A 4-month-old intact female Boston Terrier was presented for evaluation of regurgitation that had been present since being purchased about 3 weeks ago. Appetite was normal but with random regurgitation. There had been no improvement with symptomatic therapy (Metronidazole, Zithromax, Metoclopramide and FortiFlora). Physical examination and thoracic radiographs were both normal.
The pyloric outflow appears stenotic. A large amount of gastric fluid was present creating dilation of the gastroesophageal inlet and significant regurgitant pressure into the esophagus, which would explain the regurgitation history. Recommend exploratory surgery with expectations of evacuating the stomach, obtaining biopsies as well as manually manipulating the pyloric outflow and pyloroplasty is likely going to be necessary in this patient. Chest radiographs and assessment of the esophagus via radiographs would also be ideal. Screening for myasthenia would also be optimal in this case, though unlikely at this age.
Stomach in this patient was filled with fluid. Pyloric outflow in this patient presented progressively shadowing material 1.5 cm that may be persistent dependent chyme or foreign matter; however, the pyloric outflow appears stenotic. A large amount of gastric fluid was present creating dilation of the gastroesophageal inlet and significant regurgitant pressure into the esophagus, which would explain the regurgitation history.
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Persistent right aortic arch, gastric foreign body, pyloric stenosis, gastro-esophageal intussusception, hiatal hernia
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