Help, My Dog Has Megaesophagus!

My Dog is Regurgitating Food!

My mom’s dog, Oscar, who passed away at the beginning of 2021, lived the last few months of his life with megaesophagus. We were able to keep weight on Oscar and help him feel his best with this disease. In this post, I am going to discuss what megaesophagus is, its causes, treatment, and what we did for Oscar.

Regurgitation, Not Vomiting:

While not the most pleasant topic, it is important to differentiate between regurgitation and vomiting. This was one of the major issues we had when determining what was wrong with Oscar. We initially just thought he was vomiting his food, and this seemed more likely because of Oscar’s kidney disease. It took us several weeks before we realized that Oscar’s food wasn’t even reaching his stomach; instead, his food was sitting in his esophagus. Oscar wasn’t retching or making any of the normal motions dogs make before they vomit, he would simply get a confused look on his face walk away from us, and all the food will come back up. This would occur within minutes of eating his meals.

Causes:

Most of the time, the cause of megaesophagus is unknown. This was true in Oscar’s case. Some dogs are born with megaesophagus, and others, like Oscar, develop it later in life. Sometimes, it is caused by another disorder, such as: myasthenia gravis, cancer, Addison’s disease, etc. It is important to treat an underlying cause, if present, as a component to handling the dog’s condition.

Diagnosis:

Once we figured out that Oscar was regurgitating food, and not vomiting, we were pretty sure of his megaesophagus diagnosis. Still, we got an X ray to visualize the dilation of his esophagus and confirm the diagnosis. X rays seem to be the most common diagnostic tool used for this disease. As stated above, since certain conditions can cause megaesophagus, it is important to do blood tests to rule out any of these other causes, such as myasthenia gravis or Addison’s disease.

Complications:

One of the most common complications associated with this disorder is aspiration pneumonia. Because the dog regurgitates food so often, it creates a situation where they are very likely to end up with some food particles in their lungs. This is potentially life threatening, so it is important to firstly, make sure you are doing everything you can to stop the dog from regurgitating food, and secondly, taking your dog to the vet at the first signs that they may have aspiration pneumonia.

Signs of aspiration pneumonia include (https://www.lakecross.com/site/blog-huntersville-vet/2020/10/22/signs-symptoms-pneumonia-dogs):

  • Coughing
  • Irregular breathing
  • Runny nose
  • Dehydration
  • Loss of appetite
  • High fever
  • Nasal whistling
  • Difficulty exercising
  • Lethargy

Treatment:

Treatment for megaesophagus consists of figuring out what food consistency is easiest for the dog to consume, and keeping the dog upright for 20 to 30 minutes after meals. From my research, most people recommend either feeding food in a small meatball form or grinding the food down to gruel. Also, dogs with megaesophagus tend to do better with three to four meals a day as opposed to one or two meals. Medications for an underlying cause are imperative if a cause of the disorder is determined.

Keeping the dog upright after meals can be one of the trickiest aspects. Many dogs do not like being kept upright while eating, as it’s an unnatural position for them. If the dog is small, he could be held by the owner for 20 to 30 minutes; this is what we did for Oscar while we awaited his Bailey chair (https://www.baileychairs4dogs.com/). After ordering and receiving the Bailey chair, Oscar still required supervision while he ate his meals and while sitting in the Bailey chair, as he would try to hop out of the chair if left alone even for a second.

In Oscar’s case, we discovered that grinding his food down and mixing it with beef broth seemed to help him the most. Oscar was on a prescription kidney food for his renal failure. While I cooked fresh food for Lady when she developed kidney disease, Oscar was not able to get the fresh food down with his megaesophagus, so we switched over to the commercial prescription diet. We would grind his kibble, grind his canned food, mix them together, and add enough beef broth to make the mixture very liquidy.

While many dogs with megaesophagus seem to do best with four meals a day, for Oscar, a four meal a day regimen did not work well. Oscar actually did better with three meals a day; breakfast, lunch, and dinner.

In addition to the above steps, Oscar’s veterinarian also prescribed sildenafil to help treat his condition. This medication really did help reduce the number of times Oscar regurgitated his meals, and I would recommend anyone caring for a dog with megaesophagus to give this medicine a try.

There is alot of trial and error when figuring out what works.

Oscar would make quite a mess at mealtimes, so we started putting a bib on him to make clean-up easier.

Prognosis:

Many of the articles I have read talking about this condition say that the prognosis for megaesophagus tends to be poor. Still, it is possible to find stories of many dogs living long, happy lives with this disorder. The most notable story is Gremlin’s. Gremlin was diagnosed with megaesophagus at one year of age. His devoted owner has helped him cope with his condition, and he did very well with his condition. I am not sure if Gremlin is still alive, but he certainly lived beyond the one year the veterinarians predicted he would live. Included here is an article talking about his story.

Summary

In summary, if your dog is showing signs of megaesophagus, you need to get an accurate diagnosis. Generally, an x-ray will show if megaesophagus is present. Blood tests will likely be needed to determine if an underlying cause is present.

For treatment, your dog will need

  • A chair to stay upright. Bailey Chairs work well for this: https://www.baileychairs4dogs.com/
  • 3 – 4 small meals a day.
  • Sildenafil, if it helps.
  • Food needs to be either fed as “meatballs” or as a gruel, whatever works best for your dog.
  • Treatment of underlying cause, if present (ie, Addison’s disease)

Remember to monitor for signs of aspiration pneumonia, and keep close track of your dog’s weight to assure they are getting enough calories.

Conclusion:

Oscars megaesophagus was difficult to manage, but it was very, very rewarding to see him be able to keep his meals down. He was able to maintain his weight, which was very surprising to us, considering he had megaesophagus and kidney disease, both diseases that cause weight loss. Oscar lived several months with his megaesophagus diagnosis, and passed away unexpectedly in his sleep. Initially, I was worried that he possibly died of aspiration pneumonia, but from reviewing what symptoms are present with this complication, I do not think his passing was in any way related to megaesophagus or pneumonia. Oscar was approximately 15 years old when he passed away, and he was able to live out his last few months very happily even with the diagnosis of megaesophagus.

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