Megaesophagus in Dogs: A Mega Problem?

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The esophagus is a muscular, distensible organ that carries food from the mouth to the stomach. Megaesophagus is a common disorder in dogs that describes slow motility with resultant dilation of the esophagus. As a result of hypomotility, food will “pool” in the esophagus and stretch it. The stretching leads to damage to the nerves. This worsens hypomotility – a vicious cycle.

Megaesophagus can be either primary or secondary. In the primary case, an underlying cause is never discovered. It predominantly occurs in puppies, and rarely in an adult-onset form. Secondary occurs when some other predisposing condition such as myasthenia gravis, an autoimmune disease, develops, leading to the megaesophagus.

Primary Megaesophagus in Dogs

Congenital

Unfortunately, some puppies are just born with a flaccid, slow-moving esophagus. Breeds that are genetically predisposed include the wire-haired fox terrier and miniature Schnauzer, but any breed can be affected. Initial symptoms may not be seen until a puppy is transitioned from maternal milk to dog food. Then symptoms of regurgitation and secondary pneumonia are noted. Regurgitation is different from vomiting. It occurs almost directly after a meal. Often the food comes back up with no effort, almost like a burp, and no digestion has occurred.
A frequent, secondary consequence of regurgitation is aspiration pneumonia. As a puppy regurgitates while inhaling, food and stomach acid can be pulled into the lungs. In these cases, puppies must be treated for aspiration. This can include oxygen therapy, nebulization and coupage, and sometimes antibiotics. Hospitalization may be needed if the pneumonia is severe.

There is no surgical treatment for this type of megaesophagus; it can be managed with a variety of life-style changes. These include feeding and watering in an upright position (using a Bailey chair) with small, frequent, calorically dense meals. Some dogs do better with gruel while others prefer meatballs. It will depend on each dog’s ability to swallow.

A recent study (2017) showed some improvement in dogs with idiopathic/congenital megaesophagus when treated with sildenafil (Viagra). More studies need to be conducted to determine if this is a viable treatment option.

Megaesophagus is a lifetime condition, and any dog born with it must be closely watched for signs of aspiration pneumonia through their life.

Vascular Ring Anomalies

An important type of megaesophagus to mention that is both congenital and secondary is due to a vascular ring anomaly. In some breeds of dogs, particularly German shepherds, an abnormal blood vessel can persist instead of regressing during development. The most common type is a persistent right aortic arch (PRAA). When a dog is born, that extra blood vessel causes constriction as the esophagus passes through the chest. In front of the vessel, the esophagus is dilated. As a puppy starts to eat dog food, it becomes trapped in the area, dilating the esophagus.

This IS a fixable condition with surgery. However, after surgical repair, hypomotility may persist due to esophageal damage. Rapid diagnosis and treatment are essential to a good outcome. Any puppy that develops regurgitation at weaning should be immediately evaluated. X-rays with and without contrast can be done to diagnose this condition. If a persistent vascular ring anomaly is diagnosed, surgery can be done to snip the extra vessel. This is generally conducted by a board-certified surgeon, but there are general practitioners who have performed this surgery as well.

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Secondary Megaesophagus

The list of underlying causes for acquired megaesophagus is extremely long and includes muscle diseases like polymyositis, infectious disease such as tetanus, Addison’s disease, cancer, myasthenia gravis, toxins including lead and thallium, and trauma.

As with primary, there is no surgical correction for this. The underlying disease must be identified and treated. In some cases, this will significantly improve the megaesophagus, but due to the stretching, it does not always return to normal size and motility. As a result, megaesophagus may persist, leading to episodes of aspiration pneumonia.

One of the most common causes in older dogs is myasthenia gravis. This is a systemic, autoimmune illness in which the body’s immune system destroys important receptors in nerve endings. It results in generalized weakness, particularly worse after exercise. There is a medication to treat MG, and it can improve the motility of the esophagus.

Ruling out other causes can take an exhaustive list of diagnostics, so be patient while your veterinarian examines possible underlying causes. By keeping close tabs on your dog’s health and providing your veterinarian with a thorough history, the etiology of megaesophagus in dogs can often be discovered.

21 COMMENTS

  1. Is Megaesophagus regurgitating food or water? My Blue Staff/Pit x regurgitates if he drinks too much water, but can scoff down a whole bowl of food with no issues. If he drinks too much water, his regurgitation may contain a little food but is 90% water.

    Not sure if this is Megaesophagus or not and cannot afford the quoted £400 to run tests (just for tests – if confirmed, looking at over £2K for operation!!!!!! – Figure my vet maybe a hustler?). Because he’s had since birth (he’s now 2), insurance doesn’t cover. Dog seems in great shape (even Vet says he looks in fine fettle).

  2. In early March I emailed the editors a suggestion to write an article about ME in the WDJ. I never got a response and never saw a print version so thought it was never received.

    Today I stumbled on this piece. Now I wonder if it is coincidence or a direct result of my request.

    I learned everything I could in 2014 when my 14 year old Golden Retriever was diagnosed with ME. Contrary to one vet’s opinion, it was not a death sentence. A yahoo support group, a Bailey’s chair (which we donated to an ME group after she passed unrelated to ME) and a custom pillow designed to elevate her head while she slept were the main changes to her life. Partner with your vet and learn all you can.

  3. Dogs with hypothyroidism (even when treated by proper medication) have a higher likelihood of developing secondary megaesophagus. I have had TWO unrelated male Weimaraners to develop the condition after being hypothyroid for a period of years and on thyroid medication. My holistic vet informed me of this fact and I have found information online, to support this. We have never gotten to the point of having to use a special feeding chair. My holistic vet gave me special “Spinal/Nerve Drops” made by Animal Nutrition Technologies which helped tremendously when given before each meal. I also decided to place the food bowl on a RAISED surface so the dog’s mouth and neckline was even with the bowl. The oldest affected dog lived to be 16. The current dog is 10 going on 11. He also is diagnosed as having spinal arthritis (2 years ago and is on Gabapentin) and that may be what does him in – NOT the ME.

    • I rescued a dog from the shelter and he was diagnosed with ME. His problem is with water and not so much with food. He also seems to be in a lot of pain after drinking water. I would love to know where I can purchase the Spinal/Nerve Drops. We have tried numerous medications without much success.

  4. I had a Greyhound with ME. After a lot of trial and error, I found that making my own dog food was the best answer. I used: ground chicken or turkey, one of my other dogs was allergic to beef and lamb so I didn’t want to take the chance he might eat it; sweet potatoes; and rice. Everything was cooked put into a food processor until it was a smooth consistency. I would make apx. 2 weeks worth and freeze it in Zip lock bags until I needed more. I added a handful of small kibble to the mix. This was over 10 years ago, before there were feeding chairs, etc. so his food bowl was put on a low stool. Cosmo wasn’t with us for long. At 6.5 y/o his stomach twisted and the vet said that he wouldn’t make it through the surgery because of his ME. He was the sweetest boy. When he didn’t feel good, he came and sat on my lap and wanted to be held.

  5. Our yellow Lab BUSTER had (ME) at 10 yo. He lasted one day after his 12th birthday. About a month ago. Boy I miss him. We mixed a little kibble with hard boiled eggs. Peanut butter. Fresh pet refrigerated dog food. Blended all together and made meatballs. We used (BIG JOE) chair from Walmart. (30 bucks) For 2 year’s he did ok. He had issues with flem from time to time. But he two was on thyroid meds since age 3. I wish I never put him on that. I wish I would have found this site as well.

    • Our 3yr old dog was born with ME. We feed her 4 times a day using her Bailey chair. We keep her in her chair for one hour each feeding. We blend wet dog food with ground up dry food, Dynes weight gainer, slippery elm and Pepcid Ac in every feeding. She was still regurgitating 7-10 times a day. I just knew there was another problem. I took her to a internal medicine specialist and he put her on 20mg of sildenafil (viagra) twice a day. It had been a miracle pill! She maybe regurgitates once a day if that! The sildenafil helps relax the sphincter between her esophagus and her stomachs so it can open and help her food pass. I have learned that a lot of dogs that have ME also have (“LES achalasia-like syndrome”). she has already gained 2lbs in just 3 weeks! There is hope!

  6. I adopted a Black Belgian Malinois, with yellow gold eyes, 10 yrs ago from a pound & Thora, me & my German Shepherd, Freyja, have been a pack since then.
    Thora was beautiful from the inside out. Super sweet disposition, never aggressive & I often told her, she was my comedian. Thora was always up for a game of ball.
    After months of ME induced pneumonia, Thora’s body just gave out. She passed, at home, in my arms yesterday morning.
    My heart is half gone with her passing. Her sister, my GSD is also grieving. We miss our Little Girl.
    ME is insidious. No one should ever have to suffer with this condition.
    I cherish every day I had with Thora. God made one thing Perfectly, the Dog.
    At least I know she is whole again & not in pain. God bless you Thora & thank you for being part of my life.

  7. I have a 4 yr old GSD whose had ME since birth. I have experimented with making food ( sweet potatoes or carrots, peas or green beans, rice brown or jasmine, boiled eggs including the shell. Cooked and then run everything through the food processor, then add raw hamburger. I have used cooked salmon or turkey too.) I have used various kibble, which I soak in water for at least 8 hrs then run through food processor. All of these experiments have a consistency moist and sticky that works the best. Water is his enemy though and seems to be getting worse for him. He gets aspiration pneumonia 1-2 times a year. I had him in a homemade Bailey chair for 2-1/2 years until he got hit by a car and shattered his hip. We then used a box at chest level for a little over a year, now I am using the chair again to see if any better. He just got over pneumonia and are now trying viagra which has recently been found to help with food moving more quickly into the stomach. It is a lot of work but I love my dog, he’s extremely active and we even compete in Nosework trials. I probably will have to stop letting him drink even small amounts of water though and might try some thickened water(he hates gelatin). Anyway, sorry so long but it can be done if you have the patience but I know it’s not for everyone and each dog is different.

  8. Our six year old Dalmatian was diagnosed with polymyositis. He was having painful issues with his mouth and was scared to open it to eat. After several emergency veterinarian visits I was referred to a neurologist. Dr. Williams did the blood test for muscle Myositis and it came back negative. Ten days later he did a CT scan and a muscle biopsy to definitely rule this out. The CT scan didn’t show anything and the biopsy came back three weeks later with some suggestions that it’s Polymyositis. Now Rusty is acting very normal , eating, taking treats prior to the diagnosis and medications. Now he is on pred and cyclophosphamide for at least two to five months. Has anyone had any experience with this inflammatory disorder?

  9. i think mine is the youngest age in here, my baby pomeranian found to have ME when she is two month old.
    her appetite is super ok, but just will vomit after food. she on antiobiotic right now. everytime after food n medication i need to carry her up right to make sure the food gies down to stomach itself prevent vomit.

    any other supplement /medication can help my baby ? i m from malaysia.

  10. I was a bit surprised to read the comment about one of the major causes of secondary megaesophagus and older dogs being myasthenia gravis. I have a seven-year-old rescue. DNA test said some mix of corgi Weimaraner and Jack Russell. but he looks more like a combo of a Jack Russell and dachshund.

    Anyhow, around the time he turned 2 he was diagnosed with myasthenia gravis. The way I found out was actually because I had gone to the vet over concern about his regurgitation and the vet suggested I have this ridiculously expensive blood test done just to be safe. I kinda had a gut feeling as soon as he suggested it. Buster had a pretty severe case of it too. We went through a couple serious bouts of aspiration pneumonia. As well as some devastating play times and walks where he would just collapse. He lost half of his bodyweight in just 2-3 months.

    I did a lot of reading on the illness at that time. Everything I remember said it was common for dogs to get it around age 2 and that sometimes dogs were going into remission from the illness. Several people said they thought I should put him down as it was extremely time-consuming and difficult to care for him with this illness. However, I never thought twice about it. I was glad he had me to care for him.

    After years of stressful living monitoring his every move and intake of food or water, He began to show signs of remission. Full disclosure I never got the super expensive blood test again. I just took his lack of collapsing as proof enough for me.

    His megaesophagus Has been causing problems recently and I’ve had to return to keeping him upright for 20 to 30 minutes after eating. the reason I found this page is because I was wondering why he was fine for some time and now seems to be having issues again. Also if it might go back to being okay again (fingers crossed). however I haven’t been able to find any thing specifically on that issue. Does any one else have some insight?

  11. How do I get my 2 year old chocolate lab (51 lbs) the water she craves? Her diet consists of 4health 13.2 oz grain free canned turkey stew rated at 82% moisture with 333 kcal. I wash off the gravy to eliminate gagging. I feed her 4 times a day with 3 1/2 hours frequency. I have tried high speed blending all contents, but she was frequently regurgitating fluid 30 minutes following feeding in a Bailey Chair. I feared aspiration, so I reverted back to canned chunk feeding.

  12. I have a mutt that I adopted at 5 months old with congenital idiopathic ME. 3 vets told me to euthanize her. She’ll turn 11 years old next month. Lots of trial and error with food, we havd success by putting kibble in a food processor until it’s a flour-like consistency. She eats from a slow-feed bowl standing at the kitchen table.

  13. Our a Portugese miniature water mutt is now fourteen years old. Dumped on our local golf course at about six months old. We could not understand why he vomited so much. Finally after a dose of pneumonia a clever young vet diagnosed his problems looked like a no hoper. Did lots of research tried food feeding. Husband built him a Bailey chair, did not work at all.
    We then started soaking kibble with some added meat, put it in a food processor, served it in a divided dish so he has to reach for it!
    No probs apart from an occasional cough up of bile.he has survived a stroke and a few other issues, but can out run and more puppy like than most puppies. Only down side…bad breath. Our vet is amazed!

  14. My Lilly is 14 and now is having trouble with the cough if she sleeps on her side. She was born with Mega does anyone have any advice how to help her.

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