CASE REPORT Suspected clindamycin-associated oesophageal injury in cats: five cases Julia A Beatty BSc(hons), BVetMed, PhD, FACVSc (Feline Medicine), MRCVS 1 *, Nigel Swift BVetMed, Dip ACVIM (Small Animal Internal Medicine), MRCVS 2 , Darren J Foster BSc, BVMS, PhD, FACVSc (Feline Medicine) 3 , Vanessa RD Barrs BVSc(hons), MVetClinStud, FACVSc (Feline Medicine) 1 1 Valentine Charlton Cat Centre, Faculty of Veterinary Science, University of Sydney, NSW 2006, Australia 2 Animal Referral Hospital, 444 Liverpool Road, South Strathfield, NSW 2136, Australia 3 Veterinary Specialist Centre, PO Box 307, North Ryde, NSW 2113, Australia The clinical findings, treatment and outcome of suspected clindamycin-associated oesophageal injury in five cats are reported. All cats were treated with one 75 mg clindamycin capsule twice daily (dose range 12e19 mg/kg). Capsules were administered without food or a water bolus. Dysphagia, regurgitation, choking or gagging were seen 3e9 days after starting clindamycin. On oesophagoscopy, three cats had oesophagitis, one of which progressed to stricture formation. Two cats had an oesophageal stricture at first presentation. This is the first report of suspected clindamycin-associated oesophageal injury in cats. It serves to further alert practitioners to the potential for drug-induced oesophageal disorders (DIOD) in cats treated with oral medications and to urge prevention by promoting a change in dosing practices. Date accepted: 24 April 2006 Ó 2006 ESFM and AAFP. Published by Elsevier Ltd. All rights reserved. D rug-induced oesophageal disorders (DIOD) are a common clinical diagnosis in humans with normal oesophageal function (Boyce 1998). Over 70 medications have been implicated and more than half of all cases are caused by antibiotics (Levine 1999). Improper ingestion promoting prolonged oesophageal re- tention is crucial in the pathogenesis (Kirkendall 1999). Severe oesophageal damage resulting in stricture formation has been associated with the administration of doxycycline hydrochloride by dry swallow to cats (Melendez et al 2000, Leib et al 2001, McGrotty and Knottenbelt 2002, German et al 2005). We report the clinical findings, treatment and outcome of five cases of suspected clindamy- cin-associated oesophageal injury in cats. Case reports Case 1 An 8-year-old female neutered Birman cat was presented with a 2-week history of regurgitation and weight loss. Seventeen days prior to presentation, the cat had been treated for chronic, intermittent bilateral nasal discharge with clinda- mycin hydrochloride capsules (Antirobe; Pfizer) (17 mg/kg per os every 12 h). After 3 days of treat- ment, the cat was noted by the owner, a veterinary student, to regurgitate during eating. Treatment was stopped but the cat continued to regurgitate and was presented to the Valentine Charlton Cat Centre (VCCC). No major abnormalities were de- tected on physical examination, routine haematol- ogy, serum biochemistry or thoracic radiographs. On oesophagoscopy, an area of circumferential, oesophageal ulceration was observed 3e5 cm dis- tal to the proximal oesophageal sphincter (Fig 1). The cat was treated with parenteral prednisolone sodium succinate (Solu Delta Cortef; Pharmacia) (1 mg/kg subcutaneously every 24 h) amoxycilline clavulanate (Clavulox; Pfizer) (14 mg/kg SC every 12 h), omeprazole (Losec; Astra Zeneca) 1 mg/kg intravenously over 1 h every 24 h) for 2 days and sucralfate suspension (Carafate; Aspen Pharmacare) (250 mg PO every 12 h  7 days). Solids were withheld for 24 h and intravenous *Corresponding author. E-mail: jbeatty@vetsci.usyd.edu.au Journal of Feline Medicine and Surgery (2006) 8, 412e419 doi:10.1016/j.jfms.2006.04.006 1098-612X/06/060412+08 $32.00/0 Ó 2006 ESFM and AAFP. Published by Elsevier Ltd. All rights reserved. at University of Sydney on May 22, 2013 jfm.sagepub.com Downloaded from