Expanding tube helps repair dog’s damaged throat

A dog unable to eat due to a serious constriction in his throat has made a complete recovery after a therapeutic tube was placed in his oesophagus.

The device, known as an oesophageal balloon dilation feeding tube, or B-tube, allowed the narrowed section of the dog’s throat to be gently restored to its normal size over time through repeated inflation of an integrated balloon. 

It also removed the need for multiple, separate dilations under general anaesthesia, while enabling 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 similar conditions.

New technology

The B-tube is a new device, developed in the US, to treat animals with an abnormal narrowing, otherwise known as a stricture, of the oesophagus. The Hospital for Small Animals is one of only a handful of places in the UK with experience of 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 through the feeding tube, as well as how and when to inflate the integrated balloon. 

The repeated dilations help to break down any scar tissue on the oesophagus 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 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.

Clinicians performed fluoroscopy, an imaging technique that displays a continuous X-ray image, to monitor Colt’s digestive tract, and identified a 9cm narrowing in his oesophagus.

After consultation with Colt’s owners, fitting a B-tube was decided as the best course of action owing to the size of the stricture, Colt’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 Colt to be discharged into his owner’s care for ongoing treatment. 

Treatment at home

Colt was discharged two days following surgery and his B-tube remained in place for 6 weeks. His owners were trained how to inflate the balloon twice a day, which Colt tolerated well. Colt was also able to eat by himself following surgery.

After removing his B-tube, Colt 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, persistent vomiting or if the oesophagus is damaged by a foreign body. 

Normally, treatment involves a series of frequent balloon dilations under anaesthetic. As anaesthesia itself can promote reflux of stomach acid, there is a risk of repeated reflux events that could make the stricture worse, so the overall success of the method can be unpredictable.

With the availability of the new B-tubes, clinicians are hoping to reduce the potential negative effects of repeated traditional balloon dilations under anaesthetic, 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