Megaesophagus in Dogs

Since the food and water are not making their way into the stomach, your dog is not getting the nutrients needed to maintain a healthy body. Megaesophagus can occur at any age and there are several breeds of dogs that have an increased prevalence. Those breeds include the Wire-haired Terrier, Miniature Schnauzer, Great Dane, German Shepherd, Labrador Retriever, Newfoundland, Chinese Shar-Pei, Irish Setter and Greyhound.

Megaesophagus is when the muscles of the esophagus do not work and food and water cannot be moved into the stomach. As a result, the food and water stay in the esophagus within the chest cavity and are never pushed into the stomach. The food and water that are stuck in the esophagus may at some point cause your dog to aspirate the contents, resulting in aspiration pneumonia.

Megaesophagus is very difficult to diagnose so if you notice any of these symptoms, call your veterinarian and schedule an immediate appointment. 

• Regurgitation
• Refusing to eat
• Loss of appetite
• Sudden weight loss
• Exaggerated or frequent swallowing
• Coughing
• Sour or foul smelling breath
• Aspiration pneumonia
• Nasal discharge
• Poor growth
• Increased respiratory noises
• Extreme hunger
• Excessive drooling

Megaesophagus can be congenital or acquired. There is often no known cause when a dog is diagnosed with congenital megaesophagus. They are simply born with the condition. In many of these cases, megaesophagus is not diagnosed until the puppy is weaning, making it more difficult to diagnose it as congenital. Persistent Right Aortic Arch is one consideration.

Acquired megaesophagus commonly has no known cause, either. When a cause can be determined, it is generally from a neuromuscular disease such as myasthenia gravis, an esophageal tumor, inflammation of the esophagus, some form of toxicity, a parasitic infection or a foreign body in the esophagus.

Your veterinarian will do a thorough physical examination and will palpate the throat area of your dog. While the examination is in progress, your veterinarian will ask you a series of questions regarding your dog’s symptoms. Be sure to answer with as much information as possible to help your veterinarian make a proper diagnosis.

A radiograph or x-ray will be done, although it can sometimes be difficult to see an enlarged esophagus. A barium swallowwill also be given so that the esophagus will stand out on the x-ray. A CT myelogram may be performed.

A CBC or complete blood count, urinalysis and biochemistry profile will be conducted, although these tests usually come back as normal with megaesophagus. Underlying conditions, however, can be found with these tests. 

Your veterinarian may also use an esophagoscopy to examine the interior of the esophagus. A thin, tube like tool with a lens and light is inserted into the esophagus to see if there are any foreign objects, neoplasia or other obstructions.

Any underlying condition must be managed first. The main goal of a treatment plan is to manage the disease. There are several options available to manage megaesophagus. Your dog can still live a good life, even when diagnosed with megaesophagus. 

Surgery

If an underlying cause of the megaesophagus has been found, surgery may be an option. When foreign objects are found within the esophagus, surgery may be necessary to remove the object and provide immediate relief while preventing further complications.

Hospitalization

If your dog has been diagnosed with aspiration pneumonia, immediate hospitalization may be required as it can be life-threatening. Your dog will have constant medical care including oxygen therapy, IV fluids. and aggressive antibiotics.  

Management

Your veterinarian will recommend that your dog be placed in a slanted or even completely vertical position when eating. Usually a slanted platform with your dog’s upper body elevated at about a 45 degree angle will do the trick.  There is also a Bailey Chair where the dog is completely upright when eating. Make sure your dog stays upright for about 30 minutes after eating. This allows gravity to work with your dog to move the food and water into the stomach. Water must also be given in this fashion.

Changing food to a different texture or a canned food rolled into small meatballs works best for dogs with megaesophagus. The meatballs should be swallowed whole for easier passing through the esophagus. Feed 3-4 small meals a day to ensure that the most nutrients are being absorbed. 

Medication

Acid reducers given 1-2 times daily and a motility drug such as low dose erythromycin can help your dog by minimizing any acid reflux from the stomach from entering the esophagus.

Your dog can live a relatively normal life with megaesophagus if the disease was detected early and appropriate feeding techniques are being used. Also, you must learn to recognize the signs of aspiration pneumonia and seek immediate treatment when it occurs. 

You have to be fully committed to caring for your dog and providing a safe, elevated feeding platform for your dog as well as continual monitoring of food intake and possible aspiration pneumonia. 

Your veterinarian will set up an appropriate treatment plan for your dog. Be sure to follow all instructions given and if your dog’s condition worsens or there are significant changes, contact your veterinarian immediately. Some dogs that have been diagnosed late will not be receptive to treatments and their quality of life can be diminished.