Dog Health: Megaesophagus
Are you familiar with the dog health problem of megaesophagus? Chances are that you’ve never heard of it. As a dog owner and former breeder and trainer, I’d heard of mesaesophagus in dogs before, but I didn’t really know much about it. I’ve never had a pet with the condition. We just found out today that my grandpup, Kayla, has it. She’s a Great Dane and just delivered a littler of Great Dane puppies two weeks ago. Last Saturday, she was admitted to the animal hospital for kennel cough, and the vet thought the pooch would get to go home in a day or so. We were bottle feeding the puppies while Kayla was away. Today, after some tests and x-rays, we were told that Kayla’s kennel cough has cleared up, but now she has another condition called Canine Megaesophagus. The vet doesn’t know if Kayla will ever recover from this condition. When I got that email, I interpreted it to mean that this dear, sweet dog wouldn’t survive. Thankfully, that’s not what the vet meant. Kayla will most likely survive, but she might have canine megaesophagus for the rest of her life. Her owners, my daughter and her family, will have to take extra steps to provide special feeding and watering. Continue reading to learn more about megaesophagus and how it affects dog health.
Megaesophagus doesn’t just affect dogs. It can also affect felines, ferrets, and humans. To understand the condition, you first need to understand the esophagus itself. The esophagus is the tube that leads from the back of the throat, or the pharynx, to the stomach. It’s the passageway for food and liquids. Muscles in the esophagus push food and water into the stomach through a squeezing action, called peristalsis. With megaesophagus, the esophagus becomes enlarged, and the muscles in the esophagus fail to do their job. The affected person or animal can’t get nutrients to their stomach, and food just sits in the esophagus, is aspirated into the lungs, or is regurgitated.
The condition varies by degrees. Cases can range from mild to severe. Sometimes the problem might worsen over time, but in other individuals, it can remain the same for years. Since the severity varies, some animals will be able to benefit by a little food actually reaching the stomach, where it can be digested and the nutrients absorbed. In severe cases, however, practically no nutrients ever reach the stomach.
Megaesophagus in Dogs:
Megaesophagus in Dogs
Megaesophagus in dogs is basically the same as it is in humans. Swallowed food can’t reach the stomach and is regurgitated, aspirated, or remains in the esophagus. Regurgitating food can cause inflammation, aspirating food can cause pneumonia, and food that stays in the esophagus decays, causing a new set of dog health problems.
What causes megaesophagus in dogs? That depends on the type. There are two types of the condition: congenital and acquired. Sometimes it accompanies another disease or condition, including thyroid disorders, Addison’s disease, or Myasthenia Gravis. Some puppies are born with a genetic cause for megaesophagus which doesn’t usually become evident until the affected puppy begins eating solid food. Sometimes, veterinarians aren’t sure of the cause, especially with adult dogs.
In Kayla’s case, her veterinarians think hers began with kennel cough. She, along with two of our dogs, had kennel cough a week or so ago. Kayla was very sick with kennel cough, and she experienced coughing, vomiting, fever, and loss of appetite. The theory is that the vomiting inflamed her esophagus and led to megaesophagus. That makes sense to me. If the cause were genetic, she would have exhibited symptoms of canine megaesophagus long ago. She’s six years old.
Some dog breeds are more prone to this condition than others. These dog breeds include the Labrador retriever, golden retriever, Irish setter, greyhound, miniature schnauzer, Shar-Pei, Shih Tzu, dachshund, wirehaired fox terrier, German shepherd, Welsh terrier, Newfoundland, and French bulldog. Add to that list the Great Dane. The Dane is one of the dog breeds that are most often susceptible to the condition.
This can be a serious condition, and with the constant threat of aspiration pneumonia, it can be deadly. Rarely is there a cure for megaesophagus, but sometimes, if the condition is secondary to another dog health problem, it might reverse if the primary condition is cured or managed well. For example, Kayla was found to have low thyroid function and has been placed on proper medication. If the hypothyroidism can be addressed, the vet says Kayla's esophagus function might improve. In rare cases, surgery might be successful. Otherwise, the condition will have to be carefully managed instead of being cured. Kayla’s family will have to be very specific in how and what she’s fed. Because nursing the puppies would put an extra burden on Kayla’s nutritional needs, the litter will have to continue to be bottle fed puppy milk. We’re using Esbilac puppy milk replacer, and the pups are thriving. I’m helping with bottle feeding puppies, as one of the Great Dane puppies is mine. The litter had a health check the other day, when they were two weeks old, and my little guy weighed almost four pounds. He attacks the bottle with enthusiasm and sucks down the Esbilac in no time!
You’re probably wondering about megaesophagus symptoms. One of the major symptoms of megaesophagus is regurgitation, which is different than vomiting. Vomiting is more of a voluntary action, in a way. You usually know beforehand that you’re going to throw up, and your abdominal muscles contract forcefully. With regurgitation, there’s no warning, and there’s no effort. The food just comes back up.
Other megaesophagus symptoms are lack of appetite and refusing food. Swallowing is usually difficult, and as a result, the swallowing action appears to be exaggerated. The canine might also hack a lot and try repeatedly to clear its throat. If food is “stuck” in the esophagus, you can often smell the decay on the dog’s breath.
Because eating and swallowing are so difficult, and because the dog’s food isn’t reaching the stomach and being digested, the dog usually loses weight. My daughter went to visit Kayla today, and she was shocked at how emaciated the dog was. And even though they’ve been giving Kayla IV fluids when she would leave in the line, she’s very dehydrated. As I’ve mentioned, she was nursing her puppies before going to the veterinary hospital, but all her milk has dried up now. Even when she comes home, I don’t think it would be fair to require her to produce milk in addition to getting enough nutrients for her own health. We plan to continue bottle feeding puppies for at least four more weeks.
Diagnosing Megaesophagus in Dogs
Diagnosing megaesophagus in dogs isn’t always easy…at first. The regurgitation can be mistaken for vomiting, so the condition somewhat mimic an upset stomach. For several days, Kayla’s veterinarian thought her symptoms were being caused by kennel cough. When the symptoms persisted, however, and more regurgitation occurred, the vet knew there was another problem. She took x-rays, and they confirmed the diagnosis of megaesophagus.
Regular x-rays will usually show signs of megaesophagus. A thoracic series, for example, can reveal air, fluid, or food in the esophagus. Small amounts of fluid and air are normal, but larger amounts aren’t. A standard x-ray can also reveal that the esophagus is dilated. An x-ray with a barium contrast might be used, as any enlargement of the esophagus will be better revealed. In some cases, fluoroscopy is used to show the constant motion of the esophagus.
Occasionally, canine megaesophagus will resolve on its own, especially in puppies. Usually, however, this isn’t the case. The most important element in megaesophagus treatment is to feed and water the dog in a vertical position. Doing so allows the force of gravity to take the food into the stomach. Affected dogs can’t just be fed anything, either. The food must have the right consistency, and that consistency varies from dog to dog. The vet is experimenting with which foods will be best for Kayla and what consistency they should be. Some dogs do better with a thin gruel, some do best with a milkshake consistency, and others might handle “balls” of soft food better. Some vets recommend a food that’s low in protein, fat, and fiber and high in carbohydrates. Affected dogs should be fed several times a day. For more tips on feeding a dog with megaesophagus, click this link.
Some dog owners chose to have a permanent feeding tube inserted into their pet. A feeding tube can make delivering nutrients easier for the dog owner, but the presence of the tube can be uncomfortable for the animal. Also, having feeding tubes inserted and changed regularly can be very expensive.
As part of megaesophagus treatment, some veterinarians suggest using an acid reducer like Maalox, Pepcid, or Pepto-Bismol. Carafate, the brand name for sucralfate, might also be prescribed. Carafate protects the esophagus from acid. With megaesophagus, ulcers often form in the esophagus, and Carafate helps prevent those. Your vet might also suggest vitamin supplements to ensure that your pet is getting the right vitamins and minerals.
Another part of megaesophagus treatment is recognizing the symptoms of aspiration pneumonia, which is a very real and common problem for dogs with megaesophagus. Symptoms of aspiration pneumonia include coughing, fever, breathing difficulties, and listlessness. If you notice any of these in an affected canine, get the pooch to your vet as soon as possible.
Bailey Chair feeding:
Many owners who have a dog with megaesophagus use a device called a Bailey Chair for feeding and watering. Basically, a Bailey Chair is a tall, narrow box with three sides and a bottom. The front is open, and there’s usually a bar across the top of the open side of the box. The dog is trained to sit up in the box, in a begging position, with its front paws resting on the bar. Most owners line the box with padding, and oftentimes the bar, so that the canine will be more comfortable. The above videos show dogs eating from a Bailey Chair.
You can build your own Bailey Chair if you’re handy. You can find plans online, but remember that the chair has to be a customized fit in order to work well. If you prefer buying a Bailey Chair that’s already made, Amazon has one. You can see it in the capsule above. Luckily, my husband is great at building, so he’s making a Bailey Chair for Kayla. Once it’s completed, I’ll post the photographs.
For dog owners who don’t want to use a Bailey chair, they often use some other device for feeding. Some strap their dog into a baby’s or child’s car seat to eat and drink, while others might use a harness clipped to a chair or other structure. Small dogs with megaesophagus might be able to be held up while eating or propped up in the corner of a chair or sofa. Larger dogs might be trained to use a ladder or stepstool while eating.
Whether you use a Bailey Chair or some other method for feeding a dog with megaesophagus, it’s important to always feed in the vertical position. That means keeping no sources of food where your pet can get to them while you’re not watching. After the canine eats, it should remain in the upright position for 20-30 minutes, to give gravity time to work. Of course, dogs also need adequate water, which also has to be given in the vertical position. Some owners prefer including adequate water in the dog’s food. You’ll also need to closely monitor the dog’s weight to make sure it’s getting enough calories and nutrients, and remember to watch for aspiration pneumonia. With the right care, many dogs with megaesophagus can live a full, happy life.