Megaesophagus is a food regurgitation disease that is common in humans, cats, dogs, and even horses. Without proper management and treatment, Megaesophagus in dogs—also referred to as “Mega E”—can be fatal.
If your vet has diagnosed your dog or puppy with Megaesophagus, it’s important to know that you can manage and treat the disease. However, you should know, it will likely require a lifestyle change for you and your pup. Dogs with Megaesophagus can still live happy and quality lives with the help, support, and care of their pet owners.
So, what exactly is Megaesophagus in dogs? What causes it and how do you treat it? Read on for a complete, in-depth guide on Megaesophagus and how you can help your pup.
What is Megaesophagus in Dogs?
Megaesophagus is a food regurgitation disease that involves the enlargement of the esophagus. Dogs with Megaesophagus have difficulty swallowing, which means that food and water cannot properly travel to the stomach. This biological process is known as esophageal motility. Believe it or not, the esophagus is full of nerves. When there is food in the mouth, the nerves in the esophagus send a signal to the brain, telling it it’s time to swallow.
Unfortunately, Megaesophagus is far from a simple disease. In fact, it is one of the most common causes of regurgitation in dogs and cats. Megaesophagus is also linked to other disorders and conditions of the esophagus. Some conditions can cause the esophagus to dilate and lose some motility. When esophageal motility is reduced or nonexistent, this then causes food and fluids to accumulate in the esophagus, which can then lead to regurgitation and/ or vomiting.
Megaesophagus can cause some pretty serious issues, such as food regurgitation, aspiration, and even pneumonia, if not properly managed.
What Causes Megaesophagus?
Although Megaesophagus has been studied by scientists, researchers, and veterinarians for years, the exact cause of the disease isn’t fully understood. Megaesophagus in dogs can be both congenital and acquired. Congenital Megaesophagus is inherited at birth, and Acquired Megaesophagus may occur later in a dog’s life.
Congenital Megaesophagus first becomes apparent when puppies and kittens are weaning off their mother’s milk and begin eating solid food. Acquired Megaesophagus can affect dogs of any age.
What perhaps is most difficult about properly diagnosing Megaesophagus is that it may be confused with other similar conditions. There are actually a number of secondary diseases and conditions that affect the stomach and esophagus, causing dog regurgitation and aspiration pneumonia.
Some of these similar conditions and diseases can be caused by the following:
- A disruption between esophagus nerves and muscles.
- Trauma affecting the brain, spinal cord or even the stomach.
- A foreign object or body blocking the esophagus (such as part of a dog toy, tumor, scar tissue or another item).
- Severe inflammation in the esophagus.
- A hormonal disease (such as Addison’s disease).
- Ingesting or being exposed to various toxins.
Here are some other conditions that affect the esophageal function and esophageal motility, similar to Megaesophagus:
Persistent Right Aortic Arch
One condition that affects the esophageal function in some dogs and cats is Persistent right aortic arch (vascular ring anomaly). This is a congenital condition, which involves an abnormal development of the blood vessels near the heart. This abnormality puts pressure on the esophagus, preventing food from passing through and into the stomach, which causes regurgitation and also aspiration pneumonia. Surgery is often the best way to correct this, especially if the puppy is young.
Cricopharyngeal Dysphagia (Achalasia)
Another condition that affects the esophagus is known as Cricopharyngeal dysphagia. This condition is often associated with Cricopharyngeal achalasia, which affects the esophageal sphincter, preventing it from relaxing and opening. As a result, this condition prevents food from passing through the esophagus and into the stomach. Although rare, Cricopharyngeal achalasia is an extremely dangerous condition that can lead to malnutrition, aspiration pneumonia, lung infections, and eventually death, if left untreated.
A hiatal hernia is another possible congenital condition. A hernia is when one part of the body takes over another. This condition involves a part of the stomach pushing through the opening of the diaphragm, preventing food from entering the stomach.A hiatal hernia often affects puppies less than a year old. However, a hiatal hernia can occur in pretty much any age, especially as a result of trauma. The most common breeds that are predisposed to this condition are the Chinese Shar-Pei and the English Bulldog.
Gastric Dilatation-Volvulus (GDV).
GDV is another serious life-threatening disease for dogs. The condition is typically brought on when a dog consumes large meals or overeats. This causes so much dilation in the stomach that it actually prevents food and gas from passing. As a result, stomach pressure becomes so intense that it can cause some pretty serious issues. Some issues that can arise from this particular condition include the following:
- Preventing proper blood flow from the heart to the abdomen
- A lack of blood flow to the stomach lining
- A rupture or breakage in the wall of the stomach
- Impaired lung functions and inhibited normal breathing
Megaesophagus Dog Breeds
It is true that some dog breeds are more prone to contracting this disease than others. History has shown us that the most common dog breeds include the following:
- Great Dane
- Irish Setters
- Wire Haired Fox Terriers
- German shepherd
- Chinese Shar-pei
- Labrador retriever
- Siamese cats
- Miniature schnauzer
Megaesophagus is more common in dogs than cats. Congenital Megaesophagus appears to be hereditary in wire haired fox terriers and miniature schnauzers.
What Are the Symptoms of Megaesophagus in Dogs?
Furthermore, disease severity can vary between dogs. Mega E can have a mild or focal motility effect on a dog’s esophagus, or the entire esophagus may be dilated and function poorly. Your dog’s general appearance likely will not change at all. In fact, most people cannot tell simply by looking at a dog that he or she has Megaesophagus. This is why many veterinarians will recommend that a dog with this disease wear a special distinguishable collar to alert friends, family, or passersby in a dog park.
The most common and obvious symptoms of Megaesophagus in dogs is regurgitation or vomiting undigested food. Some other common symptoms can include the following:
- Loss of appetite
- Weight loss
- Refusal to eat
- Difficulty breathing
- Difficulty swallowing
- Excessive coughing
- Painful or bulging esophagus
- Signs of pneumonia
- Muscle weakness
- Gurgling sounds
- Nasal discharge
- Bad breath
Unfortunately, vets often misdiagnose Megaesophagus as many of the symptoms resemble those of other gastrointestinal problems and issues, as we described above. Additionally, symptoms and clinical signs of Megaesophagus are incredibly similar to those of Myasthenia Gravis, which is a neuromuscular disorder that often affects the esophagus.
Aspiration pneumonia is another condition that is often a serious side effect and secondary condition of both Megaesophagus and Myasthenia Gravis. Aspiration pneumonia can occur when a dog’s lungs become inflamed due to small bits of undigested food, vomiting, or constant regurgitation.
All in all, if your dog is showing clinical signs and symptoms of either Megaesophagus or Myasthenia Gravis, then it’s important to monitor him or her carefully and call your veterinarian as soon as possible.
If your dog is showing signs of pneumonia or Megaesophagus, the two may be related. All in all, a call and a trip to your vet is in order. Your vet will know exactly where to start to officially diagnose your dog.
A number of factors can cause dog regurgitation and vomiting, making it difficult at times to pinpoint the exact cause. Therefore, a barium esophagram may also be issued to determine the cause of dog regurgitation or vomiting. A dog barium test involves feeding a dog “barium”, or the metallic compound visible in X-rays. This compound helps to make the inner portion of the esophagus and stomach more visible to veterinarians.
Most cases of Megaesophagus can be found by performing X-rays. The X-rays will generally show a dilated esophagus, which is caused by an accumulation of food, fluid, and excess gas in the esophagus.
Your vet may recommend a blood test or a Tensilon test in addition to an X-ray in order to test for Myasthenia Gravis, since the signs and symptoms of this disease are similar to those of Megaesophagus. The blood test or Tensilon test will show the presence of the ACHr antibody, which is a common link to Myasthenia Gravis.
Some other possible diagnostic tests that may be performed include an endoscopy to evaluate the esophagogastric junction or the esophageal sphincter. These tests will determine if your dog has another type of swallowing disorder.
How to Treat Megaesophagus?
In some cases, you can treat Megaesophagus with a surgical myotomy. One procedure is known as a Laparoscopic Heller myotomy. This particular procedure involves making a small incision at the lower esophageal sphincter in order to relieve the dysphagia. Another type of procedure includes a laparoscopic myotomy, which involves a small incision in the abdomen, large enough to insert a scope to see inside the dog’s stomach.
Most dogs that undergo these procedures are in the secondary stage of Megaesophagus, which means they are adult dogs. Furthermore, not every dog is a good candidate for a Laparoscopic Heller myotomy or laparoscopic myotomy. Your vet will likely advise you on whether or not your dog is a good candidate for surgery.
Pepcid for Dogs
Veterinarians will often prescribe medications to help dogs with Megaesophagus. Most prescriptions include an acid reducer, such as Pepcid for dogs. These medications also help treat esophageal dysmotility, which help the dog empty his or her stomach. For dogs that end up with aspiration pneumonia as a result from Megaesophagus, their veterinarian will often prescribe medications to help clear up the lungs.
Slippery Elm for Dogs
If you prefer a natural or holistic approach to treating your dog, then you can try slippery elm for dogs. Slippery elm is a natural, safe, and nontoxic herb to help treat stomach problems and other wounds in animals. Slippery elm contains a number of essential nutrients, which include the following:
- Healthy fats
- Ascorbic acid
All of these ingredients are essential for your dog’s nutrition, especially if he or she has been regurgitating food and losing weight and muscle mass as a result of Megaesophagus. However, it can be difficult to give your dog slippery elm due to its rough texture in its natural form. So, be sure to give your dog capsules or mix the slippery elm powder in his or her food.
It’s also important to note that slippery elm may interfere with some prescription medications. So, be sure to clearly communicate to your vet your intentions of giving your dog slippery elm. You should give slippery elm to your dog separately from medications.
A Bailey Chair for Dogs
One of the best things you can do for your dog is change and monitor his or her eating habits. Dogs with Megaesophagus must eat in a vertical or upright position in order to allow food to pass through the esophagus and into the stomach without regurgitation. This also prevents aspiration pneumonia.
Some may recommend using an elevated bowl, however, this doesn’t always help the esophagus stay in the right position. One of the best ways to do this is to get a Bailey Chair designed for dogs. Your dog should stay in the Bailey Chair for approximately 20 to 30 minutes during and after feeding time. This allows a sufficient amount of time for the dog’s food to successfully pass through the esophagus and enter the stomach.
Neck Pillows for Dogs
In addition to building or purchasing a Bailey Chair for to assist your dog with feeding, neck pillows for dogs also work wonders. Just as it is important to keep your dog elevated and in a vertical and upright position while he or she eats, keeping your dog elevated during the night is also a good idea. During the night or a nap, excess saliva, leftover food or liquid can pool up in the esophagus, which can seep into the lungs and cause food regurgitation or aspiration pneumonia. You can easily find and purchase a neck pillow in your local pet store or online.
How to Feed Your Megaesophagus Dog
Some experts also recommend feeding your dog smaller and more frequent meals (between three to four times per day). This prevents your dog from inhaling or overeating his or her food, which also prevents food regurgitation. Additionally, we recommend wet or soft food. If your dog is typically fed dry food, then consider turning it into a powder by mixing it in a blender and adding water. The soft consistency will make it easier for your dog to eat and digest it.
You can also make “meatballs” with powdered or dry kibble, canned food, raw or cooked meat and eggs, or even a combination of these foods.
You can also add some other natural elements to your dog’s diet, which can include:
Finding the best way to feed your dog will likely require some trial and error as not every dog will take to a new diet easily. Some pet owners have better luck feeding their dogs liquid diets than others. All in all, as you adjust your dog’s diet and feeding habits, pay close attention to his or her weight. If your dog continues to drop weight, then it’s time to make adjustments.
What is the Prognosis for Dogs with Megaesophagus?
Unfortunately, there is a great deal of risk that comes with Megaesophagus. The prognosis is often poor, depending on the dog’s age as well as complications. If you and your vet do not treat your dog’s Megaesophagus, starvation, poor nutrition, and aspiration pneumonia will eventually lead to death. Other neuromuscular problems can also develop, which only make matters worse for your pup.
But there’s good news…
The good news is that treatment—both veterinary care and at home care—will result in the best outcome for your dog. As we mentioned above, there is a lot you can do to help your pup live more comfortably, such as adjusting diets as well as monitoring feeding and sleep habits. Having a dog with Megaesophagus certainly requires a lifestyle change.
All in all, the best treatment plan and care begins with a firm diagnosis. It is also important for friends, family, and other visitors who come in contact with your dog on a regular basis to understand what Megaesophagus is and how it affects your dog. This is why we recommend that your dog wear a special collar or even a medical tag to indicate this. It’s also important that others understand that they cannot feed your dog food, water, or treats—this also includes sneaking dinner scraps under the table!
Living with Megaesophagus
Living with and caring for a dog with Megaesophagus can certainly be difficult and heart-breaking. However caring, dedicated pet owners will find that the necessary lifestyle changes are quite simple to make.
Megaesophagus is a life-threatening disease that can be fatal. However, with the right care and commitment, your dog can still live a long, happy, and healthy life.
Illustrations inspired by our furry friend Puck!