Tag Archives: Medication

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.


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.


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.


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 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.


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.


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.


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.

Multiple Sclerosis in Dogs: Degenerative Myelopathy

What is Degenerative Myelopathy?

Veterinarians are still not completely sure what degenerative myelopathy is, but it appears to be autoimmune in nature, much like multiple sclerosis in humans. It seems to run in bloodlines, and is quite common in German Shepherd dogs, although it also regularly affects Huskies, Pembroke Welsh Corgis, Weimaraners, and other breeds and their various mixes. While it starts off as weakness in the hind legs, the disease eventually progresses to complete paralysis. (Dog Owner’s Home Veterinary Handbook 4th edition).

A more detailed description of what the immune system is doing in a German Shepherd Dog with DM can be found here: http://dog2doc.com/neuro/DM_Web/DMofGS.htm. This page also has information on medications and supplements that sometimes prove somewhat beneficial to German Shepherd dogs with the disease. Most research into the disease seems to be aimed at GSDs, since they are the most commonly affected breed. With this being said, I don’t see the hurt in using the information for a breed other than a GSD, as long as a veterinarian is helping alter the plan accordingly.

How is DM Diagnosed and what are the Symptoms?

DM is diagnosed through a process of elimination, because the only way to be certain a dog has the disease is to examine their spinal cord in autopsy (http://www.caninegeneticdiseases.net/dm/basicdm.htm). Other diseases that can have similar symptoms are hip dysplasia and slipped discs in the vertebral column. Dogs affected by DM are usually older dogs, aged 8 and above.

One of the ways a vet tries to determine if a dog has DM is by manipulating the dogs back paw so that the top of their foot is against the ground. A dog with a healthy spinal cord will correct this posture of the foot quickly. Dogs with DM that has progressed to a point will not “right” their foot automatically(http://dog2doc.com/neuro/DM_Web/Jack_Flash.htm). Dogs with DM will often drag their back feet, and their toenails consequently become worn down (Dog Owner’s Home Veterinary Handbook 4th edition). As the dragging of the back feet becomes worse the dog may develop cuts and scrapes on the back paws.Lady in Snow editted

As degenerative myelopathy progresses, the dog loses more and more control over her back legs, resulting in paralysis. This can result anywhere from 6 months to 1 year from initial diagnosis (http://www.caninegeneticdiseases.net/dm/basicdm.htm).

From what I have read, degenerative myelopathy is not painful for the dog. What is extremely painful is watching one’s dog slowly lose the ability to walk, especially as the animal is completely alert and mentally still very healthy.

Treatment for Degenerative Myelopathy:

There is no cure for DM. With this being said, a veterinarian by the name of Dr. R. M. Clemmons makes several recommendations on medication and supplements that he believes prove beneficial for dogs affected by this disease. Dr. Clemmons specific recommendations can be found at here (http://dog2doc.com/neuro/DM_Web/DMofGS.htm) (same article referenced earlier).

This veterinarian emphasizes regular walks or swimming to help keep a dog with DM mobile for as long as possible. Because DM affects the nerves in the legs, it also results in muscle loss. Both walking and swimming will help the dog retain as much muscle tone as possible. The walks or swimming sessions don’t have to be extremely long according to Dr. Clemmons. He recommends working the dog up to two 30 minute walks and one hour long walk each week. Obviously, some dogs will be able to do more, and some dogs will need to do less.

In addition to regular exercise, Dr. Clemmons recommends a diet and supplement guidelines. Vitamin C, vitamin E, selenium, CoQ10, and omega 3 fatty acids are all recommended. As always, consult with your pet’s veterinarian before adding supplements to the diet, as not all supplements are safe for all dogs.

The two medications that may help dogs with DM are aminocaproic acid and n-acetylcysteine. Around 50% of dogs will positively respond to these drugs according to the Dog Owner’s Home Veterinary Handbook 4th edition. Dr. Clemmons reports a higher number of dogs respond positively when medication, exercise, diet, and supplements are used in conjunction: “We always hope that all patients will respond to our treatment protocol. Unfortunately, it does not work in all cases; however, this combined treatment has been up to 80% effective in patients diagnosed at the University of Florida.”


Many problems could be causing weakness in a dog’s back legs and hips. One of these issues that could be the source is degenerative myelopathy. The disease is devastating as it results in paralysis of the hind legs. With this being said, certain medications and supplements may prove helpful for some dogs. Chances of these therapies working are best when DM is caught early. For this reason, it is important to schedule an appointment with your veterinarian as soon as you notice changes in your dog’s mobility.



Dog Owner’s Home Veterinary Handbook 4th edition


Galliprant: Will it Help my Dog?

IMG_0154Why Galliprant:

Arthritis is an unfortunate disease that many pets develop in their golden years of life. Nutrition can play a big role in improving a dog’s mobility who has arthritis. First hand, I have seen the amazing effects that a low carb, high protein diet can have to improve the life of a dog with arthritis. But what happens when the diet can’t be tailored to reduce joint pain? This is the predicament I am in with my elderly dog, Lady.

Lady was diagnosed with kidney disease a few years ago. As the disease has progressed, so has her joint pain. For a long time, glucosamine and fish oil kept her joint pain under control, but eventually, I realized she needed additional relief. Anyone who has or has had a dog with kidney disease knows that your diet options are limited. Low phosphorus carbohydrates are a must. These include white rice, couscous, pearled barley, white potatoes, sweet potatoes, and butternut squash. Only the last two are arthritis friendly, and Lady happens to hate those foods ☹. Managing Lady’s arthritis with diet and nutritional supplementation alone became impossible, and many pain killers are hard on the kidneys, making them bad for kidney patients.

So, what does a loving pet owner do? Luckily, a new drug recently came out on the market that appears to be very safe for dogs with kidney disease. Traditional NSAIDs are notoriously hard on the kidneys, but the new drug, Galliprant, is not a traditional NSAID.

What is arthritis and how do drugs reduce the symptoms?

Before taking a look at how Galliprant specifically works, it is helpful to understand what arthritis is and how NSAIDs usually reduce the symptoms of this disease.

Arthritis is inflammation of the joints. While there are different types of arthritis, all types result in inflammation. Lady did not have any form of joint problems in her younger years, but as she aged it became obvious she was having issues. She was stiff when getting up, less playful, and less alert and vibrant. She specifically has osteoarthritis, or degenerative joint disease. This type of arthritis is the result of the wearing down of cartilage. Many dogs, especially big dogs over 50 lbs., develop this disease as they get older. The disease creates a viscous cycle, because as the dog experiences pain, he becomes less active. With less movement the dog’s muscles become weaker, and this puts more strain on already painful joints. For many dogs, a time comes when the only solution is prescription medications that can reduce inflammation.

Some of the main contributors to inflammation anywhere in the body are prostaglandins (Prostaglandins and Inflammation). Prostaglandins are formed from a cascade of events in the body. While prostaglandins contribute to inflammation, its important to note that they are imperative for homeostatic functions in the body (Prostaglandins and Inflammation). In simple terms, they help the body work the way it is supposed to work. One of the functions of certain prostaglandins is to support the proper function of the kidneys by regulating the dilation of the blood vessels (Significant Acute Kidney Injury Due to Non-steroidal Anti-inflammatory Drugs: Inpatient Setting).

So, what do pain relieving pills such as NSAIDs have to do with any of this? Traditional NSAIDs such as carprofen are cyclooxygenase (COX) inhibitors. COX is important in the production of prostaglandins, including the prostaglandins needed by the kidneys (Prostaglandins and Inflammation). When NSAIDs inhibit cyclooxygenase, they in turn reduce the production of prostaglandins. This is not limited to the prostaglandins that contribute to joint inflammation; it includes the prostaglandins needed for regular kidney function. This is one of the ways NSAIDs can damage the kidneys.

How does Galliprant work?

Prostaglandins have to get to their proper receptor to cause their desired effect. There are many types of receptors in the body. Galliprant does not stop the production of prostaglandins; instead it blocks prostaglandins from reaching the receptors they need to in order to cause inflammation associated with arthritis (See Galliprant website: https://www.galliprantfordogs.com/vet ). This action does not prevent prostaglandins that are needed by the kidneys from being produced. This is a very simplified explanation, but I hope it helps show why Galliprant should be a safer alternative for kidney failure patients than NSAIDs.

As a note, Galliprant does have reported side effects, including vomiting and diarrhea. I suspect more adverse responses will be reported as more dogs take this medication for long periods of time. I don’t particularly like giving my dog a new drug for this reason, but the alternative is to let her be in more pain than she has to be, so I truly believe that the benefits out-way the potential risks.

Lady’s experience with Galliprant:

Galliprant has been helpful in reducing Lady’s joint pain. She is not as mobile as she was in her younger years, but Galliprant has improved her mobility. Before starting this medicine, she seemed more depressed, and was having a hard time jumping on and off furniture. She would often abruptly stop and lay down as if it hurt to continue standing. She was sleeping more as well. Since starting Galliprant, she is more alert and more willing to play. When she is feeling particularly spry, she will chase my other dogs around the yard. She can once again jump on and off the couch. She can no longer jump on the bed which is considerably higher, and I do have to watch her go up and down the staircase to make sure she doesn’t slip. We go on walks still, which is her favorite thing in the world. Our pace is slower, but for a 15-year-old dog she is doing well.

If I had any question as to whether or not Galliprant helps Lady, it was answered when I skipped a dose when I thought it was causing Lady to vomit. That day poor Lady was noticeably stiffer, and she did not want to play with her toys. I never figured out what made her vomit, but I have since continued giving her the medicine with good results and no vomiting.

A side note: I had stopped giving Lady her daily Cosequin DS during a bout of inappetence. I give her Cosequin consistently with the Galliprant now, and I feel this combo works better than Galliprant alone. I just add this to encourage you to continue giving a glucosamine and chondroitin supplement in addition to pain killers since the results seem better from my own experience with my dog.


Galliprant can make a difference in the life of dogs who have arthritis and concurrent diseases that make typical NSAIDs a bad choice. I have used this medicine to help improve Lady’s mobility for over six months now. It has not returned her to where she was as a young dog, but she can still go for walks and play with the other dogs in my home. More side effects of this drug will probably pop up as more dogs are treated with it; this is the case with most new medications. Despite this, seeing Lady go for walks and play makes it worth the potential drawbacks. As always, work with your veterinarian to come up with the best treatment plan for your individual dog.

Cited articles:

Prostaglandins and Inflammation – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081099/

Significant Acute Kidney Injury Due to Non-steroidal Anti-inflammatory Drugs: Inpatient Setting – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034033/