Page 620 - Problem-Based Feline Medicine

29. The cat with signs of regurgitation

(acute or chronic)

Debra L Zoran

KEY SIGNS
● Passive elimination via the mouth of swallowed food.
● Food is typically undigested.
● Gagging or retching may occur concurrently.

MECHANISM?
● Regurgitation is a passive act that may involve several anatomic regions of the alimentary
tract: oral cavity, oropharynx, esophagus or occasionally the stomach.
● Oral or pharyngeal disease is more often associated with dysphagia (difficulty swallowing).
● Regurgitation is a more typical presenting sign of esophageal disease.
● Regurgitation is not associated with prodromal signs (no anxiety, nausea or hypersalivation),
there will be no abdominal muscular activity, and is often composed of recently swallowed
food (undigested, whole).
● In cases of chronic megaesophagus, where food may sit undisturbed for hours in the distal
esophagus, the food may have a more liquid, unformed character.
● The pH of the material may be neutral, slightly basic (oral) or slightly acidic (stomach), but
is typically in a range of pH 4–7.

WHERE?
● Regurgitation is usually associated with disease of the esophagus:
● Megaesophagus (acquired or congenital).
● Associated with esophageal anomalies, e.g. diverticular structures, vascular ring anomalies.
● Esophagitis, esophageal strictures or foreign bodies.
● Associated with oropharyngeal disease, e.g. stomatitis-pharyngitis complex.
● Parasitic diseases of the esophagus.
Signs of gagging or retching are often associated with regurgitation (or vomiting) in cats
and include many oral, dental and pharyngeal infectious, inflammatory, neoplastic or toxic
disorders.

WHAT?
● The most common causes of regurgitation in cats are esophagitis (due to a variety of infectious
or inflammatory causes), esophageal stricture, esophageal foreign bodies, and more rarely pha-
ryngeal or esophageal neoplasia.

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