Endoscopic Balloon Dilation of Esophageal Strictures in 9 Horses

Abstract

BackgroundMedical treatment of esophageal strictures in horses is limited and the use of balloon dilatation is described in few cases. Long‐term follow up after balloon dilatation and the use of intralesional corticosteroids has not been evaluated.ObjectivesTo describe the use of endoscopic guided, esophageal balloon dilatation in horses for cervical and thoracic esophageal strictures and administration of intralesional corticosteroids at the time of dilatation.AnimalsNine horses from the hospital population with benign esophageal strictures.MethodsRetrospective study: Medical records were reviewed from horses presented to the William R. Pritchard, Veterinary Medical Teaching Hospital at UC Davis from 2002 to 2013. Records were searched using the key words: equine, horse, balloon dilatation, bougienage, and esophageal stricture.ResultsNine horses with esophageal strictures were treated with esophageal balloon dilatation. Five horses survived (survival at writing ranged from 2 to 11 years after discharge) and all nonsurvivors were <1 year of age and presented with concurrent problems or developed complications including megaesophagus, unresolved esophageal obstruction requiring esophagostomy, or severe aspiration pneumonia. Four horses were treated with intralesional corticosteroids with no adverse effects noted in the survivors (n = 3). Four horses available for long‐term follow up were alive at 2, 5, 6, and 11 years after presentation and 3 of these horses were being fed a hay‐based diet.ConclusionsResolution of esophageal strictures in the horse can be performed successfully, safely, and under standing sedation using balloon dilatation. Intralesional corticosteroids might reduce the incidence of recurrent strictures.

Balloon dilation to treat oesophageal strictures in five foals

“…Use of the technique in equine oesophageal strictures has been reported once, with 3 of the 4 treated horses surviving without recurrence of the stricture (Prutton et al . ).…”

“…Interestingly, the presence of megaoesophagus did not appear to negatively affect long‐term outcome in Foal B , in comparison to the study by Prutton et al . (), which found that animals with concurrent megaoesophagus had a worse prognosis.…”

“…This was considered to be obstruction-induced megaoesophagus rather than dysfunction-induced megaoesophagus, with dilation of the oesophagus proximal to the stricture presumed to have occurred secondary to the repeated episodes of oesophageal obstruction (Broekman and Kuiper 2002). Interestingly, the presence of megaoesophagus did not appear to negatively affect longterm outcome in Foal B, in comparison to the study by Prutton et al (2015), which found that animals with concurrent megaoesophagus had a worse prognosis.…”

“…One report documented the occurrence of intramural infection at the corticosteroid injection sites in 2/7 patients (Zein et al 1995), although several other studies report no complications (Kochhar and Makharia 2002;Altintas et al 2004;Ramage et al 2005). Use of the technique in equine oesophageal strictures has been reported once, with 3 of the 4 treated horses surviving without recurrence of the stricture (Prutton et al 2015).…”

Oesophageal ectasia as a cause of dysphagia and milk regurgitation in a neonatal foal

“…; Prutton et al . ). Of these disorders, only a few have been reported to manifest with clinical signs in neonatal foals (Petrick et al .…”