An anatomical and clinical review of cricopharyngeal achalasia in the dog

Abstract

Cricopharyngeal achalasia is a rare cause of dysphagia in the dog. However it must be differentiated from other causes of dysphagia as it is treatable with surgery. It is a disruption of the cricopharyngeal phase of the oropharyngeal phase of deglutition. There appears to be an incoordination in the swallowing process between the relaxation of the rostral, middle pharyngeal muscles and the caudal pharyngeal muscles. It is seen as a primary condition in young animals presenting soon after weaning onto solid food. The dogs appear clinically healthy unless there is secondary aspiration pneumonia or emaciation. These dogs may present as respiratory emergencies and require intensive support and treatment prior to corrective surgery. The diagnosis is made on videofluoroscopy. The condition carries a good prognosis for cure with surgical myectomy of the cricopharyngeal muscle and the thyropharyngeal muscle, which make up the upper oesophageal sphincter. Temporary relief prior to surgery can be achieved by injection of the cricopharyngeal muscle with botulism toxin. Surgical treatment for dysphagia secondary to an underlying neurological, neuromuscular or pharyngeal weakness carries a guarded prognosis and will make aspiration pneumonia worse

A Comparative Assessment of the Diagnosis of Swallowing Impairment and Gastroesophageal Reflux in Canines and Humans

“…A hereditary cause for cricopharyngeus muscle dysfunction has been identified in Golden Retrievers, and results of complex segregation analysis suggest that a single recessive allele of large effect contributed to the expression of this disease in the breed (92). In addition, miniature dachshunds, Maltese, toy poodles, and spaniels are predisposed to the congenital development of cricopharyngeus muscle dysfunction (Table 1) (92)(93)(94)(95).…”

“…The approach to the human or canine patient with swallowing impairment begins with a careful review of the patient's signalment which is particularly important in the canine in light of hereditary and breed-related predispositions (Table 1) (7,42,51,78,89,(92)(93)(94)(95).…”

Table_1.DOCX

“…A hereditary cause for cricopharyngeus muscle dysfunction has been identified in Golden Retrievers, and results of complex segregation analysis suggest that a single recessive allele of large effect contributed to the expression of this disease in the breed (92). In addition, miniature dachshunds, Maltese, toy poodles, and spaniels are predisposed to the congenital development of cricopharyngeus muscle dysfunction (Table 1) (92)(93)(94)(95).…”

“…The approach to the human or canine patient with swallowing impairment begins with a careful review of the patient's signalment which is particularly important in the canine in light of hereditary and breed-related predispositions (Table 1) (7,42,51,78,89,(92)(93)(94)(95).…”