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ladyjane · 11-14-2013, 05:14 PM

I have been meaning to post about my sweet foster, Tootsie, to see if anyone had any ideas other than what I was thinking....just never got around to it.

I took her to the specialist today for testing and am now sharing this because it is extremely rare and we never know who might come along with a similar condition.

Tootsie has been regurgitating water (not vomiting...it just comes up with no gagging or retching). She is able to keep food down. I had noticed that she was drinking a lot of water when she did drink but only a small amount was coming up. My vet had done x-rays and sent them to the specialist who then suggested Tootsie have a barium swallow with a fluoroscopy. She went there today and had that done. They also found her cortisol level to be low so they did the ACTH test to rule out Addison's. I don't have the results of that yet.

Easier for me to copy/paste this information...kind of fascinating but I hate that it is in my house. Seems every pup that lands here gets some weird thing. I keep joking about God teaching me but this is really getting crazy...I told Him the joke needs to stop.

From her discharge summary:

Results: 3-Phase Esophagram: Liquid is unable to easily move past the upper esophageal sphincter into the esophagus without 10-15 swallowing motions. Food is able to move normally, whether canned food or kibble.

DISCUSSION: Tootsie's history suggested issues with swallowing and regurgitating liquids like water, and this has been confirmed by fluoroscopy. Her upper esophageal sphincter will not open properly to allow water to enter. However, food readily enters the upper esophageal sphincter. Since swallowing is a reflex of the nervous system, this implies that water is not stimulating the nerves in the upper esophageal sphincter to activate and trigger the swallowing reflex. This decreased sensation of the nerves is what
leads to conditions like mega-esophagus, otherwise known as esophageal ectasia. So, we can tentatively say Tootsie has ectasia of her upper esophageal sphincter. Again, this is due to the nerves not reacting to a liquid stimulas to swallow. This condition is very rare and it may progress or may stay stable overtime. If it does progress, treatment options would be injecting the upper esophageal sphincter with botox or other substances to bulk it up and hopefully make nervous stimulation easier. However, Tootsie's signs are no where near severe enough to warrant that. For now, after she drinks, just hold her up for 15-30 seconds to help gravity push liquid against the sphincter to better trigger swallowing.

Monitor Tootsie closely for worsening of her regurgitation or difficulty breathing. Difficulty breathing may indicate she has aspirated some fluid or food, leading to aspiration pneumonia.

Here is darling Tootsie!

IMG_5657.jpg

11-14-2013, 05:14 PM	#1
ladyjane Resident Yorkie Nut Donating YT 20K Club Member Join Date: Sep 2006 Location: Texas Posts: 27,454	Tootsie unable to keep water down... I have been meaning to post about my sweet foster, Tootsie, to see if anyone had any ideas other than what I was thinking....just never got around to it. I took her to the specialist today for testing and am now sharing this because it is extremely rare and we never know who might come along with a similar condition. Tootsie has been regurgitating water (not vomiting...it just comes up with no gagging or retching). She is able to keep food down. I had noticed that she was drinking a lot of water when she did drink but only a small amount was coming up. My vet had done x-rays and sent them to the specialist who then suggested Tootsie have a barium swallow with a fluoroscopy. She went there today and had that done. They also found her cortisol level to be low so they did the ACTH test to rule out Addison's. I don't have the results of that yet. Easier for me to copy/paste this information...kind of fascinating but I hate that it is in my house. Seems every pup that lands here gets some weird thing. I keep joking about God teaching me but this is really getting crazy...I told Him the joke needs to stop. From her discharge summary: Results: 3-Phase Esophagram: Liquid is unable to easily move past the upper esophageal sphincter into the esophagus without 10-15 swallowing motions. Food is able to move normally, whether canned food or kibble. DISCUSSION: Tootsie's history suggested issues with swallowing and regurgitating liquids like water, and this has been confirmed by fluoroscopy. Her upper esophageal sphincter will not open properly to allow water to enter. However, food readily enters the upper esophageal sphincter. Since swallowing is a reflex of the nervous system, this implies that water is not stimulating the nerves in the upper esophageal sphincter to activate and trigger the swallowing reflex. This decreased sensation of the nerves is what leads to conditions like mega-esophagus, otherwise known as esophageal ectasia. So, we can tentatively say Tootsie has ectasia of her upper esophageal sphincter. Again, this is due to the nerves not reacting to a liquid stimulas to swallow. This condition is very rare and it may progress or may stay stable overtime. If it does progress, treatment options would be injecting the upper esophageal sphincter with botox or other substances to bulk it up and hopefully make nervous stimulation easier. However, Tootsie's signs are no where near severe enough to warrant that. For now, after she drinks, just hold her up for 15-30 seconds to help gravity push liquid against the sphincter to better trigger swallowing. Monitor Tootsie closely for worsening of her regurgitation or difficulty breathing. Difficulty breathing may indicate she has aspirated some fluid or food, leading to aspiration pneumonia. Here is darling Tootsie! IMG_5657.jpg __________________ CLOUD NINE BEDS--YORKIE HAVEN RESCUE MY ETSY SHOP Last edited by ladyjane; 11-14-2013 at 05:16 PM.