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Sunday, November 7, 2010

Painful Swallowing

Here's a case sent in by Kristin...

I have an 8 month old Maltipoo that I rescued 4 months ago. He was late getting his shots because the previous owners did not give him his shots. He has had his 6 in 1 shots but has not received Bordatella because I thought it was included in the 6 in 1.

Recently he has been sick. Slight cough, slight fever so I took him to the vet and he has been on antibiotics for approximately a week.

Nothing too abnormal about this scenario so far right? Well, here is where it gets interesting.
I told the vet the first thing I noticed about him being sick was an unusual behavior. When he would attempt to eat he would extend his front left leg out in front of him and whine in pain. He went off his feed entirely just prior to me taking him to the vet for about 3 days. The vet prescribed him doxycycline twice a day and he seems better in the sense that he is not lethargic, wants to play. However he still does not want to eat and still exhibits discomfort when he does try to eat.

I know you say its unlikely he would have anything stuck in his throat-as did my vet but he is acting normal with exception to this behavior and he refuses to eat. Whenever he does attempt to eat he extends that front leg and it seems painful to him. I've tried force feeding him baby food, canned food and soft table scraps. He wants to eat but then he remembers that its going to hurt and only eats a very little when hes practically starving.

If he did have kennel cough, wouldn't a weeks worth of doxy get him back on track-why is he still experiencing pain? Any thoughts, advise or experience you may have had with these symptoms would be so greatly appreciated. 

This doesn't sound like kennel cough to me, though I can't say for certain without having seen the patient.  Kennel cough normally causes a dry, resonant cough that can be easily stimulated with palpation of the trachea.  Doxycycline is a great antibiotic for this kind of infection, though it can take 10-14 days to fully resolve a case.  The pain and odd behavior that you describe isn't something that we see with kennel cough or other respiratory infections.

I'm a bit puzzled as to what could be causing the behavior based only on the description.  It sounds like there is pain in swallowing, which may be related to a problem in the esophagus. I would want to rule out some kind of stricture or narrowing of the esophagus, which can be very difficult to determine in a general practice.  The two best ways are with an endoscope or fluoroscopy.  Fluoroscopy involves a moving x-ray taken while a pet is in the act of swallowing, and requires special radiology equipment that you won't find in a private general practice.  Some veterinarians do have endoscopes, so this might be another option.

However, a simpler option could be pain from an inflamed throat or esophagus, similar to what happens to us when we have a sore throat.  This should improve with antibiotics, though it may take longer than a week.  Analgesics or steroids prescribed by your vet could also help.  I would recommending talking to your vet about this option first, and if you don't start seeing results within a few days look into further diagnostics.  Keep in mind that such diagnostics may involve being referred to a specialist and will not be cheap, but at the same time he can't go for long without eating easily.

Make sure to do follow-ups with your vet.  Good luck!