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. 2015 Jul-Aug;29(4):1105-11.
doi: 10.1111/jvim.13572. Epub 2015 Jun 25.

Endoscopic Balloon Dilation of Esophageal Strictures in 9 Horses

J S W Prutton  1 , S L Marks  2 , M Aleman  2
Affiliations

Endoscopic Balloon Dilation of Esophageal Strictures in 9 Horses

J S W Prutton et al. J Vet Intern Med. 2015 Jul-Aug.

Abstract

Background: Medical treatment of esophageal strictures in horses is limited and the use of balloon dilatation is described in few cases. Long-term follow up after balloon dilatation and the use of intralesional corticosteroids has not been evaluated.

Objectives: To describe the use of endoscopic guided, esophageal balloon dilatation in horses for cervical and thoracic esophageal strictures and administration of intralesional corticosteroids at the time of dilatation.

Animals: Nine horses from the hospital population with benign esophageal strictures.

Methods: Retrospective study: Medical records were reviewed from horses presented to the William R. Pritchard, Veterinary Medical Teaching Hospital at UC Davis from 2002 to 2013. Records were searched using the key words: equine, horse, balloon dilatation, bougienage, and esophageal stricture.

Results: Nine horses with esophageal strictures were treated with esophageal balloon dilatation. Five horses survived (survival at writing ranged from 2 to 11 years after discharge) and all nonsurvivors were <1 year of age and presented with concurrent problems or developed complications including megaesophagus, unresolved esophageal obstruction requiring esophagostomy, or severe aspiration pneumonia. Four horses were treated with intralesional corticosteroids with no adverse effects noted in the survivors (n = 3). Four horses available for long-term follow up were alive at 2, 5, 6, and 11 years after presentation and 3 of these horses were being fed a hay-based diet.

Conclusions: Resolution of esophageal strictures in the horse can be performed successfully, safely, and under standing sedation using balloon dilatation. Intralesional corticosteroids might reduce the incidence of recurrent strictures.

Keywords: Bougienage; Choke; Esophagus; Horse.

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Figures

Figure 1
Figure 1
Esophagram of a 2‐month filly with a thoracic esophageal stricture (small arrow) and megaesophagus (large arrow) orad to the stricture performed under standing sedation. Barium pooling can be noted orad and caudal to the stricture site.
Figure 2
Figure 2
Severe esophageal stricture in a 24‐year‐old miniature horse gelding with a 0.8 cm diameter after esophageal impaction.
Figure 3
Figure 3
Location of balloon dilator before inflation for treatment of esophageal strictures under endoscopic guidance.
Figure 4
Figure 4
Location of balloon dilator during treatment for esophageal stricture under endoscopic guidance.
Figure 5
Figure 5
Postballoon dilatation of an esophageal stricture showing mucosal hemorrhage and erythema.
Figure 6
Figure 6
Insertion of a Wang needle into the esophageal submucosa under endoscopic guidance for the administration of corticosteroids after dilatation of an esophageal stricture.
Figure 7
Figure 7
Severe circumferential mucosal sloughing after resolution of esophageal impaction.
Figure 8
Figure 8
Resolving esophageal stricture after balloon dilatation 2 days before re‐examination.
See this image and copyright information in PMC

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