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ASG Specialties:

  • Hip Dysplasia
  • Patella Luxation
  • Medial Patella Luxation
  • Elbow Dysplasia
  • Fragmented Coronoid Process
  • OCD Osteochondritis Dissecans Fractures
  • Arthritis
  • Ruptured Cruciate Ligament
  • Ruptured Cranial Cruciate Ligament
  • Ruptured Anterior Cruciate Ligament


Megaesophagus

Megaoesophagus: X-ray

Megaesophagus is a clinical disease in which the esophagus becomes dilated and loses its normal motility function.

By Emilie Chaplow, VMD
Diplomate American College of Veterinary Internal Medicine

Clinical signs:

The most common clinical sign associated with megaesophagus is regurgitation. Regurgitation can be differentiated from vomiting by a lack of an abdominal heaving component. Regurgitation localizes the problem to the esophagus vs vomiting localizes the problem to the gastrointestinal tract.

Diagnosis:

Thoracic radiographs will identify a large dilated esophagus

Etiology:

Potential causes of megaesophagus include myasthenia gravis (MG) (a neuromuscular disease), hypothyroidism, Addison’s disease (cortisol insufficiency), idiopathic (unknown cause), esophagitis (inflammation in the esophagus) and tumors. We can test for myasthenia gravis, hypothyroidism, and Addison’s disease. An endoscopy may be recommended if there is a suspicion for a mass.
Megaesophagus: Bailey Chair

Treatment:

Treatment for megaesophagus involves primarily management of symptoms and monitoring for signs of aspiration pneumonia (coughing, lethargy, decreased appetite, fever).

It is recommended that megaesophagus dogs be fed in an upright position when they eat and drink. This means that the dog is vertical so that the esophagus is perpendicular to the ground. The dog should be kept in this position for at least 20-30minutes after the feeding. This needs to be done every time he is fed water or food. There is a device called the “Bailey Chair” that can help keep the dog elevated after eating and drinking. You can try feeding canned food in the form of meatballs, as this may go down easier. Alternatively, some people find a slurried diet better.

Due to the megaesophagus and subsequent regurgitation, these dogs are at risk for recurrent aspiration pneumonia. They must be monitored for any coughing, increased breathing rate/effort, nasal discharge, or lethargy as these can be signs of pneumonia

We recommend the following medications to help manage megaesophagus:

  1. To help with inflammation of his esophagus secondary to the regurgitation, we recommend sucralfate. This drug coats the esophagus to heal any irritated mucosal surfaces.
  2. To decrease the damage the regurgitation causes to the esophagus, an antacid should be administered (e.g. omeprazole or famotidine).
  3. The anti-vomiting medication metoclopramide can increase the tone of the lower esophageal sphincter which may help decrease regurgitation and help move food through the gastrointestinal tract

Prognosis:

Megaesophagus can be a very challenging disease to treat. Generally this disease is not reversible so we focus on management. If dogs are able to tolerate upright feedings and maintain their nutrition then they can do quite well. No matter how well managed, though, there is always the risk of recurrent aspiration pneumonia.

Helpful resources:

  1. Megaesophagus yahoo group
  2. Bailey Chair website
  3. Bailey Chair 4 Dogs

Animal Specialty Group

VMD, Diplomate American College of Veterinary Internal Medicine

Dr. Emilie Chaplow received her Veterinary Medical Doctor degree from the University of Pennsylvania in 2001, and became board certified in 2005. She is skilled in endoscopy, abdominal ultrasound, bone marrow aspirates, feeding tube placement (PEG and E-tube), CSF taps, joint taps, arterial blood gas, and numerous other areas of internal medicine.


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