The presence of an esophageal foreign body is considered a veterinary emergency. Small-breed dogs are more often affected by foreign bodies, as are young animals with a depraved appetite and lack of selectivity with respect to food. The most common foreign bodies reported in literature are bones, as they are frequently offered to pets. In this report, a carrot caused esophageal obstruction. Current literature recommends that a complete anamnesis and physical examination, including cervical and thoracic radiography, be performed in animals with suspected foreign material in their esophagus. This case contextualizes a problem that requires full attention, directly related to a dog’s accessibility to and consumption of objects or foods that can result in esophageal obstruction. Therefore, education by the instructor is considered essential in the prevention of these conditions.
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