Megaesophagus In Dogs – Symptoms & Treatments

Megaesophagus is a loss of esophageal motor function and is characterized by ineffective esophageal dilation and esophageal peristalsis. This is not considered to be a distinct disease as it is a combination disorder.

Perhaps, the term ‘Megaesophagus’ is a mouthful to utter, but when you break it down, it is easy to understand. Megaesophagus dogs have an inflated (mega) esophagus.

The esophagus (muscular tube connecting mouth and stomach, contracts to push food and liquid into the stomach) gets enlarged hampering its motility (its ability for food to move into the stomach). When food pipe motility is absent/decreased/interrupted, food and liquid mount up in the esophagus and causing them to regurgitate.

The normal functioning esophagus (when there is food in the mouth) stirs nerves that fire signals to the brainstem swallowing center which in turn shoots the swallow reflex. When these reflexes are disrupted (due to any esophageal disorders or by neurological reasons), the ability to actively transport food by the esophagus is messed up losing all the tone and becoming enlarged.

• Regurgitating food or water
• Excessive drooling
• Bad breath
• Refusing to eat
• Trouble swallowing/ Exaggerated or frequent swallowing
• Hacking sounds to try to clear the throat.
• Aspiration Pneumonia - Cough, fever, nasal discharge, lethargy, and poor appetite.

Megaesophagus treatment depends upon the management of the underlying cause (if there is any) and treating any secondary conditions like aspiration pneumonia.

In general, the treatment protocol is focused on averting regurgitation and making the food pass through the GI tract so that it can be digested.

Elevated feeding techniques are used to minimize the effects of gravity.

1. Step ladder feeding with food is placed on top and the dog should eat with his feet on the upper step and grab the food which is one step above.
2. Food is placed on top of a cardboard box at neck level.
3. Bailey Chair: Bailey chair is specially designed for vertical feeding as the pet sits in the upright position (floor: 45 - 90°). This post-feeding waiting period is 15 minutes in the chair. Owners of a megaesophagus dog named Bailey invented this chair to counteract regurgitation.

Surgery: Surgery may be necessary sometimes; if an underlying cause of the megaesophagus (such as foreign objects) has to be removed from the esophagus. This will provide immediate respite and prevents further complications.

• Make sure your dog stays vertical for about 15 minutes after you feed.
• Gravity takes care of everything and moves the food and water into the stomach. Water must also be given in this fashion.
• Change the food to a different texture or experiment with the food. Some animals do good with solid foods and some with liquid foods.
• Canned food can be rolled into small meatballs. The meatballs must be swallowed by the dog and this stimulates enough esophageal motility to easily pass through the esophagus.
• To ensure that the most nutrients are being absorbed, it is good to feed 3-4 small meals a day.

Check with your vet on the proper medication and the appropriate dosage for your dog.

Always act sensibly and make sure to keep all medications (for people and pets) in a safe place that is inaccessible to pets, if possible in a locked cabinet.

When you're taking medications and you drop any of the pills, don’t leave them on the floor.

Wire Fox Terrier, Miniature Schnauzer, German Shepherd, Newfoundland, Great Dane, Irish Setter, Shar Pei, Labrador Retriever, Adult Dogs

Types:

Congenital Megaesophagus:

Some breeds are predisposed. When the puppy is weaned from a liquid to a solid-food diet, Regurgitation is observed.

Acquired Megaesophagus:

Secondary Megaesophagus: Generally caused due to a neuromuscular disease such as myasthenia gravis, inflammation of the esophagus, an esophageal tumor, parasitic infections, a foreign body in the esophagus, or some form of toxicity.

Idiopathic Megaesophagus: Late-onset and occurs in older dogs without no known cause.

Causes:

Congenital Megaesophagus is hereditary.

Acquired Secondary Megaesophagus occurs secondarily to another condition or disease including:

• Esophagus autoimmune disorders (e.g., myasthenia gravis).
• Trauma or Degeneration in the spinal cord or brain.
• The esophagus blockage by scar tissue or tumor or a foreign body.
• Hormonal disorders (e.g., hypoadrenocorticism (Addison's Disease), hypothyroidism).
• Toxin exposure /Severe inflammation of the esophagus.

Morbidity:

Regurgitation Vs Vomiting:

The most salient clinical sign is postprandial regurgitation. This is different from vomiting. Vomiting is an active business as a pet will gag; heave and the body actively retches or expel the stomach contents. Pets will have a connected sensation of nausea prior to vomiting even humans have. Your pet may also lick its lips or drool before vomiting indicating nausea. Nevertheless, regurgitation is a passive process. Food and water splashes in the esophagus and gravity make it released back up. With respect to regurgitation, there is no heaving, gagging, or retching.

Diagnosis:

• X-rays, contrast medium such as barium
• Fluoroscopy or endoscopy
• Electrical tests to assess the nerve-muscle connection
• Nerve-muscle biopsy

Mortality:

Megaesophagus in dogs due to cancer and toxins are fatal and the mortality rate is actually higher.

Prognosis:

Prognosis depends on the diagnosis and appropriate treatment for acquired cases of megaesophagus.

Very severe cases with aspiration pneumonia have a poor prognosis.

Right away transport your pet to the closest vet clinic, if you suspect drug poisoning or when your dog is showing any signs of distress.

• Regurgitating food or water.
• Hacking sounds to try to clear the throat.

• Meatballs of homemade or canned dog food.
• A thicker gruel.
• A thin slurry of food and water.
• Soaked kibble.
• Gelatin squares (often called “Knox blocks”) for dogs that are unable to get liquid to meet their needs.
• Yogurt/cheese/oatmeal.
• Pedialyte (unflavored).
• Peanut butter “soup".
• Pureed rice/chicken.
• Baby cereal/ baby food meats.

Sadly, most dogs with megaesophagus have really guarded prognosis with or without treatment. The risk for other complications is really high. Aspiration pneumonia and Malnutrition are the main causes of death.

For a megaesophagus caused by a nervous system anomaly, the possibility for other neurologic problems to develop is higher. Esophageal functions can be improved by successful treatment of underlying conditions.