B-tube repairs oesophageal stricture in dog

A young dog with a large oesophageal stricture has made a complete recovery after being fitted with an oesophageal balloon dilation feeding tube, or B-tube.

The device allowed the stricture to be repeatedly ballooned at home by the dog’s owners, removing the need for multiple, separate dilations under general anaesthesia, while also providing adequate nutrition through the tube. 

Clinicians at the University of Edinburgh’s Hospital for Small Animals are now looking to increase their use of B-tubes in other dogs and cats with strictures.

New technology

The B-tube is a new device, first developed in the US, to treat animals with strictures. The Hospital for Small Animals is one of only a handful of places in the UK with experience of successfully placing B-tubes in its patients.

The stricture is dilated under anaesthaesia with progressively larger balloons before a B-tube is fitted. Following recovery, the patient’s owner is trained how to provide the correct amount of nutrition to the patient through its feeding tube and how to inflate an integrated balloon twice a day for several weeks. This helps to break down the scar tissue and reduce the risk of recurrence of the stricture.

Successful case

Colt, a two-and-a-half-year-old Labrador, was referred to the Internal Medicine Service of the Hospital by his primary vet, after losing 20 per cent of his body weight due to persistent regurgitation of his food, following gastroenteritis that developed after a general anaesthetic procedure.

Fluoroscopy identified a 9cm stricture in the young dog’s oesophagus.

After consultation with the owners, a B-tube was decided as the best course of action owing to the extensive stricture, the dog’s need for assisted nutrition due to his marked weight loss, and the likely need for multiple balloon procedures under anaesthesia to repair the stricture. Placing the B-tube also enabled the dog to be discharged into his owner’s care for ongoing treatment. 

The dog was discharged two days following surgery and the B-tube remained in place for 6 weeks. The clients inflated the balloon twice a day, which the dog tolerated well, and was able to eat by himself following surgery.

After removing the B-tube, the dog continued to eat a softened GI low-fat food by himself. Within 2 months, he had returned to his original food, was no longer regurgitating and was back to his normal target weight. 

Oesophageal strictures

Although not common, oesophageal strictures can be very debilitating. They usually occur following gastro-oesophageal reflux during general anaesthesia, or after injury of the oesophagus - for example by a foreign body - or due to chronic vomiting. Normally, treatment involves a series of frequent balloon dilations under anaesthetic. As anaesthesia itself can promote gastro-oesophageal reflux of stomach acid, there is a risk of repeated reflux events further exacerbating the existing stricture, so the overall success of this method can be unpredictable.

With the availability of the new B-tubes, clinicians are hoping to negate the potential negative effects of repeated traditional balloon dilations of oesophageal strictures, while maintaining the benefit of being able to stretch the patient's stricture repeatedly, while at home. 

“Colt is a lovely boy and we are pleased he has made a full recovery whilst avoiding the concerns of multiple anaesthetics. His care required close collaboration between our internal medicine team with many of our other specialist teams including anaesthesia and diagnostic imaging, as well as our specialist medicine and nutrition nurses. Importantly, Colt’s care was continued by his dedicated owners at home to achieve this positive outcome. We wish him well for the future.” 

Dr Tyler Morrison, ECATv-Clinical Lecturer in Small Animal Internal Medicine, Hospital for Small Animals

“We are forever grateful for all of the wonderful staff and students at the Hospital for Small Animals who treated Colt. He was incredibly unwell when he arrived and the treatment that he received and the aftercare that he still receives is outstanding. Colt is now bouncing back to his normal happy self. We can’t thank you enough for getting our boy back!” 

Colt’s owners