Dear Dr. Weaver,
I recently rescued a puggle from an animal shelter. I soon discovered that he has a condition known as megaesophagus, which, from what I understand, is serious and requires constant vigilance to control.
I was assured by my vet that it is not the type of condition that will resolve itself over time and is something that could lead to pneumonia asphyxiation. He was placed on antibiotics, some type of throat syrup, and requires his food elevated to aid in digestion. Is there anything else that I could be doing to help him get through this disorder?
Sincerely,
Jeff Wood
Dear Jeff,
Megaesophagus is a dilation of the esophagus, the tube from the mouth to the stomach. Because of the dilation, the esophagus doesn’t push food into the stomach for digestion. The food sits in the esophagus until it is regurgitated back up. If a dog is lucky, some of the food will trickle through to the stomach to be absorbed. In those dogs, feeding a fairly liquid food followed by making the dog stand like a human for 10 or 20 minutes will result in normal digestion and weight gain. If the vomiting is not controlled, it can result in pneumonia, weight loss and serious illness. In a dog that makes it to adulthood before adoption, these complications are much less likely.
Megaesophagus can be primary or secondary. Primary megaesophagus is usually diagnosed in a puppy or a very young dog who regurgitates frequently and cant gain weight. One form of primary megaesophagus can be corrected with surgery. This can usually be differentiated on x-ray. Other forms are not curable, but the dogs can be kept healthy by lifetime elevated feedings. Many of these dogs live very normal lives, and, since your dog made adulthood before being turned in, it is likely that he is one of them.
In a dog who is an adult, secondary megaesophagus is somewhat more likely than primary. One cause of megaesophagus is hypothyroidism. This is easily treated with inexpensive medication and is easily diagnosed with a full thyroid panel (not just a T4). Another cause, which is more rare and slightly harder to control, is Myasthenia Gravis. MG dogs usually have a loss of muscle tone and weak jaw muscles in addition to the regurgitating. As with primary megaesophagus, there are also some types which must be fed elevated for life.
Megaesophagus can be a devastating disease, and I don’t want to imply that it will always be easy. On the other hand, often the treatment is relatively simple, and the rewards of a loving companion make it worthwhile. I have had several patients over the years who lived long and happy lives with this disease.
