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Regurgitation due to megaesophagus in a ram.

Regurgitation can be defined as the emptying of food from the esophagus through the mouth or nostrils after it has been swallowed but before it has reached the forestomachs. Regurgitated feed is mixed with saliva, not thoroughly chewed, and therefore appears green with most ovine diets. This differs from vomited feed which appears pulpy, fluid, and considerably chewed and has the odor and color of rumen content. Since we are not aware of any case report on regurgitation in sheep, we describe herein a 12-monthold White Alpine ram showing regurgitation due to megaesophagus. The ram belonged to a flock with six ewes. The animals were kept at pasture and were fed additional hay, a few turnips, concentrates, and mineral supplements. The ram had been purchased by the present owner four months before admission to the clinic. Since the purchase, the owner had observed that the animal "vomited" feed, that it suffered occasionally from mild bloat, and, additionally, had intermittent brown nasal discharge. The referring practitioner treated the ram unsuccessfully with neostigmine and several stomachic drugs containing tanning agents and bitter constituents of plant origin to stimulate digestion. Because the animal was a promising breeding ram, it was admitted to our clinic for diagnostic purposes. The animal was in a good nutritional state and wellgroomed. Vital signs and other body systems were normal. Both nostrils were soiled by dark, dried discharge due to frequent regurgitation through them. Examination of rumen fluid indicated moderate inactivation of forestomach flora and fauna. The parasitological examination of feces revealed a few oocysts of coccidia and a few strongyles eggs. Endoscopy of the nose, pharynx, and esophagus using a bronchoscope (Olympus BF, type P 10, Olympus Optical AG, CH-8702 Zollikon, Switzerland) revealed feed particles both in the ventral nasal meatus and in the pharynx. The esophagus appeared normal in the cranial region (about 20 cm). The caudal region was difficult to evaluate but it seemed to be dilated. No stricture, stenosis, or foreign body could be found. Lateral radiographs of the cervical and thoracic esophagus (taken in lateral recumbency after the administration of 50 mL of a barium sulphate suspension by esophageal tube) showed that the esophagus was markedly dilated in the thoracic area and contained a mixture of barium, feed, and gas (Figure 1).