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Foreign Body, Esophageal 351

• Miscellaneous: noninflammatory hypomela- ○ For more severe hyperkeratosis, daily
nosis (vitiligo), cutaneous horns, idiopathic foot soaks in 50% propylene glycol.
VetBooks.ir disease, and sterile granuloma/pyogranuloma days. Lifelong maintenance therapy (1-2 Diseases and Disorders
nasodigital hyperkeratosis, split paw pad
Improvement is expected within a few
times weekly as needed) is often required.
syndrome
Initial Database • Surgery can be considered for some diseases:
closure of uncontaminated sharp lacerations,
• History and general exam are important in excision of cutaneous horns and tumors,
the diagnostic process. surgical debridement of devitalized tissues
• Cytology of exudates: bacteria, inflammatory • Medication varies, depending on underlying
cells, acantholytic keratinocytes (pemphigus), cause.
and fungal organisms
PROGNOSIS & OUTCOME
Advanced or Confirmatory Testing
• Skin biopsies for histopathology Will vary according to the disease; generally
• CBC/biochemistry panel/urinalysis: results good with localized lesions, reversible causes,
variable, depending on cause and dedicated owners and guarded to poor
• Thoracic/abdominal imaging, if relevant, to with progressive systemic illness
confirm systemic disease (e.g., SND) or to
stage tumors PEARLS & CONSIDERATIONS
• Endocrine tests and serology, depending on
suspected disease Comments
• Coombs’ test: cryoglobulinemia/cryofibri- • Successful therapy is based on identifying
nogenemia the underlying cause.
• Antinuclear antibody test (ANA): positive • Skin biopsies are often needed for the
for most patients with SLE diagnosis of footpad disorders.
FOOTPAD DISORDERS Swollen, ulcerated footpad
in a cat with plasma cell pododermatitis. Prevention
TREATMENT
Advise against breeding of animals with
• Endocrine/metabolic: SND (dogs), footpad Treatment Overview hereditary diseases.
calcinosis cutis (often associated with chronic The goal of treatment is to reach permanent
kidney disease), paraneoplastic alopecia (cats), cure or control of the disease, but sometimes, Technician Tips
xanthomatosis (when associated with diabetes palliative treatment is the only option (e.g., Patients with footpad lesions can be painful
mellitus or presumed feline hereditary malignancy). and reluctant to walk. Care should be taken
hyperlipoproteinemia) when walking them.
• Neoplastic: epitheliotropic cutaneous lym- Acute General Treatment
phoma, squamous cell carcinoma, fibrosarcoma, Depends on the cause of the lesion and possible SUGGESTED READING
mast cell tumor, others secondary infection Miller WH Jr, et al: Muller & Kirk’s Small animal
• Infectious: canine distemper, cowpox virus • Foot soaks or bandages sometimes useful dermatology, ed 7, St. Louis, 2013, Elsevier.
or calicivirus infection in cats, subcutane- ○ Hyperkeratotic lesions: warm water foot
ous or systemic mycotic infections, canine soaks for 5-10 minutes, followed by AUTHOR: Nadia Pagé, DMV, MSc, DACVD
EDITOR: Manon Paradis, DMV, MVSc, DACVD
papillomatosis, and hookworm and Pelodera application of a softening agent (e.g.,
dermatitis petroleum jelly). This can be messy.

Foreign Body, Esophageal Client Education
Sheet

BASIC INFORMATION ASSOCIATED DISORDERS HISTORY, CHIEF COMPLAINT
• Some degree of esophagitis is expected with • Acute regurgitation is suggestive.
Definition any foreign body present for more than a ○ Distinguish acute vomiting (prodromal
Any object that lodges in the esophagus day. signs, active abdominal contractions
• Esophageal perforation can occur within 3-5 leading to expulsion of food, bile or digested
Epidemiology days in some cases and cause septic medias- blood in expelled material) from acute
SPECIES, AGE, SEX tinitis, pyothorax, and/or pneumothorax. regurgitation (no prodromal signs, passive
Dogs (more commonly) and cats of any age, Clinical Presentation expulsion of food from the mouth,
either sex no bile or digested blood in expelled
DISEASE FORMS/SUBTYPES material).
GENETICS, BREED PREDISPOSITION • Nonpenetrating foreign objects: main • Anorexia and ptyalism can occur.
Smaller dogs seem to be affected more concerns are malnutrition, esophagitis • Some patients can drink and retain water
commonly. potentially leading to stricture, and aspiration but will not attempt to eat solid food; some
pneumonia. exhibit pain when swallowing, and if they eat
RISK FACTORS • Penetrating foreign objects: main concerns solid food it is often promptly regurgitated.
Feeding bones, carelessness when fishing (expos- are mediastinitis, pyothorax, esophagitis, • Lethargy, anorexia, fever, and/or dyspnea are
ing hook/lure to dog) aspiration, and pneumonia. possible if perforation occurs.

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