Megaesophagus

What is Megaesophagus?
The esophagus is the tube through which food travels from the mouth to the stomach by means of contractions that squeeze the food along as the dog swallows. In megaesophagus, the esophagus is dilated so that it's abnormally wide. The muscles cannot effectively squeeze food down it, causing swallowing difficulties.

How does my dog get Megaesophagus?
In most cases the cause is unknown. In some dogs (Wire Fox Terriers and Miniature Schnauzers) a congenital hereditary form is found. In others, the dog has another disease, most often myasthenia gravis, that affects nerve and muscle function.  Less commonly, dogs may have tumors, obstructions, strictures, or even certain toxic or endocrine influences.

How do I know if my dog has Megaesophagus?
The major sign is regurgitation. Regurgitation is different from vomiting in that in regurgitation the food never reaches the stomach. Regurgitation tends to happen fairly soon after eating, and the regurgitated food is mixed with thick mucus rather than stomach bile, and looks more like it looked when served. Unlike vomiting, regurgitation usually lacks heaving or abdominal contractions beforehand. Your dog may lose weight, may drool, may have unusually bad breath or may have a nasal discharge (in cases of aspiration pneumonia).  Your veterinarian will take radiographs of the esophagus and lungs. She may also perform a contrast esophagram in which the dog eats or drinks barium, which will then be detected abnormally pooling in the esophagus if he has megaesophagus. Even more sophisticated imaging procedures are available depending on what the veterinarian finds or suspects. The veterinarian will also collect a blood sample in order to run several tests that could identify endocrine disorders or muscle diseases that could be responsible. She may also look for toxic levels of lead in the blood and urine, as this can also be responsible.

What can I do about Megaesophagus?
If any underlying cause is found, it should be treated. Regardless, it's important that your dog be able to eat effectively, without regurgitating and without inhaling liquid into his lungs (which can cause aspiration pneumonia). Aspiration pneumonia is a leading cause of death in dogs with megaesophagus. If the dog has pneumonia, this must be addressed first. Even when underlying causes are corrected, the megaesophagus remains. Some drugs are available to improve esophageal and gastric motility. Drugs usually given orally may need to be given by other means to avoid any possibility of aspiration. Finding a way to safely and effectively feed a dog with megaesophagus is the mainstay of treatment. You may need to experiment with blending foods to various consistencies; some dogs do better with a gruel whereas others do better with meatballs. All dogs do better if food is fed elevated in order to let gravity help move the food downward. One method is to feed him on a stepladder so that he has to place his front feet on one rung in order to reach his food on a higher rung.  He should be encouraged to keep his head elevated for 20 minutes or so after eating. A special chair is available to hold the dog in a vertical position during and after eating (see the links below).

Is there anything I can do to prevent my dog from getting Megaesophagus?
There is nothing you can do to prevent the condition. Having your dog checked at the earliest signs may prevent it from getting very bad before you address underlying issues.

Are there certain breeds that get Megaesophagus more often?
The condition is hereditary in Wire Fox Terriers and Miniature Schnauzers, but is seen in many breeds.