Megaesophagus

This is Maiya, shown at 2 years old in these first two pictures, just 2 days after being rescued.

She has Megaesophagus.

Megaesophagus ~ A condition in which the esophagus loses all tone and dilates making swallowing extremely difficult which increases the risk of aspiration pneumonia and malnutrition.

Symptoms are regurgitation of food, weight loss, coughing, aspiration pneumonia.

Comes in three forms ~ Congenital, Secondary, and Idiopathic

Congenital ~ Dog is born with it. Can be caused by a PERSISTENT RIGHT AORTIC ARCH, but most times is just genetically inherited. The link to genetic inheritability is unknown.

Puppies with congenital megaesophagus have the best chance of survival and management. As the pup matures nerve function may increase either curing the disease or making it more manageable. Some puppies never improve.

Secondary MegaE ~ is megaesophagus caused by another disease. This can happen at any age. Thyroid diseases, neurological conditions, Addison's disease and Myasthenia Gravis are a few diseases but not inclusive of all the diseases that may cause megaE. It is reported that Myasthenia Gravis accounts for 25% of secondary Mega cases. Megaesophagus can be cured in this case if the underlying disease is corrected before the esophagus becomes too stretched out in which by that time it may not return to normal function.

Idiopathic ~ Common in dogs 6 years +. It appears for no reason and is the poorest prospect for treatment.

Surgery is usually not an option as not only is this primarily a neurological condition, but the esophagus itself is slow to heal when operated on.

There is no standard treatment for megaE which makes it one of the hardest diseases to manage. Elevated feeding in which the dog sits in a "high chair" or held in the begging position helps use gravity to draw the food down into the stomach. Consistency of food is everything with megaE. The unfortunate part is that you never know what consistency works best with your dog. It's all trial and error. While some dogs require a soupy consistency, others may require a thicker oatmeal like consistency. Some even do very well with canned food rolled into meatballs and then dropped down the throat. Many times dogs are in such poor condition that it does not leave much room for the error part of the trial. It may take a lot of changes before you find something that works, and even then, you may never find something that works.
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Maiya showing her climbing abilities, letting her mom know she can do the same things dogs without MegaE do.

Medications are virtually useless in MegaE. Vets will often prescribe reglan or cisapride. Neither of which will give the esophagus tone or motility, but may help strengthen the esophageal sphincter if it is having trouble staying closed leading to reflux.

A Histamine-2 blocker such as Zantac, or Proton-Pump Inhibitor such as Prilosec are often standard medications. Again, like the latter, they don't do much for the esophagus itself but can neutralize or even eliminate the stomach acid that is regurgitated up into the throat causing esophagitis.

Carafate can be useful in preventing esophagitis (inflammation of the esophagus). It soothes and creates a coating over the tissue to help prevent burning and irritation of regurgitated stomach acid.

Maiya getting dinner. Look how patient she is.

Gastrostomy tubes are a last resort. Some dogs do not fair well no matter how many different ways you mouth feed. Those dogs are good candidates for a G-tube. G-tubes don't require much more maintenance than the megaE dogs themselves, but can be a scary thought at first. A dog with a G-tube can function in every way as a normal dog except he/she will receive their nutrition directly into the stomach bypassing the useless esophagus.

Sweet and spoiled Maiya has the best spot in the house.

Prognosis is guarded to poor with MegaE dogs. In most cases it boils down to the time and dedication the owner has for the dog. Even then, with the most dedicated owners, and scrupulous treatment the dog still may not respond and need to be euthanized.

Aspiration Pneumonia is the number one cause of death in Mega dogs. Maiya has had it 6 times.

Maiya belongs to a very close friend of mine. She is almost 4 years old now. She was not expected to survive this long. Maiya is a very special girl with an outstanding dog mom that has gone far above and beyond to give Maiya the life she has so deserved.

Thank you my dear friend for being such an inspiration to us all, and doing all you do for Maiya.

Updated November 6, 2009 Maiya and Megaesophagus

Updated November 13, 2009 Maiya Update