Congenital Megaesophagus in Dogs

The small tube that connects from your dog’s mouth to his stomach is the esophagus. The walls of the esophagus have muscles that move like waves in order to push the food to your dog’s stomach. In dogs with congenital megaesophagus, their esophagus is lacking in muscle tone; while a typical esophagus will appear like a “muscular hose”, the esophagus of a dog with megaesophagus will look like a thin tube. Without the muscle of a typical esophagus, the food your dog eats will sit in his esophagus rather than travel to the stomach, leading him to regularly regurgitate his food.

Congenital megaesophagus is a condition that occurs in dogs at birth where the esophagus is lacking in muscle, leading to the dog regurgitating his food.

Symptoms of congenital megaesophagus are typically first seen when puppies are weaned and start to eat solid food; the most obvious symptom is likely that your dog will regularly regurgitate his food. In most cases, a problem will be evident by the time your dog is three months of age. In more mild cases, the symptoms may not be evident for up to one year. Other symptoms include:

• Excessive salivation
• Trouble swallowing
• Failure to thrive in puppies
• Aspiration pneumonia, also known as inhalation pneumonia (happens when your dog inhales into his lungs an infected material (likely food in the case of a dog with megaesophagus)

Types 

Megaesophagus is a congenital abnormality in the esophagus of your dog. Two other congenital conditions in the esophagus of dogs include:

• Vascular ring anomalies: this is when the esophagus is constricted by other tissue; this is more likely in Boston Terriers, German Shepherds and Irish Setters
• Cricopharyngeal achalasia: this is when the throat’s cricopharyngeal muscle won’t relax when swallowing; occurs in the toy breeds

Congenital megaesophagus is typically due to abnormal nerve development in your dog’s esophagus. This leads to the muscles being unable to carry the food that your dog eats from his mouth to his stomach. Breeds that are more likely to have congenital megaesophagus include:

• Chinese Shar-Peis
• Fox Terriers
• German Shepherds
• Great Danes
• Irish Setters
• Labrador Retrievers
• Miniature Schnauzers
• Newfoundlands

Your veterinarian will conduct an examination of your dog and ask you about the symptoms you have noticed and for how long they have been present. Should your dog be showing signs of a congenital condition of his esophagus, your veterinarian will have several options available to confirm the diagnosis. These include:

• Contrast imaging
• Radiography (this may show that your dog’s esophagus is filled with gas and distended)
• Fluoroscopy (this may show how the esophagus of your dog is functioning differently)
• A 3-D CT scan 

To confirm that the megaesophagus is congenital, your veterinarian may also consider an endoscopy or endocrine function testing. Your veterinarian will also examine your dog to ensure that he is not suffering from aspiration pneumonia, a common infection for those with congenital megaesophagus.

There is no cure for megaesophagus. There are a few things that you can do to best help your dog:

• Feed your dog a liquid diet or a diet of easily digestible, soft food. Food should be high in both protein and in calories
• Provide small quantities of food to your dog on a frequent basis; some dogs may do best with the food pureed and others may be more successful with wet food rolled into small meatballs
• Water should also be given in small amounts on a frequent basis
• Have your dog eat in an elevated position where your dog is standing on his hind limbs; this will allow gravity to help the food he has eaten travel to his stomach

Should your dog develop aspiration pneumonia during any time in his treatment, your veterinarian will prescribe antibiotics.

Congenital megaesophagus will require ongoing management. It is key that you work closely with your veterinarian on finding a diet that will provide your dog with the nutrients that he needs and a way to ensure that his food gets to his stomach, for example by having your dog eat in an elevated position. 

The interval at which your veterinarian will request a follow up visit will depend on the severity of your dog’s condition. During follow up visits, your veterinarian can examine your dog to make sure he is getting the nutrition he needs. 

As aspiration pneumonia is a common problem for dogs living with megaesophagus, it will be important for your veterinarian to make sure that your dog’s lungs are clear. Aspiration pneumonia can be fatal, so it will be helpful to gain a good understanding from your veterinarian as far as what symptoms to watch for in your dog so that he will have the best chance of recovery with early treatment.