We are so glad you've found us! You're probably worried, scared, and feeling slightly hopeless after your dog's diagnosis -- Don't Be Discouraged! It CAN get better!
CanineMegaesophagusInfo.com is your one-stop destination for:
- Information (We're all experienced with the condition, so we know how it works!)
- Management Tips (Chairs, Food, Treats!)
- Recommended Veterinarians (We know they're good because we use them!)
- Awareness Events (Let's get ME off the "rare" list!)
- Support (Who better than ME parents to laugh, and cry with you throughout your journey!?)
Welcome to our family -- Welcome to our crazy ME world -- Let us help your dog live a long and healthy life with Megaesophagus ♥
*DISCLAIMER* We are NOT veterinarians, and we are NOT speaking on behalf of any companies or others. We ARE a community of pet parents with ME/MG dogs. The information contained on this website is not meant to diagnose, treat, or take the place of advice from your vet. Utilize this information at your own risk. - Thank you*
- What Is Megaesophagus?
- What are the Signs and Symptoms of ME?
- How is Megaesophagus Diagnosed?
- How should ME be managed?
- What are some of the common medications given for ME?
Megaesophagus (ME) is basically a "floppy" esophagus. The esophagus is a tube connecting the mouth to the stomach. A normal esophagus moves food to the stomach with wave-like contractions called peristalsis. An ME dog's esophagus loses its muscle tone, becomes enlarged, and can develop pockets where food can become trapped. Since the esophagus does not function normally, food sits in the esophagus and doesn't make its way to the stomach. This can cause malnutrition and regurgitation of vast amounts of undigested materials.
ME can be idiopathic (no known cause), or a result of a secondary disease. The most common secondary diseases causing ME are Persistent Right Aortic Arch (PRAA), which is most commonly seen in puppies and can sometimes be successfully treated with surgery, and Myasthenia Gravis (MG), which is a neuromuscular condition that can be treated with medication. Please see the links on our homepage for more information about PRAA and MG.
One of the main symptoms of Megaesophagus is regurgitation. Regurgitation is different than vomiting. When a dog regurgitates, it does not usually require much effort from the dog, and the food comes out looking a lot like it went in (undigested), sometimes in a tube shape (like the esophagus). When a dog vomits, there's a lot of effort involved. A vomiting dog will exhibit a heaving motion (the ribcage and stomach will rapidly contract multiple times) before partially or totally digested food and/or bile is expelled. A dog will also lick his lips often prior to vomiting (this is a sign of nausea). It is important to know whether your dog is regurgitating or vomiting, as it aids in diagnosis. Often, a vet will not even consider ME if he or she is told that a dog is "vomiting."
When a dog regurgitates, some of the regurgitated material (food, water, saliva) can be inhaled into his lungs. Inhalation of foreign material into the lungs can cause another, more dangerous, symptom of Megaesophagus, Aspiration Pneumonia (AP). It is imperative that your dog be seen right away by your vet if you suspect AP. In some cases, a bout with AP is the trigger for an ME diagnosis.
Common symptoms of aspiration pneumonia in dogs include trouble breathing (heavy panting without strenuous exercise), shuddering/shaking/shivering, lack of appetite (not drinking water or eating), lack of activity (not playing), and fever. Not all of these symptoms may be present at the same time if your dog has AP. Again, if you suspect your dog has inhaled material into his or her lungs, it is our recommendation that you seek veterinary treatment.
The most common method of diagnosis for Canine Megaesophagus is an x-ray (radiograph). Since an enlarged esophagus can be difficult to see on an x-ray, often a Barium Swallow will be done. In a Barium Swallow, the dog is fed a contrast material that makes the esophagus stand out on an x-ray. This contrast material is used regularly in humans to provide clearer x-ray results.
With proper management, ME dogs can live long and healthy lives!
The most important management technique for ME is Vertical Feeding. Since the esophagus isn't working correctly in an ME dog, gravity is needed to get food to the stomach.
# 1 Feed your Dog Upright - You can use a “Bailey Chair," a high chair, a laundry basket, ANYTHING that keeps your pup vertical! After each feeding, have your dog remain upright in the chair for at least 10 minutes. Some dogs may need more time upright than others -- this part is trial and error.
*Please check out the Bailey Chairs 4 Dogs link on the homepage to purchase a chair, request a chair donation, or even get plans to make your own MegaE chair!*
# 2 Food Consistency- Yet another area that requires some trial and error. Some dogs do well with a slurry or milkshake consistency. Some dogs thrive on soaked kibble (water or broth overnight to make into a "mush"), and some dogs do better with food shaped into little meatballs (be sure that they are small enough so that your dog can swallow them--chewing negates the benefits of the meatball shape).
Many ME dogs do not do well with water, so water is added to their food (in addition to the softer easy-to-swallow consistency of softened food, it's a great way to incorporate water into your pup's diet). Dogs that eat meatballs can get their water with something called Knox Blocks -- basically jigglers for your pup! *See Recipes under link on homepage* Other dogs may do well with a large hamster style bottle mounted high enough to keep the throat in an elevated position.
There are several recipes you can try to add nutrition and weight to your dog, like “satin balls,” or you can try adding coconut milk or “Ensure” to their food. Please continue to check the Recipes link for new concoctions!
What works for one dog may not work for another, so keep track of what you try so that you can find what works best!
# 3 Smaller more frequent meals. Some dogs can eat twice a day while others may tolerate smaller, more frequent meals better. Say it with us, "this requires trial and error!"
Don't get discouraged and don't give up -- you'll find something that works!
# 4 Try a “Pro Collar” or “Neck Hug”. These devices help to elevate your dog's head while reclining. Keeping your dog's head elevated helps keep any food that's still in the esophagus, or saliva (face it, that's always there), from being regurged. Some dogs take a while to get used to this large fluffy collar -- This elevates your dog’s head off the floor when they are laying down. You can find inflatable Pro Collars at Petsmart or Petco. The Neck Hug from Wag Tail Farms is a stuffed elizabethan collar.
Please check out the Wag Tail Farms website via the link on our homepage!
# 5 Try medications - Antacids, like famotidine or omeprazole can to help to control stomach acid. Your vet may also prescribe a motility drug. One more time, "this requires trial and error!"
Each dog is different, so don't be afraid to try new things! Don't give up!
Listed here are some of the most commonly prescribed drugs associated with Canine Megaesophagus.
Not all ME dogs take the medications listed below - trial and error (and the advice of your vet) will help you to find what works best.
The sphincter between the esophagus and stomach in ME dogs does not work properly and often allows acidic stomach fluids to reflux (leak back) in the esophagus. Acid can cause burning and ulcers and lead to esophagitis. Here are some common antacids that your vet may prescribe:
- (esomeprazole magnesium)
- ( famotidine )
- (ranitidine )
Antibiotics to treat AP (Aspiration Pneumonia)
It is very important to recognize the signs of AP and act on it right away. If your dog shows signs of being lethargic, coughing, wheezing, sneezing, increased respiration rate, fever, off of their food or water, incessant panting it’s best to get them in for x-rays.
Many times a vet cannot tell just by listening on their stethoscope. Your vet may take two x-rays of the lungs –one with the dog on its stomach or back, and one with the dog lying on its side.
Often, two antibiotics will be prescribed for 2-6 weeks, consisting of a broad -spectrum antibiotic, like Enrofloxacin, along with one other. If a dog has chronic or recurring AP, the drugs can be administered through a Nebulizer to avoid taking orally.
*Each of these meds has side effects that may or may not impact your pup. Clavamox, for example, can cause nausea, loss of appetite, or vomiting. You will need to monitor your pup while taking this medication for any complications.
(sulcralfate)- is an anti-ulcer medication used in the treatment of ulcers of the esophagus, stomach , or small intestines. Give orally on an empty stomach (1 hour before or 2 hours after feeding or giving other medications). It is best to crush them and mix with water (can be given with a syringe), so the medication is better absorbed.
(maropitant) - Severe Esophagitis can cause nausea. This is an anti-emetics drug that really works!
(neurontin) – Esophagitis can be painful for your pup, causing him to avoid eating. This is a medication that helps manage your pup's pain.
Slippery Elm is an herbal treatment prepared from the inner bark of the Slippery or Red Elm Tree. The term “slippery” refers to the remarkable sticky gel that is formed when the powdered bark comes in contact with water. It is a protector and lubricator for pets with gastrointestinal disease and esophageal diseases. It is very soothing to the esophagus.
Recipe for Slippery Elm Soup can be found here http://www.dogsnaturallymagazine.com/the-soothing-qualities-of-slippery-elm/
(Tramadol) - Pain medication that is used often for pain management associated with many illnesses/injuries in dogs.
(ondanestron) - anti-emetics for nausea caused by severe Esophagitis
Pro-motility drugs help open up the sphincter between the stomach and small intestines, allowing stomach contents to more quickly enter the small intestines, so that it is less likely to reflux back up into the esophagus.
(Propulsid )- helps with reflux –give 15-30 minutes to an hour prior to eating
(metoclopromide)- helps empty the stomach – give 15-30 minutes to an hour prior to eating
(Bethanechol)- increases the speed of rhythmic contractions in esophageal muscle
Note: Again, some dogs do not require drugs to manage ME, though most are on some sort of antacid. Some have had success with the pro-motility drugs and others have not. Keep trying until you find what works for your pup!
*Any and all medications and dosages should be regulated by your veterinarian.*
Reno's Satin Balls Recipe
5lbs ground beef
6.5 cups of a corn flake cereal
7.5 cups of quick oats
5 raw eggs with shell
2 cups organic wheat germ
5 packs of unflavored gelatin
1.5 cups vegetable oil
2/3 cup of molasses
2 tablespoons of elk velvet powder
6 tablespoons of powdered puppy milk
4 tablespoons of cranberry powder
Mix together raw, and shape into meatballs that are the appropriate size so your dog can swallow without chewing. Separate meatballs into meal sizes and store in freezer bags. Feed in upright position. Recipe courtesy of Reno's Mom, Chrissy Wilson.
Megaesophagus is NOT a death sentence!
There is a frustrating lack of information accessible to pet parents given the Megaesophagus diagnosis; it often seems as if there's no hope. Our group, pet parents living with ME dogs (congenital, idiopathic, Myasthenia Gravis - young and old) and a family who have been inspired by an ME story, have decided that it's time to dispel the myth that ME is a death sentence.
Member Recommended Vets and Specialists
This list is made up of veterinarians and specialists recommended by members of the ME/MG community. This list is only a starting point - please choose your vet based upon your own criteria.
There are many knowledgeable vets that are not included in this list... YET!
Please send us your recommendations!
"I've had Shade since she was a puppy. She was fine her first year. The older she got, the worse her regurge got. I had been in and out of the vet for years trying to figure out what was wrong, and they just gave her Pepcid and told me to feed her sensitive stomach food. No X-rays or other tests. I finally got a diagnosis a month and a half ago when I insisted on a better answer- clearly it wasn't just a case of food sensitivity or acid reflux. I had never even heard of ME, so I didn't know to ask about it. It amazes (and irritates) me that it took YEARS for vets to figure out what was wrong [...] It took 4 years to get an accurate diagnosis."
How to give subcutaneous fluids
Click here for Carter's Story
Carter's Story ♥
Carter is a Boxer/St. Barnard mix.
We call him a Boxnard.
Until 2013, he was a perfectly healthy 140+ pound lover boy. Around April 2013, he began regurgitating everything he ate and drank. Our vet started treating him for acid re-flux, but nothing seemed to be working.
We watched as he dropped in weight to just under 100 lbs.
We were afraid we were going to lose him.
On Memorial Day weekend he developed aspiration pneumonia. We took him to a pet ER and we were promptly sent to MedVet Animal and Cancer Hospital in Columbus, Ohio.
It was there that he was properly diagnosed with hypothyrodism.
Once we got him back home it took a bit to get his meds and food regimen squared away, but he just couldn't handle any liquids. We tried it all: ice chips, ensure, thickening agents, gelatin blocks - you name it, we tried it.
I would even make him an Elvis smoothie.
Anything with even the slightest amount of liquid would be promptly regurgitated. We would end up in the vet's office 3 times a week getting our boy re-hydrated.
Our vet finally told us we could give him fluids at home. He instructed us how to do it and my husband does it every evening.
We want to share it so that you can see that it isn't as scary as it sounds.
We feel very blessed to still have our boy with us. While he may never achieve his 140+ pre-diagnosis weight, I am happy to say that at his last vet visit he weighed 127lbs.
Since Carter was diagnosed, our vet has been amazing. He apologized over and over for months of misdiagnosis. Carter is his first ME patient (he did have a mega-colon cat, though). Our vet has become our champion.
*Sweet Carter lost his battle in 2014. His spirit lives on in his story and video -- helping others manage and thrive with ME.