Clinical presentation, diagnosis, and treatment of caudal mediastinal paraesophageal abscesses in dogs: a multi-institutional retrospective study.

CT-guided diagnosis and surgical drainage with antimicrobials yield favorable outcomes in canine caudal mediastinal paraesophageal abscesses.

This multi-institutional retrospective cohort study describes the clinical presentation, diagnosis, management, and outcomes of caudal mediastinal paraesophageal abscesses (CMPA) in 12 client-owned dogs. The most common presenting complaints were inappetence and lethargy, with tachypnea and dyspnea frequently noted on physical examination. All 12 dogs underwent CT imaging, which served as the primary diagnostic modality. In 7 of 12 dogs, the CMPA was located within the mediastinal serous cavity. Esophageal communication was identified in 3 dogs, all of which had concurrent esophageal foreign bodies, suggesting foreign body migration as a potential etiopathogenic mechanism. Ten dogs underwent surgical intervention involving abscess drainage (n=8) and debridement (n=7), combined with systemic antimicrobial therapy. Two dogs were managed non-surgically or did not survive to surgery. All dogs that survived surgery were successfully discharged from the hospital. No recurrence was documented in dogs with available long-term follow-up data. The study concludes that CMPA in dogs presents with nonspecific clinical signs, making advanced imaging essential for definitive diagnosis. CT is the recommended imaging modality of choice due to its ability to characterize abscess location, extent, and potential esophageal involvement. Surgical drainage, debridement, and targeted antimicrobial therapy are associated with a favorable short- and long-term prognosis, supporting an aggressive but rewarding treatment approach for this uncommon condition.

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