Esophageal varices in dogs: A retrospective case series

Abstract

Background Esophageal varices (EV) are abnormally dilated veins in the esophagus caused by alterations of blood flow or pressure. Esophageal variceal hemorrhage is a major complication of hepatic disease in humans, but a lack of information exists regarding associated adverse events in dogs. Objective To describe the clinical manifestations and associated etiologies and outcomes of dogs with EV. Animals Twenty‐five client‐owned dogs with EV diagnosed via computed tomography (CT), endoscopy, or fluoroscopy. Methods Retrospective case series. Cases were identified by review of the hospital imaging records database between 2010 and 2020. Signalment, clinical signs, and outcomes were documented. When present, additional collateral vasculature was also recorded. Cases were subcategorized into suspected etiology based upon the anatomic location or absence of an attributable underlying disease process, as well as the direction of blood flow. Results Twenty‐four of 25 cases were identified via CT, with a prevalence of 0.012% (24/1950 total studies). Presenting clinical signs were nonspecific, and more likely because of the underlying cause as opposed to complications secondary to EV themselves. Etiologic anatomic locations were similar in occurrence between the abdomen (N = 14) and thorax (N = 11). All cases with an abdominal etiologic location had presumed or confirmed portal hypertension and 9/11 cases with a thoracic etiologic location had pulmonary, caval, or systemic hypertension. No cases died or were euthanized as a direct result of EV or associated hemorrhage. Conclusions and Clinical Importance Esophageal varices are rarely reported in dogs and commonly identified concurrently with portal, pulmonary, and caval hypertension. Hemorrhage is not a common clinical manifestation of EV.

Gastroduodenal ulceration in dogs with liver disease

“…8 A recent retrospective study of 25 dogs with esophageal varices, predominantly diagnosed by CT, included 9 cases with hepatic disease and confirmed or presumed portal hypertension as the cause. 17 In our study, only 20 dogs had CT scans available for review, and thus some esophageal varices may have not been detected.…”

“…Varices are not well described in the veterinary literature, but 1 case series included a dog with an intrahepatic arterioportal communication that had multiple types of varices 8 . A recent retrospective study of 25 dogs with esophageal varices, predominantly diagnosed by CT, included 9 cases with hepatic disease and confirmed or presumed portal hypertension as the cause 17 . In our study, only 20 dogs had CT scans available for review, and thus some esophageal varices may have not been detected.…”

ACVIM consensus statement on diagnosis and management of urinary incontinence in dogs

“…Although direct comparison studies still are needed, female dogs are more likely to experience storage disorders whereas male dogs have equal prevalence of storage and voiding disorders. 28 In several studies, some breeds were overrepresented in the UI group, either with urethral sphincter mechanism incompetence (USMI) or ectopic ureter (EU; Box 1). 4,5,29,30 Urethral sphincter mechanism incompetence is the most common functional urine storage disorder in dogs and is usually, but not always, associated with alterations in sex hormones after neutering of female and male dogs.…”

“…Disorders of urine storage are characterized by UI with normal postvoiding residual volume (PVRV; see Section 4.3) and further subdivided into functional and mechanical causes (Table 1). Although direct comparison studies still are needed, female dogs are more likely to experience storage disorders whereas male dogs have equal prevalence of storage and voiding disorders 28 . In several studies, some breeds were overrepresented in the UI group, either with urethral sphincter mechanism incompetence (USMI) or ectopic ureter (EU; Box 1).…”

“…Although direct comparison studies still are needed, female dogs are more likely to experience storage disorders whereas male dogs have equal prevalence of storage and voiding disorders. 28 In several studies, some breeds were overrepresented in the UI group, either with urethral sphincter mechanism incompetence (USMI) or ectopic ureter (EU; Box 1 ). 4 , 5 , 29 , 30 …”