Help! Has Anyone Dealt with Esophageal Strictures?

monyd · Mar 8, 2007

Hi. I'm brand new to this forum and am hoping someone out there can offer me some advice.

We have been dealing with a situation for almost 3 months now with our Maine Coon, Gabby, and are seriously, beside ourselves!

To make a very, very long story short, she had esophagitis (an injury to the lining of the esophagus). When it healed, it healed with scar tissue, causing a serious stricture. An endoscopic exam revealed her esophagus was practically closed up at 3mm. in diameter. We had a specialist perform 2 balloon dilations of her throat (an inflation of a balloon in her throat to stretch the scar tissue back). She appeared to respond well to the treatment, however her symptoms eventually returned -- gagging, coughing and unable to swallow anything but mushed up and watered down canned food.

Her symptoms were not nearly as severe as they originally were (before her first surgery we were spoon feeding her because if she ate to fast everything came back up). Infact, she was eating on her own, relatively good portions and could be safely left to free feed. But she still could only tolerate very soft foods. We decided to go in for a third time -- thinking that one more treatment would be a charm and she would come out being even better.

Turns out her stricture had recurred and was right back to the original 3mm diameter that it was before the inital surgery. We (even our vet) were shocked! The first two surgeries took place back in mid-February and were performed within a 4 days of each other. We waited three weeks before exploring again -- her third procedure was yesterday. So over the past 3 weeks or so, the scar tissue grew back.

The specialist is suggesting another 2 balloon dilations within a week. Bear in mind each treatmeant is roughly $600cdn. and although that is not our main concern here, it's starting to add up. What bothers me, is that I cannot get a firm answer from this specialist if our cat's case is "typical" of this condition, or if it is just a lost cause.

I am wondering if there is anyone out there who has dealt with this type of condition with their cat, or if you have ever heard of anything like this? Before I subject my cat to the stress of two more procedures I want some sort of assurance that the scar tissue won't eventually grow back and choke her in the end.

Any advice at all would be so greatly appreciated. You have no idea!

Thanks for listening.

Ramona
Mission, B.C.

jcat · Mar 8, 2007

to TCS! I have no experience with this, but hope that somebody who has will be along soon to advise you.

jean44 · Mar 8, 2007

My Palekana also has an esophageal stricture. It was discovered during an endoscopy of her stomach. She also has an infected ulcer in her stomach. The vet who performed the endoscopy said her esophagus is opening and that the stricture should not be a problem. However after 10 days of antibiotic to heal the ulcer and medication to sooth her stomach she is still having severe problems eating. This problem started in January. Her behavior when attempting to eat leads me to believe the stricture is, in fact, a problem. I've had many conversations with the vet about her problems with no good solution. One of my other cats has an appointment for her annual exam tomorrow so I'll be discussing Palekana with the vet yet again at that time. Any information will be appreciated.

Moynd, I hope you can find something that works for your kitty. I did not know there was a procedure that could possibly open the esophagus. I'll mention that to my vet.

monyd · Mar 8, 2007

Jean 44
Does your cat gag her food back up? I don't mean vomitting -- with a severe stricture the food will not make it into her tummy, but will be choked back up in a thick clear mucus. Our Gabby also gulps and you can see she is having a hard time swallowing.

Definitely ask your vet about a balloon dilation. This is the procedure we've been doing on Gabby. They put the cat to sleep and insert an endoscope down the throat. (This is actually the only way you can tell if the cat has a stricture in the first place.) Then they inflate a tiny balloon under pressure and stretch the esophagus and scar tissue back. After the second surgery Gabby was fully dilated at 10 to 15mm. but yesterday (3 wks. after her last treatment) we were told it had strictured back to 3-4mm. This is why we are now being told that 2 more successive treatments are necessary. From what I've read -- 4 or 5 treatments are not uncommon.

Not all vets are trained in this procedure, so you will want to consult with a very experienced specialist. The risks for this surgery are typical, but the biggest one is the esophagus getting perforated during the procedure.

We have the utmost confidence in the doctors who have been treating Gabby.

One more thing -- I noticed that you said your cat had been taking antibiotics. So was our Gabby. In fact, she had been on a very intense course of Clyndamicin and she either got a pill lodged in her throat or the acid reflux of the drugs burned her esophagus. Our vet called the condition esophagitis. It is in the healing of this injury that the scar tissue forms and causes the stricture. When our specialist heard that she had been on this drug, he said right away that he had seen that happen alot.

We have learned a very valuable and expensive lesson and I will never administer pills to my pets again unless they are crushed up and in a liquid suspension.

By the way, I got a lot of info off the internet. Just do a search for "esophageal strictures in cats" you'll find a lot of good reading.

Good luck at the vets tomorrow. Let me know how you make out.

Ramona

jean44 · Mar 9, 2007

I discussed Palekana with the vet again today and mentioned the balloon treatment for the esophageal stricture. She is familiar with the procedure but said it wasn't necessary in Palekana's case. She believes Palekana's esophagus is opening sufficiently. Also, the balloon treatment is used only in case of scarring of the esophagus. which is not the case with Palekana.

The vet decided to put Palekana on an antacid, specifically famotidine which is the generic for Pepcid. She is supposed to get 1/4 tablet crushed in water per day. I gave her the first dose late this afternoon. I hope this works to sooth her tummy so that she can start eating properly again.

Monyd:
No Palekana does not gag or cough up mucus. I guess that is another clue that her problem is not related to her esophagus. I feel as though she has difficulty swallowing because she shakes and twists her head as she eats. It just seems that something is bothering her in getting the food down. I've mentioned this to the vet several times but she doesn't think it is related to the esophagus.

Her antibiotic was a trans dermal. There is no way that Palekana will take a pill and she has refused to eat any food that has medication hidden in it. I was surprised that the specialist said a pill lodged in the throat could cause Gabby's problem. That is very interesting. My Eric has been on daily pills (prednisolone) for about six years so now I'm thinking about him, although he has no symptoms of a problem.

selb · Nov 27, 2016

Dear Ramona,

I know it has been years since you posted this but our ragdoll is dealing with a stricture and pneumonia (from aspirating while regurgitating) and I'm desperate.

how did your vet stabilize Gabby in the end?

Best

Liz

jacilynm · Dec 7, 2016

Hi, i'm dealing with this with my cat at the moment also and looking for advice. Also curious to know what came of the original post's case. This is a very tough thing and I am really concerned my cat is not getting enough nutrition to sustain her since she can only eat very soft foods and they are either not very appealing or are causing her discomfort. Her stricture developed from a stuck foreign object (cartilage from wet food). The object was removed and she's had the balloon procedure once but it doesn't seem to have made any difference. I should add that my cat is 16 years old and recently diagnosed with congestive heart failure which is being treated successfully with medication. Soon after that diagnosis, she developed the esophagus issue. It has been a very difficult past few months! Any help or advice would be appreciated!!

white shadow · Dec 7, 2016

JacilynM said:
...she can only eat very soft foods and they are either not very appealing or are causing her discomfort.

Just to address the immediate feeding issue: I use a hand blender to puree pate foods into a texture like soft-serve ice cream.....I use a mug to hold the food (2-3 oz at a time) and insert the blender. It works like a charm on any food, and I also add shredded chicken/turkey for a better protein & fat content. I also warm the food a tad - just above room temp.

You may have to show her that this really is food before she'll take to it.....

One of my cats has what I believe to be some sort of esophageal injury/issue. I use this method for him - he still takes small amounts at a time, but returns over and over.

ginny · Dec 7, 2016

I don't know what to tell you about your cat, and I don't know if my experience will help you at all but nothing ventured nothing gained! I had an esophageal stricture. I had to chew food very carefully and thoroughly and swallow very small bites. Even then, food would get stuck about part of the way down. It would hurt so bad, then the food would pass and it was a relief. I believe it was caused by having reflux for so many years. Even as a teenager I took Rolaids and Tums.

About 3 years ago I had a health scare (the stricture was the least of my problems but it was still a biggy.) So I went on the paleo diet which is basically I eliminated all grains, legumes, dairy, sugar, and vegetable oils. I began eating high fat/ fairly low carb/mod protein. It took about 4 months but the heartburn and the stricture eventually went away with this diet. It's never come back.

I don't know how to extrapolate this information and fit it to your cat's case, so I would ask a nutritionist about it. And keep doing research about this.

jacilynm · Dec 11, 2016

Thank you so much White Shadow and Ginny for your helpful advice.

White Shadow -- Thank you for the very helpful advice! before the foreign object removal from my cat on Nov 11 I was pureeing the food such as what you mentioned in your post, and I started it again a few days ago. Sometimes she gobbles it down and sometimes she doesn't touch it (i've been trying different foods to see what she likes best). So glad to know someone else has gone to these lengths to help their kitty! Is your cat able to keep its weight up with the pureed foods? That is my concern for the long term.

Ginny -- thank you for sharing your story, it is very, very interesting that your issues have resolved with the diet. So amazing! I hope you continue to have relief.

ginny · Dec 12, 2016

JacilynM said:
Thank you so much White Shadow and Ginny for your helpful advice.

White Shadow -- Thank you for the very helpful advice! before the foreign object removal from my cat on Nov 11 I was pureeing the food such as what you mentioned in your post, and I started it again a few days ago. Sometimes she gobbles it down and sometimes she doesn't touch it (i've been trying different foods to see what she likes best). So glad to know someone else has gone to these lengths to help their kitty! Is your cat able to keep its weight up with the pureed foods? That is my concern for the long term.

Ginny -- thank you for sharing your story, it is very, very interesting that your issues have resolved with the diet. So amazing! I hope you continue to have relief.

I'm so glad to have helped! I hope your kitty gets better soon. What does she eat? Have you considered, or are you feeding a home-cooked diet?

I recall a nurse I worked with back in the 80's. She also had severe esophageal stricture. Mine wasn't quite as bad as hers, but when it started happening to me, I immediately thought of her. When I started the paleo diet, I didn't even KNOW at the time that diet would help an esophageal stricture, so the result I got can't be blamed on placebo effect. IIRC this woman was considering having the surgery to cut the vagus nerve, either that or she already HAD that surgery done and it did no good whatsoever. Many times at lunch she would take a bite, sit there in pain, then go to the bathroom and throw up. She had already had several surgeries to stretch out the esophagus. That didn't help her either. I felt so sorry for her. She could not eat a single meal without food getting stuck.

Like White Shadow suggested I had to almost puree all my foods and take very small bites. It was miserable so I feel for your kitty! And would definitely look into diet changes to see if it helps before considering costly surgeries. The foreign object removal was necessary. For me it took several months to realize it wasn't coming back, but the removal of certain inflammatory foods (milk/sugar/grains) gave me fairly fast relief of stricture symptoms even though the heartburn continued.

I wish I had known then about probiotics and enzymes. That would have helped with the heartburn tremendously and with digestion. I would recommend them both highly. Dr. Karen Becker recommends this: http://products.mercola.com/healthypets/digestive-enzymes-for-pet/

I really wish @selb (Liz) would update us on how her kitty is doing

white shadow · Dec 12, 2016

JacilynM said:
White Shadow -- ....Sometimes she gobbles it down and sometimes she doesn't touch it .... Is your cat able to keep its weight up with the pureed foods?

In a word, yes....an unqualified yes.

Obviously she'll need to maintain her caloric intake requirements. There were some periphery actions that I took such as using the tastiest foods, sometimes using the Hill's a/d 'recovery' food (for the extra calories), warming the puree, and assist-feeding by having him lick the puree from the underside of a teaspoon.

There were a few times when I 'kick-started' him by syringe-feeding a couple of teaspoonfulls (if you've never done this, great care needs to be taken that the cat doesn't aspirate the food - use a small syringe [I use 10cc] just a few drops at a time into the side corner of the mouth, allow the cat to swallow....wait, and repeat. You can 'introduce' the syringe by dipping the end of the syringe in the puree and presenting it for the smell-and-taste test).

A cat will by nature eat small quantities frequently......this is just smaller amounts, more frequently.

selb · Jan 6, 2017

Hi JaclynM, Ginny and White Shadow
Apologies for the delay... Didn't mean to be rude and not reply. My ragdoll passed away on nov 28th in a second round of emergency surgery to dilate the stricture where they discovered that a tear had occurred. His pneumonia had gotten so bad that combined with fluid leaking through the tear into his mediastinum, he stopped breathing while under GA.

I am so heartbroken.

For anyone who is administering antibiotics to their cat, please insist that the vet provides you with liquid suspension form as my kitty's complications came from a doxycycline pill that must've gotten stuck in his upper esophagus. Even after I had asked my vet a million times about how to administer the medication, they still didn't warn me about this and it wasn't until I did my own research and self-diagnosed him that I realized what happened. Two hospitalizations and three vets later he was gone in two weeks.

I wish I had more to share on how to deal with esophagitis and strictures but the best advice I can give is to be proactive even if it seems invasive. Nag your vet even when they say your kitty is going to be fine as you know your cat best. [emoji]128542[/emoji] And get a second opinion early...

ginny · Jan 6, 2017

selb said:
Hi JaclynM, Ginny and White Shadow
Apologies for the delay... Didn't mean to be rude and not reply. My ragdoll passed away on nov 28th in a second round of emergency surgery to dilate the stricture where they discovered that a tear had occurred. His pneumonia had gotten so bad that combined with fluid leaking through the tear into his mediastinum, he stopped breathing while under GA.

I am so heartbroken.

For anyone who is administering antibiotics to their cat, please insist that the vet provides you with liquid suspension form as my kitty's complications came from a doxycycline pill that must've gotten stuck in his upper esophagus. Even after I had asked my vet a million times about how to administer the medication, they still didn't warn me about this and it wasn't until I did my own research and self-diagnosed him that I realized what happened. Two hospitalizations and three vets later he was gone in two weeks.

I wish I had more to share on how to deal with esophagitis and strictures but the best advice I can give is to be proactive even if it seems invasive. Nag your vet even when they say your kitty is going to be fine as you know your cat best. [emoji]128542[/emoji] And get a second opinion early...

Gosh I'm so so sorry! Unfortunately, your vet didn't provide you with enough information for you to give informed consent. This happens a lot. To me too. After Gracie died, I questioned the internal medicine vet about why wasn't a certain med wasn't even tried or even discussed with me. I was told it probably wouldn't work anyway. That sounds like a flimsy excuse, not an answer. And from an internal med vet! I still so wish I had found a good one for her. I still regret so much about that situation. But we live and learn. The hard way. Hugs.

PTCarol · Jul 13, 2023

selb said:
Hi JaclynM, Ginny and White Shadow
Apologies for the delay... Didn't mean to be rude and not reply. My ragdoll passed away on nov 28th in a second round of emergency surgery to dilate the stricture where they discovered that a tear had occurred. His pneumonia had gotten so bad that combined with fluid leaking through the tear into his mediastinum, he stopped breathing while under GA.

I am so heartbroken.

For anyone who is administering antibiotics to their cat, please insist that the vet provides you with liquid suspension form as my kitty's complications came from a doxycycline pill that must've gotten stuck in his upper esophagus. Even after I had asked my vet a million times about how to administer the medication, they still didn't warn me about this and it wasn't until I did my own research and self-diagnosed him that I realized what happened. Two hospitalizations and three vets later he was gone in two weeks.

I wish I had more to share on how to deal with esophagitis and strictures but the best advice I can give is to be proactive even if it seems invasive. Nag your vet even when they say your kitty is going to be fine as you know your cat best. [emoji]128542[/emoji] And get a second opinion early...

PTCarol · Jul 13, 2023

I know this post is several years old but I am dealing with the same issue. Darn Doxycycline! I will never use pills again. I am so sorry about your baby.

Help! Has Anyone Dealt with Esophageal Strictures?

monyd

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jcat

Mo(w)gli's can opener

jean44

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monyd

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jean44

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selb

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jacilynm

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white shadow

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ginny

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jacilynm

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ginny

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white shadow

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selb

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ginny

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PTCarol

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PTCarol

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