Replying to Nathalie Cunha 08/03/2022 - 17:31
Of course! Brilliant thoughts everyone!
I think based on the brilliant videos and the clinical presentation i would be cricopharyngeal dysphagia, especially as you have ruled out a cleft palate. A bit more information:
Cricopharyngeal dysphagia is a congenital or acquired neuromuscular disorder of the upped oesophageal sphincter characterized by failure of the sphincter to relax (achalasia) or a lack of coordination between sphincter relaxation and pharyngeal contraction (asynchrony). Affected dogs have abnormal transport of bolus from the hypopharynx to the proximal oesophagus. Affected animals demonstrate progressive dysphagia (typically worse when drinking water) at the time of, or shortly after, weaning. Clinical signs are characterized by repeated attempts to swallow, gagging, retching, and nasal regurgitation. The clinical signs of dogs with cricopharyngeal achalasia are indistinguishable from cricopharyngeal asynchrony. Physical examination may reveal evidence of aspiration pneumonia (coughing, moist crackles on auscultation, fever).
Dogs suspected of having cricopharyngeal dysphagia should be thoroughly evaluated prior to surgical intervention to ensure that systemic disorders (myopathies, polyneuropathies) have been ruled out with AChR antibody titers, CK level, electromyography, and muscle biopsy. In addition, ensure that aspiration pneumonia is properly managed. Thoracic radiographs help rule out structural causes of dysphagia (foreign body, mass); however, a videofluoroscopic swallow study is the diagnostic procedure of choice. Most affected dogs with cricopharyngeal achalasia have a prominent thickened cricopharyngeus muscle (cricopharyngeal “bar”) visible on videofluoroscopy or endoscopy causing severe obstruction to propulsion of the bolus through the upper oesophageal sphincter. Static contrast radiographs may demonstrate barium retention in the pharynx or aspiration into the trachea; however, static studies do not allow the functional integrity of the upper oesophageal sphincter or the coordinated contraction of the pharynx and relaxation of the upper oesophageal sphincter to be evaluated.
I do think fluoroscopy is next sensible step.
Hope that helps.
Scott 🙂
