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Tierarztl Prax Ausg K Kleintiere Heimtiere 2013; 41(02): 123-131
DOI: 10.1055/s-0038-1623697
Für Studium und Praxis
Schattauer GmbH

Megaösophagus bei Hund und Katze[*]

Megaesophagus in the dog and cat
S. Mace
1   Veterinary Specialty Center of the Hudson Valley, NY, USA
,
G. D. Shelton
2   University of California, CA, USA
,
S. Eddlestone
3   Louisiana State University, LA, USA
› Author Affiliations
Further Information

Publication History

Eingegangen: 15 February 2013

Akzeptiert: 27 February 2013

Publication Date:
08 January 2018 (online)

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Zusammenfassung

Das Krankheitsbild des Megaösophagus ist durch eine diffuse Dilatation und verminderte Peristaltik der Speiseröhre gekennzeichnet. Unterschieden wird eine kongenitale und eine erworbene Form. Die Letztgenannte tritt in Zusammenhang mit gastrointestinalen, endokrinen, immunvermittelten, neuromuskulären und paraneoplastischen Erkrankungen sowie toxischen Zuständen auf. Zu den häufigsten klinischen Symptomen zählen Regurgitieren, Gewichtsverlust, Husten und Foetor ex ore. In den meisten Fällen lässt sich die Diagnose durch röntgenologische Untersuchung des Thorax stellen. Die Diagnose der zugrunde liegenden Ursache erfordert jedoch neben einer ausführlichen Anamneseerhebung zusätzliche diagnostische Maßnahmen. Die Behandlung und die Prognose von Patienten mit Megaösophagus hängen in hohem Maße von der zugrunde liegenden Ursache der Erkrankung ab.

Summary

Megaesophagus is a disorder of the esophagus characterized by diffuse dilation and decreased peristalsis. It is classified into congenital and acquired forms. Gastrointestinal, endocrine, immune-mediated, neuromuscular, paraneoplastic, and toxic disorders have been associated with acquired megaesophagus. Common clinical signs of megaesophagus are regurgitation, weight loss, coughing, and halitosis. Most cases of megaesophagus can be diagnosed using thoracic radiography; however, diagnosing the underlying cause requires a thorough history and additional diagnostics. The treatment, management, and prognosis of megaesophagus vary greatly depending on the underlying cause.

Schlüsselwörter

Speiseröhre - Regurgitieren - Myasthenia gravis

Key words

Esophagus - regurgitation - myasthenia gravis

* Übersetzter modifizierter Nachdruck des Artikels Mace S, Shelton GD, Eddlestone S. Megaesophagus. Compend Contin Educ Vet 2012; 34 (2): E1–E8. Nachdruck mit freundlicher Genehmigung von Vetstreet.


 

  • Literatur

  • 1 Washabau RJ. Gastrointestinal motility disorders and gastrointestinal prokinetic therapy. Vet Clin North Am Small Anim Pract 2003; 33 (05) 1007-1028.
    CrossrefPubMedGoogle Scholar
  • 2 Wray JD, Sparkes AH. Use of radiographic measurements in distinguishing myasthenia gravis from other causes of canine megaesophagus. J Small Anim Pract 2006; 47 (05) 256-263.
    CrossrefPubMedGoogle Scholar
  • 3 Hopper K, Beck C, Slocombe R. Megaoesophagus in adult dogs secondary to Australian tiger snake envenomation. Aust Vet J 2001; 79 (10) 672-675.
    CrossrefPubMedGoogle Scholar
  • 4 Miller LM, Lennon VA, Lambert EH. et al. Congenital myasthenia gravis in 13 smooth fox terriers. JAVMA 1983; 182 (07) 694-697.
    PubMedGoogle Scholar
  • 5 Warnock JJ, Marks SL, Pollard R. et al. Surgical management of cricopharyngeal dysphagia in dogs: 14 cases (1989–2001). JAVMA 2003; 223 (10) 1462-1468.
    CrossrefPubMedGoogle Scholar
  • 6 Lipsitz D, Berry JL, Shelton GD. Inherited predisposition to myasthenia gravis in Newfoundlands. JAVMA 1999; 215 (07) 946 956–958..
    PubMedGoogle Scholar
  • 7 Bexfield NH, Watson PJ, Herrtage ME. Esophageal dysmotility in young dogs. J Vet Intern Med 2006; 20 (06) 1314-1318.
    CrossrefPubMedGoogle Scholar
  • 8 Shelton GD. Myasthenia gravis and disorders of neuromuscular transmission. Vet Clin North Am Small Anim Pract 2002; 32 (01) 189-206.
    CrossrefPubMedGoogle Scholar
  • 9 Burgener IA, Gerold A, Tomek A, Konar M. Empty sella syndrome, hyperadrenocorticism and megaesophagus in a dachshund. J Small Anim Pract 2007; 48 (10) 584-587.
    CrossrefPubMedGoogle Scholar
  • 10 Kirkby KA, Bright RM, Owen HD. Paraoesophageal hiatal hernia and megaesophagus in a three-week-old Alaskan malamute. J Small Anim Pract 2005; 46 (08) 402-405.
    CrossrefPubMedGoogle Scholar
  • 11 Watrous BJ, Blumenfeld B. Congenital megaesophagus with hypertrophic osteopathy in a 6-year-old dog. Vet Radiol Ultrasound 2002; 43 (06) 545-549.
    CrossrefPubMedGoogle Scholar
  • 12 Uchida K, Awamura Y, Nakamura T. et al. Thymoma and multiple thymic cysts in a dog with acquired myasthenia gravis. J Vet Med Sci 2002; 64 (07) 637-640.
    CrossrefPubMedGoogle Scholar
  • 13 Gabriel A, Poncelet L, Van Ham L. et al. Laryngeal paralysis-polyneuropathy complex in young related Pyrenean mountain dogs. J Small Anim Pract 2006; 47 (03) 144-149.
    CrossrefPubMedGoogle Scholar
  • 14 Evans J, Levesque D, Shelton GD. Canine inflammatory myopathies: a clinicopathologic review of 200 cases. J Vet Intern Med 2004; 18 (05) 679-691.
    CrossrefPubMedGoogle Scholar
  • 15 Otte MA, Graves TK, Marks SL. Canine acquired myasthenia gravis. Stand Care Emerg Crit Care Med 2003; 05 (07) 6-10.
    PubMedGoogle Scholar
  • 16 Shelton GD, Schule A, Kass PH. Risk factors for acquired myasthenia gravis in dogs: 1,154 cases (1991–1995). JAVMA 1997; 211 (11) 1428-1431.
    PubMedGoogle Scholar
  • 17 Kent M, Glass EN, Acierno M, Shelton GD. Adult onset acquired myasthenia gravis in three great dane littermates. J Small Anim Pract 2008; 49 (12) 647-650.
    CrossrefPubMedGoogle Scholar
  • 18 Shelton GD, Ho M, Kass PH. Risk factors for acquired myasthenia gravis in cats: 105 cases (1986–1998). JAVMA 2000; 216 (01) 55-57.
    CrossrefPubMedGoogle Scholar
  • 19 Botteron C, Zurbriggen A, Griot C, Vandevelde M. Canine distemper virus immune complexes induce bystander degeneration of oligodendrocytes. Acta Neuropathol 1992; 83 (04) 402-407.
    CrossrefPubMedGoogle Scholar
  • 20 Tipold A, Vandevelde M, Jaggy A. Neurological manifestations of canine distemper virus infection. J Small Anim Pract 1992; 33 (10) 466-470.
    CrossrefPubMedGoogle Scholar
  • 21 Maeda H, Ozaki K, Takagi Y. et al. Distemper skin lesions in a dog. Zentralbl Veterinarmed A 1994; 41 (03) 247-250.
    CrossrefPubMedGoogle Scholar
  • 22 Dieringer TM, Wolf AM. Esophageal hiatal hernia and megaesophagus complicating tetanus in two dogs. JAVMA 1991; 199 (01) 87-89.
    PubMedGoogle Scholar
  • 23 Detweiler DA, Biller DS, Hoskinson JJ, Harkin KR. Radiographic findings of canine dysautonomia in twenty-four dogs. Vet Radiol Ultrasound 2001; 42 (02) 108-112.
    CrossrefPubMedGoogle Scholar
  • 24 Kidder AC, Johannes C, O’Brien DP. et al. Feline dysautonomia in the Midwestern United States: a retrospective study of nine cases. J Feline Med Surg 2008; 10 (02) 130-136.
    CrossrefPubMedGoogle Scholar
  • 25 Walvoort HC. Glycogen storage diseases in animals and their potential value as models of human disease. J Inherit Metab Dis 1983; 06 (01) 3-16.
    CrossrefPubMedGoogle Scholar
  • 26 Scherk MA, Center SA. Toxic, metabolic, infectious, and neoplastic liver diseases. In: Ettinger SJ, Feldman EC. eds. Textbook of Veterinary Internal Medicine. St. Louis, MO: Elsevier Saunders; 2005: 1464-1478.
    Google Scholar
  • 27 Vanhaesebrouck AE, Couturier J, Cauzinille L. et al. Demyelinating polyneuropathy with focally folded myelin sheaths in a family of miniature schnauzer dogs. J Neurol Sci 2008; 275 (1–2): 100-105.
    CrossrefPubMedGoogle Scholar
  • 28 Gaynor AR, Shofer FS, Washabau RJ. Risk factors for acquired megaesophagus in dogs. JAVMA 1997; 211 (11) 1406-1412.
    PubMedGoogle Scholar
  • 29 Panciera DL. Conditions associated with canine hypothyroidism. Vet Clin North Am Small Anim Pract 2001; 31 (05) 935-950.
    CrossrefPubMedGoogle Scholar
  • 30 Ridyard AE, Corcoran BM, Tasker S. et al. Spontaneous laryngeal paralysis in four white-coated German shepherd dogs. J Small Anim Pract 2000; 41 (12) 558-561.
    CrossrefPubMedGoogle Scholar
  • 31 Huber E. Resolution of megaesophagus in an adult female mixed breed dog after treatment of concomitant hypothyroidism. http: //vetneuromuscular.ucsd.edu/cases/2001/aug01.html Accessed January 2012
    PubMedGoogle Scholar
  • 32 Leib M, Dinnel H, Ward D. et al. Endoscopic balloon dilation of benign esophageal strictures in dogs and cats. J Vet Intern Med 2001; 15 (06) 547-552.
    CrossrefPubMedGoogle Scholar
  • 33 Glazer A, Walters PC. Esophagitis and esophageal strictures. Compend Contin Educ Vet 2008; 30 (05) 281-292.
    PubMedGoogle Scholar
  • 34 Larcher T, Abadie J, Roux FA. et al. Persistent left cranial vena cava causing oesophageal obstruction and consequent megaesophagus in a dog. J Comp Pathol 2006; 135 (2–3): 150-152.
    CrossrefPubMedGoogle Scholar
  • 35 Buchanan JW. Tracheal signs and associated vascular anomalies in dogs with persistent right aortic arch. J Vet Intern Med 2004; 18 (04) 510-514.
    CrossrefPubMedGoogle Scholar
  • 36 Atwater S, Powers B, Park R. et al. Thymoma in dogs: 23 cases (1980–1991). JAVMA 1994; 205 (07) 1007-1013.
    PubMedGoogle Scholar
  • 37 Okumura M, Fujii Y, Shiono H. Immunological function of thymoma and pathogenesis of paraneoplastic myasthenia gravis. Gen Thorac Cardiovasc Surg 2008; 56 (04) 143-150.
    PubMedGoogle Scholar
  • 38 Stenner V, Parry B, Holloway S. Acquired myasthenia gravis associated with a noninvasive thymic carcinoma in a dog. Aust Vet J 2003; 81 (09) 543-546.
    CrossrefPubMedGoogle Scholar
  • 39 Maddison JE, Allan GS. Megaesophagus attributable to lead toxicosis in a cat. JAVMA 1990; 197 (10) 1357-1358.
    PubMedGoogle Scholar
  • 40 Farrow B. Tremor syndromes in dogs. Proc ACVIM 1988
    PubMedGoogle Scholar
  • 41 UCSD Comparative Neuromuscular Laboratory. Sample requirements. http: //vetneuromuscular.ucsd.edu/Samplerequirements.html Accessed January 2012
    PubMed
  • 42 Washabau RJ, Hall JA. Gastrointestinal prokinetic therapy: serotonergic drugs. Compend Contin Educ Vet 1997; 19 (04) 473-480.
    PubMedGoogle Scholar
  • 43 Clooten JK, Woods JP, Smith-Maxie LL. Myasthenia gravis and masticatory muscle myositis in a dog. Can Vet J 2003; 44 (06) 480-483.
    PubMedGoogle Scholar
  • 44 Finora K, Greco D. Hypothyroidism and myxedema coma. Compend Contin Educ Vet 2007; 29 (01) 19-31.
    PubMedGoogle Scholar
  • 45 Tyler TW, Lathan P. Canine hypoadrenocorticism: diagnosis and treatment. Compend Contin Educ Vet 2005; 27 (02) 121-132.
    PubMedGoogle Scholar
  • 46 Ames C. Lead toxicosis: an unexpected foreign body. Vet Forum 2007; 24 (01) 46-48.
    PubMedGoogle Scholar
  • 47 Tecles F, Martinez SSubiela, Bernal LJ, Ceron JJ. Use of whole blood for spectrophotometric determination of cholinesterase activity in dogs. Vet J 2000; 160 (03) 242-249.
    CrossrefPubMedGoogle Scholar
  • 48 Basso W, Venturini MC, Bacigalupe D. et al. Confirmed clinical Neospora caninum infection in a boxer puppy from Argentina. Vet Parasitol 2005; 131 (3–4): 299-303.
    CrossrefPubMedGoogle Scholar
  • 49 Washabau RJ, Hall JA. Diagnosis and management of gastrointestinal motility disorders in dogs and cats. Compend Contin Educ Vet 1997; 19 (06) 721-736.
    PubMedGoogle Scholar
  • 50 Han E. Diagnosis and management of reflux esophagitis. Clin Tech Small Anim Pract 2003; 18 (04) 231-238.
    CrossrefPubMedGoogle Scholar
  • 51 Sellon RK, Willard MD. Esophagitis and esophageal strictures. Vet Clin North Am Small Anim Pract 2003; 33 (05) 945-967.
    CrossrefPubMedGoogle Scholar
  • 52 Willard MD. Recognizing and treating esophageal disorders in dogs and cats. Vet Med 2004; 99 (05) 448-454.
    PubMedGoogle Scholar
  • 53 Shelton GD. Treatment of autoimmune myasthenia gravis. In: Bonagura JD, Twedt DC. eds. Kirk’s Current Vet Therapy XIV. Philadelphia, PA: WB Saunders; 2008: 1108-1111.
    Google Scholar
  • 54 Shelton D, Lindstrom J. Spontaneous remission in canine myasthenia gravis: implications for assessing human MG therapies. Neurology 2001; 57 (11) 2139-2141.
    CrossrefPubMedGoogle Scholar
  • 55 King LG, Vite CH. Acute fulminating myasthenia gravis in five dogs. JAVMA 1998; 212 (06) 830.
    PubMedGoogle Scholar