Pneumonia due to aspiration Causes of Cricopharyngeal Achalasia in Dogs The true cause for older animals is unknown, but it may be related to other disorders. The current accepted causes of cricopharyngeal achalasia are: Congenital abnormalities of the upper esophageal sphincter Acquired neuromuscular disorders Breed predisposition Golden Retrievers, Cocker Spaniels, Springer Spaniels Diagnosis of Cricopharyngeal Achalasia in Dogs Disorders leading to dysphagia are common in dogs, and a full physical exam will be performed to assess the extent of the problem. The inability to swallow can be caused by an issue with the swallowing reflex, or from an injury, tumor or foreign body, so be sure to relate any symptoms or incidences to your veterinarian. It is highly important to correctly diagnose the true cause, and to note any secondary symptoms that need immediate treatment.
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Cricopharyngeal dysfunction is also known as cricopharyngeal achalasia. The cause is usually unknown. This muscle is always contracted except at the moment of swallowing, when it relaxes briefly to let food or liquid pass through. Symptoms and treatment for cricopharyngeal dysfunction: Typically, individuals with cricopharyngeal dysfunction first notice that pills or solid food begin to lodge at the level of the lower part of the larynx.
The problem tends to progress inexorably, though often slowly, as the years pass, until the individual must limit himself or herself to liquid and soft foods. Cricopharyngeal dysfunction is fully resolved through a straightforward surgical procedure cricopharyngeal myotomy , performed through the mouth with the laser or, only occasionally, through a neck incision.
Photos: Cricopharyngeal dysfunction, before and after myotomy: Series of 2 photos Cricopharyngeal dysfunction: before myotomy 1 of 2 Lateral x-ray of the neck while swallowing barium seen as a dark column. The non-relaxing cricopharyngeus muscle light-grey bulge outlined by a dotted line is causing narrowing of the upper esophageal passageway, as highlighted by the narrowed stream of dark barium at that point arrow.
Liquids and very soft foods can squeak through this narrow opening, but solid foods tend to get stuck. Cricopharyngeal dysfunction: after myotomy, resolved 2 of 2 After myotomy. The surgically divided muscle can no longer narrow the upper esophageal passageway, as seen by the widened stream of dark barium at the level of the muscle arrows. Very high-pitched voice elicits the same pharynx contraction as swallowing: Series of 4 photos Secretions 1 of 4 This person has cricopharyngeus dysfunction--the "catcher" problem described in the teaching video "Swallowing Trouble Here the patient produces the highest pitch she can make on "EEEE!
Cracker residue 3 of 4 After chewing and swallowing a cheese cracker, some residue remains in the vallecula and also in the swallowing crescent.
Pharyngeal walls 4 of 4 As the patient swallows, the pharyngeal walls come to near-approximation from lateral to medial, just before the view is lost during the upheaval of the swallow.
Cricopharyngeal dysfunction, before and after myotomy: Series of 2 photos Cricopharyngeal dysfunction: before myotomy 1 of 2 Lateral x-ray of the neck while swallowing barium the dark material seen here in the throat. Cricopharyngeal dysfunction: after myotomy, resolved 1 of 2 After myotomy. Reflux into hypopharynx, characteristic of cricopharyngeal dysfunction: Series of 3 photos Reflux into hypopharynx 1 of 3 The patient has swallowing problems typical of cricopharyngeal dysfunction.
In this photo, blue-stained water has just been swallowed, and the vocal cords are beginning to open. At this point, the hypopharynx contains no residue.
Reflux into hypopharynx 2 of 3 One second later, the blue-stained water begins to emerge from just above the cricopharyngeus muscle into the "swallowing crescent". Reflux into hypopharynx 3 of 3 Another two seconds later, the larynx has fully opened post-swallow.
The post-swallow hypopharyngeal re-emergence of the blue-stained water is apparent. Trace applesauce on pharyngeal walls, immediately after a completed swallow.
Un-relaxed cricopharyngeus muscle 3 of 4 During water administration, a glimpse of the un-relaxed cricopharyngeus muscle is seen concentric dotted lines. More water 4 of 4 After several more boluses of blue-stained water, the applesauce has mostly washed away, and the same findings of photo 3 are seen more clearly.
Bastian explains this progressive swallowing problem and presents options for treatment. Cricopharyngeal Dysfunction: Before and After Cricopharyngeal Myotomy This video shows x-rays of barium passing through the throat, first with a narrowed area caused by a non-relaxing upper esophageal sphincter cricopharyngeus muscle , and then after laser division of this muscle.
Preoperatively, food and pills were getting stuck at the level of the mid-neck, and the person was eating mostly soft foods. After the myotomy division of the muscle , the patient could again swallow meat, pizza, pills, etc.
Cricopharyngeal Achalasia in Dogs
Cricopharyngeal dysfunction (CPD)