Presentation
Presented with trouble swallowing. Recently diagnosed with Hemobartonella and treated with doxycycline.
Patient Data
Plain radiographs were unremarkable. Fluoroscopy was performed using liquid barium. There is a persistent narrowing in the cranial cervical esophagus which never dilates as the peristaltic bolus passes through it. There is also slowing of the bolus passage at this site.
Impression: esophageal stricture.
Case Discussion
Esophageal stricture secondary to doxycycline toxicity.
Strictures often cause a chronic partial obstruction of the esophagus. Common causes are gastric reflux under anesthesia, vomiting, foreign bodies and caustic agents. There are reports of doxycycline capsules being retained in the esophagus of cats and causing localized necrosis and evantual scarring with stricture.
Plain radiographs are often normal in these cases, and contrast radiography and fluoroscopy are required. Liquid barium may reveal a stricture with radiography if the timing is correct. Fluoroscopy is ideal to watch the passage of contrast throughout the length of the esophagus. Barium soaked kibble is a good second step after liquid barium, as moderate strictures are often well delineated.
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