Posted: Dec. 12, 2008, 3 a.m. EST
Q: I have a 7-week-old kitten who has been diagnosed with megaesophagus aortic arch condition; she is very healthy otherwise. One vet says put her down, while another vet says liquid diet then surgery. Do you have any other options in terms of her diet, or less invasive surgery options? I appreciate any advice.
A: The condition you’re describing is called persistent right aortic arch, and is very rare in cats. I’ve been a veterinarian for 20 years, and have yet to have a case of this. When cats are fetuses, they have some blood vessels in their chest cavity called aortic arches. These vessels atrophy and disappear as the fetus grows. Occasionally, one of the aortic arches, called the right aortic arch, fails to atrophy and disappear. This arch runs near the esophagus. If this vessel persists, it can trap the esophagus,inhibiting its normal growth and development, preventing food from getting to the stomach. The main symptom is regurgitation immediately after eating and stunted growth. Symptoms usually appear before 6 months of age.
Surgical removal of the persistent aortic arch is the best treatment. It should be done early in the course of the disease, before permanent damage to the esophagus occurs. Because the persistent arch is compressing the esophagus, solid food can’t get past the narrowed area, but liquid food may be able to pass. This usually only helps temporarily. Your cat will eventually need surgery before permanent damage to the esophagus occurs.
Anesthesia is certainly a major risk in a 7-week-old kitten. A liquid diet can be fed temporarily to try to put some weight on the kitten and get her into the best shape you can before having the surgery done. This is an advanced surgery that will need to be performed at a referral center by a board-certified surgeon. It is bound to be fairly pricey. If you can afford it, however, I’m in favor of trying it. If successful, this kitten can end up leading a normal life afterward.