Celine Toh^1,2, Alistair Freeman³, Laura Doeven⁴, Nicola Kulendra⁵, Julia Riggs⁶, Emma Deards³, Andrew Phillips⁷, Anna Frykfors von Hekkel¹

¹Royal Veterinary College, University of London, London, United Kingdom. ²University of Glasgow, Glasgow, United Kingdom. ³University of Liverpool, Liverpool, United Kingdom. ⁴Pride Veterinary Referrals, Derby, United Kingdom. ⁵North Downs Specialist Referrals, Redhill, United Kingdom. ⁶University of Cambridge, Cambridge, United Kingdom. ⁷Anderson Moores Veterinary Specialists, Winchester, United Kingdom

Objectives

To describe outcomes of surgical and non-surgical management of dogs with cricopharyngeal dysphagia

Methods

Multi-centre retrospective review of medical records of dogs diagnosed with cricopharyngeal dysphagia on video fluoroscopy. Follow-up information was obtained from medical records and owner questionnaires.

Results

40 dogs were included: 29 surgically-managed and 11 non-surgical. Surgical cases were significantly younger at onset of clinical signs (median 2.5 months; range 0-55) than non-surgical cases (median 36 months; range 2-136) (p=0.0006). Surgical cases had a significantly lower body condition score (median 3 out of 9, range 1.5-4) than non-surgical cases (median 4.25, range 3-6.5) (p=0.015). Twenty-three complications were recorded in 15 surgical cases, most commonly aspiration pneumonia (n=7). In surgical cases dysphagia partially or completely resolved in around half of dogs (15/26, 57.6%), resolved only transiently and recurred in 8/26 dogs (30.7%), while no improvement was seen in 3/26 dogs (11.5%).  Median time to recurrence was 20.5 days (range 10-90). A majority of non-surgical cases had no improvement in dysphagia (7/10, 70%). Overall mortality rate was 9/29 (31%) for surgical cases and 6/11 (55%) for nonsurgical cases. Grading of dysphagia by clinicians and owners showed no significant change in severity of dysphagia after treatment for both groups but frequency of dysphagia significantly improved after treatment in surgical cases.

Statement: Impact/ Clinical Significance

Surgical management results in sustained improvement of dysphagia in around half of cases and provides more favourable outcomes than nonsurgical management, though this could be related to inherent differences between the surgical and non-surgical populations.