Reply To: Oesophagel Foreign Body!
I think you are right, this is obviously a bad complication, but quite rare in the grand scheme of things. I had a look through the other literature and overall it is reassuring. This recent JVECCS paper is helpful:
Retrospective evaluation of factors associated with degree of oesophagitis, treatment, and outcomes in dogs presenting with esophageal foreign bodies (2004-2014): 114 cases
Objective: To characterize a population of dogs presenting for oesophageal foreign body removal and evaluate factors associated with degree of oesophagitis and minor and major complications.
Design: Retrospective evaluation of dogs who presented for oesophageal foreign body removal between January 2004 and December 2014.
Setting: University veterinary teaching hospital.
Animals: Data collected from 114 dogs included signalment, history, clinical signs, physical examination findings, duration and location of foreign body, degree of oesophagitis, foreign body removal success, feeding tube placement, and clinical outcomes. Owners were contacted for outcome data not available in the medical record. Data were analyzed for breed predispositions, whether duration or type of foreign body was associated with degree of esophagitis or complications, and factors associated with feeding tube placement.
Measurements and main results: The overall success rate for foreign body removal via oesophagoscopy was 95% with a complication rate of 22%. Small breed dogs were overrepresented. Dogs with a foreign body present for >24 h were significantly more likely to have severe esophagitis (P < 0.001) and major complications (P = 0.0044). Foreign body type did not predict degree of oesophagitis or complications, though fishhooks were more likely to require surgical removal (P = 0.033). Feeding tubes (15 gastrostomy, 1 nasoesophageal) were placed in 14% of dogs and were more likely to be placed if the foreign body had been present for >24 h (P < 0.001). Conclusions: Consistent with previous studies, oesophageal foreign bodies, appropriately identified and endoscopically removed, carry a good prognosis, particularly if they have been present for ≤24 h. The majority of dogs recovered without any minor or major complications (56/72, 78%). Overall, 16 patients had a complication reported, including those who did not survive to discharge. Four dogs recovered with minor complications (6%); 5 dogs suffered major complications (7%); 1 dog had a gastrostomy tube-associated complication (1%); 2 dogs underwent cardiopulmonary arrest under anesthesia (3%); 3 were euthanized prior to discharge (4%), and 1 decompensated within 24 h of discharge and was represented for euthanasia (1%). Minor complications included vomiting/diarrhea (3) and cough/tracheitis (1). No dogs were reported to have inappetence following foreign body removal. Major complications included oesophageal stricture (4) and aspiration pneumonia (2); 1 of the 5 dogs with major complications suffered from both aspiration pneumonia and an oesophageal stricture. Of the 4 dogs with a documented stricture, 2 were ultimately euthanized due to this complication, and 2 were managed with a gastrostomy tube. The gastrostomy tube-associated complication was described as pain associated with the feeding tube stoma. The overall complication rate for our patient population was 22% (16/72). Take home message... don't be scared! Scott 🙂