Follow Us on Facebook   Follow Us on Twitter   Follow Us on LinkedIn   Follow Us on Pinterest   Follow Us on YouTube   Follow Us on Google+
Dr. Justine Lee
  • HOME
  • ABOUT
  • BOOKS
    • It’s a Dog’s Life
    • It’s a Cat’s World
  • BLOG
  • MEDIA
  • PUBLICATIONS
  • EVENTS
  • CONTACT
Home » Animal Safety » Megaesophagus in dogs | Dr. Justine Lee, DACVECC, DABT, Board-certified Veterinary Specialist
Nov01 7
Megaesophagus in dogs | Dr. Justine Lee, DACVECC, DABT, Board-certified Veterinary Specialist

Megaesophagus in dogs | Dr. Justine Lee, DACVECC, DABT, Board-certified Veterinary Specialist

Posted by justinelee in Animal Safety, Blog

Was your dog just diagnosed with megaesophagus, a dilated flaccid esophagus which lacks muscular contraction? The esophagus, the tube that carries food and water from the mouth to the stomach, can become inappropriated dilated, causing food to be regurgitated (not vomited!) back up. With regurgitation, there is no “warning” or retching – food or liquid just “blurbs” back up suddenly. Unfortunately, megaesophagus can shorten the life-span of dogs, as it can cause secondary aspiration pneumonia chronically.

There are numerous published causes of megasophagus including:

  • Hypoadrenocorticism (rare)
  • Hypothyroidism (rare)
  • Myasthenia gravis
  • Polymyositis
  • Lead poisoning
  • Persistent right aortic arch (in puppies)
  • Congenital causes
  • Dysautonomia
  • Vagal nerve dysfunction
  • Systemic lupus erythematous
  • Gastric dilatation and volvulus
  • Thymoma
  • Pyloric stenosis
  • Tetanus
  • Botulism

BTW, veterinary professionals, here’s a great article by DVM360 on this disease here. Pet owners, here’s a great article by board-certified veterinary internists at PetPlace.com here.

Well, there may finally be a some good news. In a recent press release by the Veterinary Health Center (VHC) at the University of Missouri’s College of Veterinary Medicine, they have a new approach to treating one type of canine megaesophagus. Check out the press release below on the use of botox to help treat this!

Photo credit: MU College of Veterinary Medicine

Photo credit: MU College of Veterinary Medicine

October 18, 2016
Press release

A partnership between the VHC’s Small Animal Internal Medicine, Radiology, Surgery, and Nutrition services and an investigator in the Otolaryngology-Head and Neck Surgery department at the university’s School of Medicine has resulted in the discovery of a breakthrough treatment for a subpopulation of dogs with megaesophagus. The Mizzou team has identified a defect of the lower esophageal sphincter (LES) as a potential treatable cause of megaesophagus. Megaesophagus (ME) refers to a large, dilated esophagus with poor or no motility preventing normal passage of food and liquid into the stomach. With ingesta not reaching the stomach to produce the sensation of being full, the dog will continue to eat. As a result, the esophagus enlarges greatly. Dogs end up not getting enough calories so they waste away. Dogs with ME also regurgitate large amounts of undigested food and some of that material can be inhaled into the lungs. This inhalation can result in aspiration pneumonia, a dangerous additional symptom that kills many affected animals.

“In general, dogs with megaesophagus typically die of malnutrition, aspiration pneumonia, or are euthanized because the owners are told they have a terrible prognosis,” according to Associate Professor Carol Reinero, DVM, PhD, an internal medicine specialist helping coordinate the efforts of the multidisciplinary team. “We’re taking a closer look at a subpopulation of dogs with idiopathic megaesophagus, which means we don’t know what causes it. We run all of our traditional tests, but we’ve never been able to find an underlying cause. Now with our video fluoroscopic swallow studies, we have identified an abnormality that we believe is driving the problem: an LES-achalasia-like syndrome.”

The LES acts as a valve between the esophagus and the stomach, opening when food and water are swallowed, then clamping tight so food doesn’t come back from the stomach into the esophagus. In dogs afflicted with megaesophagus caused by an achalasia-like syndrome, the LES remains closed. “Video fluoroscopic swallow studies have been around a long time,” Reinero said. “The problem with prior protocols is they did not represent normal eating and drinking behaviors. Those tests had very little to do with reality. A dog had to be restrained, lying on its side, and syringe-fed barium, which was not palatable even when mixed with food. If dogs don’t eat during the swallow study you’re not going to get a diagnostic study.” In order to receive a better diagnostic result, the Mizzou collaborative research team blended innovation with adaptation, developing new techniques and tools while borrowing procedures from human medical practices to diagnose and treat this type of canine ME.

Assistant Professor Teresa Lever, MS, PhD, from the Otolaryngology-Head and Neck Surgery department, spearheaded the development of trapezoidal holding chambers or kennels — which are now patented — where dogs walk in and are funneled to the narrow end of the enclosure. The animals are more naturally restrained and are given food that they consume while standing upright. Lever’s lab, in cooperation with an independent company that conducts feeding trials in dogs, also developed a number of different recipes and consistencies of food and liquid to optimize how well the dogs could take it down and discover which contrast agent was more palatable and effective.

“So, now we have these chambers, we have optimized palatable recipes, and we have experience in normal, healthy dogs without swallowing disorders, as well as lots and lots of patients coming in with other swallowing disorders,” Reinero said. “It was in the process of developing this protocol and having clinical patients come in when we recognized that LES-achalasia-like syndrome was the underlying cause of megaesophagus in some dogs. That’s when we began to adapt what they do with humans, a therapy where we’re opening or dilating the LES with Botox and/or balloon dilation.

“We perform an endoscopy to first dilate the LES and then administer Botox, which paralyzes the sphincter muscles that formerly wanted to remain closed. While we are still evaluating this procedure, we’ve had dogs with remarkable clinical improvement. Additionally, when we repeat the fluoroscopic studies, we can document an open LES. The patients that show improvement can be candidates for surgery, and that surgery is potentially curative,” Reinero said.

During a patient’s recovery, residents in the Nutrition Service monitor the dog’s weight and food intake. The amount of food an owner may give a pet might need to be altered every couple of days. James Schachtel, Bvet Med, MRCVS, is a Radiology resident and key collaborator in the study. “This approach gives these dogs a chance, whereas a lot of them didn’t have much of one,” Schachtel said. “At this time, it is early in the evaluation process, but it’s a novel approach that shows promise.

“This subpopulation can receive a really significant benefit from our direct ability to detect their malady. It can give them a really good quality of life. This is a revolutionary diagnostic technique for a disorder identified with a pathological outcome. It offers us the opportunity to use therapies that have been successful in people, so we’re optimistic we can experience similar success with canines,” Schachtel said. Schachtel will present an oral abstract of the swallowing protocol and early identification of the LES achalasia on Oct. 20 at the American College of Veterinary Radiation Annual Scientific Conference in Orlando.

###

The Missouri team encourages veterinarians, pet owners and breeders to contact the VHC for information about the new diagnostic and treatment. To have a pet evaluated, contact the Small Animal Hospital at 573-882-7821.

7 Comments

  1. Marilyn Barker | December 18, 2016 at 1:26 pm

    I wish we were closer to you. We have an Olde English Sheepdog who is 6 1/2 now. He was just diagnosed a few months ago. This disease is so terrible (and expensive) and on a retired or low income makes it hard when you love your dog so much. I hope and pray a cure is found someday soon. Thank you for the research you are doing. 🙂

    Reply
  2. Christina Plues | May 18, 2018 at 5:22 pm

    My jack Russell pokey was diagnosed as a pup.

    He will be 14 tomorrow.
    With feeding very small amount of pate’ at a time smeared flat on an elevated plate . And only biljac little jac soft treats..He still occasionally throws up….but I sit with him and make sure he doesn’t inhale it or try and re eat it..I know yuk

    But carefully monitoring and with help of vets and dear friends at All Creatures Vet who give occasional meds if we think he has aspirated anything

    He will be celebrating his 14th birthday tomorrow.
    Megaespagus is NOT a death sentence.
    He had an xray and ultrasound yesterday, he has a few issues, heart murmur and slight calcification on liver. Vet says for his age and with megaespagus he looks good.

    Reply
    • Mataya Benter | September 13, 2018 at 6:20 pm

      O reading this makes me more confident that our dog will live a heathy life. He was just diagnosed with megaespagus today. I have done some research finding some scary stuff and some reassurance. If you have any suggestions for me please send them my way.

      Reply
  3. Sarah | March 20, 2019 at 9:05 pm

    My dog suffered for four years before we figured out what he had. The bailey chair has saved his life! I highly reccomend feeding your pup in one. Also before bed we put a pillow (like the one people were on airplanes) on him to keep his head elevated. The improvements have been amazing!

    Reply
    • Pam McCabe | April 11, 2019 at 11:36 am

      How do you keep his head on the pillow? I have a two year old Goldendoodle which was diagnosed at six months. She has a problem at night because of the water she has drank after dinner. I do not put her in the Bailey chair when she drinks water and I believe this is the problem…..she is lying flat in her bed.

      Reply
      • Name * | June 19, 2020 at 8:34 pm

        Go to Wag Tails and they make neck hugs for pets with Megaesophagus!

        Reply
  4. Josie | April 22, 2019 at 5:05 pm

    My Labrador was diagnosed with ME about one year ago. After trying many things at night to prevent him from regurgitating, I bought one of those blue donut round pillows (from Walmart – about $10.00) that you put around their neck usually for surgery healing etc. He sleeps with that on every night and that prevents him from laying flat with his head down. We’ve finally been able to get sleep now and not lose his food! Doesn’t look like it is the most comfortable but he has adjusted and has been able to put some weight back on. I also feed him at least four times a day, about every three hours,, along with water, in his Bailey chair and that has saved his life. This is a terrible disease for our little guys to have to go through!

    Reply

Leave a Comment Cancel reply

Your email address will not be published. Required fields are marked *

Recent Posts

  • Should you get an automatic pet feeder for your dog or cat?
  • Is there a blood test for cancer in dogs and cats?
  • Sign this petition to have Amazon take dog ear cropping kits off!
  • How to keep your geriatric dog more comfortable
  • How to euthanize a dog with Tylenol… and why you don’t….

Recent Comments

  • justinelee on Immune-mediated hemolytic anemia in dogs | Dr. Justine Lee, DACVECC, DABT, Board-Certified Veterinary Specialist
  • justinelee on Pet Hoarders: How many cats are too many? | Dr. Justine Lee
  • Bec on Pet Hoarders: How many cats are too many? | Dr. Justine Lee
  • Debbie P on Immune-mediated hemolytic anemia in dogs | Dr. Justine Lee, DACVECC, DABT, Board-Certified Veterinary Specialist
  • Juliet on My cat has squamous cell carcinoma | Dr. Justine Lee, DACVECC, DABT, Board-Certified Veterinary Specialist

Archives

  • December 2020
  • November 2020
  • August 2020
  • June 2020
  • May 2020
  • April 2020
  • March 2020
  • February 2020
  • January 2020
  • December 2019
  • November 2019
  • October 2019
  • August 2019
  • June 2019
  • May 2019
  • March 2019
  • February 2019
  • January 2019
  • December 2018
  • November 2018
  • October 2018
  • September 2018
  • August 2018
  • July 2018
  • June 2018
  • May 2018
  • April 2018
  • March 2018
  • February 2018
  • January 2018
  • December 2017
  • November 2017
  • October 2017
  • September 2017
  • August 2017
  • July 2017
  • June 2017
  • May 2017
  • April 2017
  • March 2017
  • February 2017
  • January 2017
  • December 2016
  • November 2016
  • October 2016
  • September 2016
  • August 2016
  • July 2016
  • June 2016
  • May 2016
  • April 2016
  • March 2016
  • February 2016
  • January 2016
  • December 2015
  • November 2015
  • October 2015
  • September 2015
  • August 2015
  • July 2015
  • June 2015
  • May 2015
  • April 2015
  • March 2015
  • February 2015
  • January 2015
  • December 2014
  • November 2014
  • October 2014
  • September 2014
  • August 2014
  • July 2014
  • June 2014
  • May 2014

Categories

  • Animal Safety
  • Blog
  • Fun Stuff
  • Interviews
  • Pet Health
  • Pet Help
  • Pet Product Reviews
  • Pet World
  • Recalls
  • Uncategorized
  • Veterinary

Meta

  • Log in
  • Entries feed
  • Comments feed
  • WordPress.org

NEWS & BLOG

  • Should you get an automatic pet feeder for your dog or cat? December 27, 2020
  • Is there a blood test for cancer in dogs and cats? December 23, 2020
  • Sign this petition to have Amazon take dog ear cropping kits off! December 5, 2020
  • How to keep your geriatric dog more comfortable November 20, 2020
  • How to euthanize a dog with Tylenol… and why you don’t…. November 9, 2020

MENU

  • HOME
  • ABOUT
  • BOOKS
    • It’s a Dog’s Life
    • It’s a Cat’s World
  • BLOG
  • MEDIA
  • PUBLICATIONS
  • EVENTS
  • CONTACT

Check out my Dr. Justine Lee YouTube channel for more information!

https://drjustinelee.com/wp-content/uploads/2016/06/Feline-Acne.mp4

© 2014 - 2021 Dr. Justine Lee. All Rights Reserved.