What is Megaesophagus and How to Treat it?

Recently a customer shared photos of their new Waterproof ScruffTag collars that had a very unique engraving about Mega E, or Megaesophagus in dogs.

Megaesophagus- the food regurgitation disease- is common in dogs, humans, cats and horses and is a fatal disease if it’s not properly managed.

The good news is that you can manage it and your pup will lead a happy life!

It is critical though that your neighbors, friends, family and any other humans that could come in contact with your dog are aware that he/she has Megaesophagus. An easy way to do that is by putting a message on his/her dog collar or medical tag, asking to please not be fed or given water and saying that he/she has Megaesophagus. Sadly, your pup can not be snuck any treats at the dinner table, or given water by a neighbor.

In honor of our customer, Hilary, who kindly sent us a photo of the collars she personalized, and in honor of June, which is Megaesophagus awareness month, we thought we would do an article educating about Megaesophagus in dogs and providing guidance to you dog parents out there that may have just found out that your pup has the disease.

If that is the case, do not fret, you are not alone and we are here to provide guidance to you! We have Hilary’s story below for you to read about too!

What is Megaesophagus in Dogs?

According to www.petmd.com Megaesophagus, or Mega E, is an enlargement of the esophagus. This means food and water are not pushed down to the stomach. Food can then be regurgitated, enter the lungs or even be left to decay in the throat.

This issue is common in breeds such as the Great Dane, Irish Setter and Wire Haired Fox Terrier. Some dogs are born with this issue while others are prone to it.

What do I do if my dog has Megaesophagus?

Megaesophagus is an enlargement of the esophagus. This means food and water are not pushed down to the stomach. Food can then be regurgitated, enter the lungs or even be left to decay in the throat. Some describe it like a balloon that has been inflated several times and then hangs limp. The muscles just fail and so the food and water can not be propelled into the stomach.

Megaesophagus in dogs can happen at any age, if it does happen in a puppy it generally means that it is genetic. There is a form of Megaesophagus that can be fixed with surgery. This form occurs in the secondary stage, meaning it is formed when the dog is an adult. Sadly, not every adult dog’s esophagus can be fixed by surgery.

This issue is common in breeds such as the Great Dane, Irish Setter, Wire Haired Fox Terrier, Schnauzer, German Shepherds, Dachshunds, Labrador Retriever, Pug, and Chinese Shar-pei. Some dogs are born with this issue while others are prone to it.

Level of severity differs. It’s not the same for all dogs. The esophagus can have a mild, focal motility problem, or the entire organ may be dilated and functioning poorly. X-Rays can determine the severity, your dog’s appearance won’t necessarily change.

In fact, the appearance of your dog shouldn’t change at all, if you were to just look at a dog with Megaesophagus you wouldn’t know that there was anything wrong, which is why it’s so important to notify people in an easy way, the collar is a good idea especially if you have a neighborhood wanderer on your hands!

What are the symptoms of Megaesophagus in dogs?

The most noticeable symptom is regurgitation of water, mucous or food. Regurgitation is throwing up without any warning. Other symptoms are loss of appetite, refusal to eat, sudden weight loss, swallowing difficulty, exaggerated and frequent swallowing, hacking noises (to clear their throat), and bad breath.

Unfortunately, mis-diagnoses happen somewhat frequently and your pup could be diagnosed with a gastrointestinal problem. So if you have a dog that has been diagnosed with that, just watch him/her carefully and look out for signs that it could be Megaesophagus.

A frequent complication of Megaesophagus in dogs is aspiration pneumonia, which is a condition in which a dog's lungs become inflamed due to the inhalation of foreign matter, from vomiting, or from the regurgitation of gastric acid contents.

What do I do if my dog has Megaesophagus?

First and foremost, talk to your vet! They are going to be the most knowledgeable and will be able to give you expert advice on where to start. They may prescribe some medications such as an acid reducer, motility drugs to help empty the stomach, pneumonia medication or whatever else your dog may need assistance with.

The biggest change is going to be how you feed your dog.

Your dog needs to be placed in a vertical feeding position so he/she does not starve and so you can prevent aspiration pneumonia. According to caninemegaesophagus.org do not use an elevated bowl because it does not place the esophagus in the right position. You’ll have to build a Bailey Chair, or order one. Some people do use the elevated bowls, but just to be safe and to keep the esophagus in a good position, we also recommend the chair.

Your pup will need to be in the chair for 20-30 minutes after eating. This gives gravity time to work its magic. Your dog will need to eat and drink water in the chair. Your fur baby just wants to eat like a human! It is highly recommended that you feed a megaesophagus dog 3-4 times daily with wet food.

Hilary says there are several consistencies of food that are more typically used:

• Slurry, which is dry food pulverized into powder in a blender, then rehydrated with water. Sometimes it's got canned food in it, or it's just canned food with water added. And then that consistency ranges from liquid shake to oatmeal thickness.
• Soaked kibble. The amount of time soaked varies. A lot of folks soak it overnight.
• Meatballs, made out of powdered and re-hydrated kibble, canned food, raw or cooked meat/eggs or a combination of any of those.
• Honest Kitchen type stuff, raw on it's own, raw with veggies, or higher quality cooked meat on it's own or with veggies.

Other things are often added to meals such as:

• Dyne (a high calorie supplement) and other high calorie supplements
• Coconut oil or other types of oils
• Coconut milk, and almond milk
• Slippery elm, and other herbs
• Probiotics
• d. Nutritional supplements

Keep an eye on their weight, check it as often as you can. This will help you know if the methods you are doing are working. If your pup’s weight is declining then something needs to be adjusted. Some folks have had luck with all liquid diets or turning the wet food into “meat balls” and training your dog to swallow them whole. Pet therapy is often times needed to help with the feeding process.

Neck pillows are also an essential part of having a dog with Megaesophagus says Hilary. It’s crucial to keep your dog’s head elevated while they are sleeping. Throughout the night (or a nap) saliva pools in the esophagus along with any leftover food, liquid or other things your dog may have swallowed. Eventually that stuff makes it way to the lungs or out of the mouth through regurgitation. You can purchase a doggie neck pillow at pet stores or Amazon!

Megaesophagus in dogs differs and each dog is different.

Find what works for you and what keeps your pup happy! We aren’t here to tell you exactly what to do, but rather provide guidance and suggestions. Please remember that your dog can and will lead a healthy, normal, playful, loving life even if he/she has Megaesophagus.

Megaesophagus in dogs is generally not a life or death matter but is something that requires a little more work for us humans. It’s always best to be mindful when coming across a neighborhood dog, check the collar, make sure there isn’t a label on the collar stating he/she has Mega-E. If they do, just remember they are a normal dog who fully deserves and needs love and attention like the other dogs, they just so happen to eat and drink a bit differently!

Below is Hilary’s story about her two babies: Max and Kiba.

Hilary, Max & Kiba’s Story

Max and Kiba are two beautiful Siberian Huskies crossed with the Wire-Haired Gun/Bird dog and the Spinone Italiano- talk about a beautiful mix! Max and Kiba are litter mates that were born with Megaesophagus.

It’s actually not uncommon for a whole litter to be born with Megaesophagus, which was the case with Max and Kiba’s brothers and sisters. The breeder of Max and Kiba took the dogs into the vet at 8 weeks old to get checked because of vomiting, being on the thinner side and not thriving as they should, Hilary told us. Several of the puppies ended up with aspiration pneumonia.

Hilary first got Max and later adopted Kiba, her experience with these pups has been incredibly rewarding to her.

When asked what was the most rewarding thing about having Max and Kiba she responded, “Seeing them thrive in my care. Knowing all my hard work is paying off. These puppies are alive and well because I love them.”

There has been quite a bit of challenges and there always will be, Megaesophagus in dogs isn’t a walk in the park but Hilary proves that it is manageable! The most difficult part for her is making sure Max and Kiba do not digest things they shouldn’t, such as snow, dirt, grass, wood chips, trash, leaves, destroyed toys, etc. She says the list goes on and on for what can “trigger an episode” for her pups. Max and Kiba’s cough will start to sound gurgly, a lot of saliva will come out of their mouth and eventually they’ll regurgitate.

Max and Kiba’s feeding routing is quite thorough and it took some time for Hilary to nail down their routine, lots of trial and error, adjusting, fixing and redesigning their Bailey Chair to be more comfortable so the dogs didn’t feel trapped and having something to rest their feet on was a huge turning point for them.

The support group Hilary is part of on Facebook called Canine Megaesophagus Support Group has helped her tremendously, and even donated a Bailey Chair to her family so her dogs did not have to eat standing at the table anymore- and so Hilary did not have to hold each 60 pound dog upright and burp them for 20 minutes after they got done eating. The group has provided her with lots of resources, learning material and support.

Here is Hilary’s feeding routine that works for her, Max and Kiba!

“I feed them while they sit upright in their Bailey chairs. First they get a stainless steel dish on their tray table filled with 1 cup of water. Water can only be fed while in their chairs in the upright position, and usually with a food. Sometimes water on it's own has a harder time getting into the stomach. I give them two-quarter portions (a portion is just under a pound) of frozen raw, one piece at a time. It's straight from the freezer, ground prey model we purchase from the butcher in 5 lb tubes, 100 pound increments.

After they eat and drink what's in their bowls I give Max 1/2 a cup, and Kiba just a little less than 1/2 cup (because he has a smaller framed body) of Diamond Naturals Extreme Athlete kibble poured into their bowls with another 1 cup of water.

When they finish that I set the timer for 10 minutes and go to work rubbing their throats and tapping their chests and sides to burp them to facilitate the food moving down their esophaguses. This is now what us ME parents refer to as their "upright time," the period of time after the meal is finished when they remain upright in order for all food and liquids to go into their stomach. The time varies greatly among dogs. Most dogs need a minimum of 15 minutes and some need an hour or more.

Our dog's upright time is between 20-45 minutes. Although it's been upwards of an hour. In those instances each time we took them out of their chairs they started hacking and/or regurgitating, so they got placed back in the chair in increments of 10 minutes.

While in their upright time they sit, and stand (my husband calls them the elevator boys). They burp, and sometimes cough as things settle, or are still stuck in their esophagus. They usually whine quietly and other times very loudly and I have to shut the windows so the neighbors don't think I'm torturing them!

After the first 10 minutes, when the timer beeps I give them each 1/2-1 syringe full of Slippery Elm soup (not sure of the exact measurement of the syringe I have, but it's probably a couple tablespoons). I cook the Slippery Elm at home using powder and water. It's a natural herbal remedy to sooth the GI tract and help reduce inflammation.

Then I set the timer for 10 minutes a second time. Again I rub their throats, pat chest and sides. I use a timer so the boys can hear the beep to have a sense of time, that way they usually remain a bit more calm. When the timer beeps they look at me, their ears perked, and I let them out only if they are sitting nicely in their chair (not standing).

I feed them 3 times a day like this except for one difference during lunch and dinner, they only get one-quarter portion of raw instead of two-quarter portions. We've realized they can tolerate more food in the morning. They're more likely to sit and remain calm longer in the morning which gives the food more of a chance to go into their tummy.

The other two meals they seem to get restless and anxious faster. Restlessness and anxiety lead to tension and the food/liquid not going down as easily, so even longer upright times.”

Max and Kiba are so blessed to have Hilary as their mom and it warms our hearts to see her care for these dogs in the way she does! Megaesophagus in dogs is a disease, but it;s a manageable one and can be so rewarding! If you are just finding out your dog has Megaesophagus, take a deep breath, Hilary and others are here for you! She highly recommends that you join the Facebook support group called Canine Megaesophagus Support Group. It’s difficult right away she says, “but if you stick it out, you'll get to a place with your dog of unimaginable joy and pride. The bond you forge with a special needs dog is unreal.”
For Max and Kiba’s full story visit their Facebook Page Max & Kiba.