Megaesophagus in Dogs
The esophagus is a muscular tube that connects the mouth to the stomach. In the condition known as megaesophagus, the esophagus is enlarged with loss of the normal ability to push food toward the stomach. The diseased esophagus is like a deflated balloon; it passively collects food and water until it can take no more, at which point the pet regurgitates all that was just swallowed.
Megaesophagus is seen most often in dogs, but can occur in cats as well. Some pets are born with this condition while others develop it later in life. Some dog breeds that seem predisposed to megaesophagus include: Miniature Schnauzers, German Shepherds, Dachshunds, Great Danes, Irish Setters, Labrador Retrievers, Pugs, and Shar-peis.
Symptoms of megaesophagus include: regurgitation (the expelling of food/water without retching or abdominal effort), changes in appetite, excessive drooling, nasal discharge, or vomiting (the forceful expulsion of food/water with abdominal effort). Megaesophagus makes pets more prone to aspiration pneumonia which can lead to coughing or harsh breathing sounds.
Causes of megaesophagus can include:
Diagnosis of megaesophagus starts with a thorough medical history and physical examination by your veterinarian. The questions your veterinarian will ask you are aimed at determining if your pet is regurgitating or vomiting (this seems like a small distinction, but is important in ruling out underlying diseases). The shape of expelled material, presence of undigested food, and length of time from ingestion to expulsion are things that you should make note of at home. Routine laboratory tests to evaluate the cells of the blood and organ function are often normal for pets with megaesophagus, but these tests are important to perform to address underlying disease or aspiration pneumonia. Xrays of your pet's chest will often show an enlarged esophagus filled with fluid, air, or food. More advanced imaging with endoscopy is sometimes needed for diagnosis of megaesophagus, removal of foreign bodies within the esophagus, or biopsy of tumors.
The main goal of megaesophagus therapy is to address the underlying cause if there is one. Dogs with megaesophagus often require life-long therapy, commitment, and patience. While some pets can be managed, many carry a poor prognosis depending on severity of symptoms. Some animals may die due to complications such as aspiration pneumonia.
Symptoms of megaesophagus include: regurgitation (the expelling of food/water without retching or abdominal effort), changes in appetite, excessive drooling, nasal discharge, or vomiting (the forceful expulsion of food/water with abdominal effort). Megaesophagus makes pets more prone to aspiration pneumonia which can lead to coughing or harsh breathing sounds.
Causes of megaesophagus can include:
- Idiopathic or congenital disorder
- Neuromuscular disease such as myasthenia gravis, distemper, or myositis
- Tumor or foreign body within the esophagus
- In many cases, the underlying cause is not found
Diagnosis of megaesophagus starts with a thorough medical history and physical examination by your veterinarian. The questions your veterinarian will ask you are aimed at determining if your pet is regurgitating or vomiting (this seems like a small distinction, but is important in ruling out underlying diseases). The shape of expelled material, presence of undigested food, and length of time from ingestion to expulsion are things that you should make note of at home. Routine laboratory tests to evaluate the cells of the blood and organ function are often normal for pets with megaesophagus, but these tests are important to perform to address underlying disease or aspiration pneumonia. Xrays of your pet's chest will often show an enlarged esophagus filled with fluid, air, or food. More advanced imaging with endoscopy is sometimes needed for diagnosis of megaesophagus, removal of foreign bodies within the esophagus, or biopsy of tumors.
The main goal of megaesophagus therapy is to address the underlying cause if there is one. Dogs with megaesophagus often require life-long therapy, commitment, and patience. While some pets can be managed, many carry a poor prognosis depending on severity of symptoms. Some animals may die due to complications such as aspiration pneumonia.
- It is important that dogs with compromised feed intake are meeting their daily nutritional requirements. In order to have your pet take in enough calories, work with your vet to find a tasty, high calorie, low volume food (which may need to be blenderized into a slurry or softened to make it easier to keep down). Exactly what to feed is sometimes a matter or trial and error. Each patient seems to have an ideal food consistency, which can vary between individuals.
- Your pet will need to remain erect while eating or drinking from a elevated position for 15 to 20 minutes- gravity will help the flow of food from mouth to stomach. This can be accomplished by use of a "Bailey Chair"- this is device that will allow your pet to sit upright during and after a meal. Scroll down to see an example of a pet in a Baily Chair.
- To optimize nutrition, you will likely need to feed your pet multiple, small meals throughout the day. You will need to prevent the pet from having access to food and water outside of monitored feeding times in order to help prevent aspiration pneumonia.
- You should weigh your pet routinely to help keep track of body condition.
- Aspiration pneumonia is life-threatening and may necessitate hospitalization, oxygen therapy, and/or antibiotics.
