Intermittent gastroesophageal intussusception in a cat with idiopathic megaesophagus

Abstract

An adult female domestic shorthair cat was evaluated for chronic upper respiratory disease and vomiting. A diagnosis of idiopathic megaesophagus with intermittent gastroesophageal intussusception (GEI) was made based on radiographic and endoscopic examinations. The GEI was manually reduced by use of a stomach tube during the endoscopic procedure. An incisional gastropexy was performed to prevent recurrence. Gastroesophageal intussusception is a rare condition in cats. In dogs it is usually associated with rapid progression of clinical signs, culminating in death. In this cat, the condition was associated with chronic signs, probably due to the intermittent nature of the GEI.

Intermittent Gastroesophageal Intussusception in a Kitten Resolved with a Percutaneous Gastropexy

“…In the previous fi ve cases reported in cats, there were different experiences with the management of this pathology: two were euthanatized due to a deteriorated condition [6,8], one suffered cardiac arrest after open surgery [4], one survived after surgical reduction [5] and one case responded to medical therapy [7]. The mortality of GEI is high, in part due to failure to recognize the condition early and the rapid deterioration of the animal without treatment.…”

“…Other unspecifi c signs included abdominal discomfort on palpation, weight loss, anorexia, hypersalivation, dehydration, depression and crying [6]. The clinical manifestation may improve spontaneously with conservative medical therapy and usually progresses and culminates in death due to respiratory or vascular compromise [5].…”

“…On the principal international scientifi c databases, there are only fi ve clinical cases of GEI in domestic cats reported between 1998 to 2015 in domestic shorthair cats [5,7,8], in a Himalayan [4] and in a Birman [6], including four males and one female; two were kittens, two adults and the last an elder cat, age ranged from 4 months to 15 years old. The clinical cases presented different clinical signs referring to gastrointestinal symptoms such as vomitus or regurgitation [6][7][8] or respiratory disease such as respiratory distress, open-mouth breathing, inspiratory stridor and mucopurulent nasal discharge, with acute or intermittent presentation [4,8].…”

“…GEI has been rarely reported in animal species such as the dog [10,11], cat [4][5][6][7][8], leopard (Panthera pardus) [12], cheetah (Acinonyx jubatus) [9] and hedgehog (Atelerix albiventris) [13]. Some authors have categorized GEI as a sliding hiatal hernia as it is defi ned as a transposition of the abdominal part of the esophagus, gastroesophageal junction and a portion of stomach through the esophageal hiatus of the diaphragm [10,11]; however, this is different than GEI because the gastroesophageal junction does not move cranially into the thorax [7,10].…”

“…Until 2014, only three case studies on esophageal diseases were published, describing esophageal dysmotility due to different origins as the principal pathology [1][2][3]; however, none of these studies refers to a gastroesophageal intussusception (GEI), a rare pathology characterized by an invagination of the stomach into the lumen caudal to the thoracic esophagus [4][5][6][7][8].…”