What is Megaesophagus?

Megaesophagus is a condition in which the esophagus loses the ability to contract and move food into the stomach. This causes the esophagus to dilate and any food or water consumed remains in the esophagus until it is passively regurgitated. Regurgitation often occurs unexpectedly, including when an animal is asleep. When this occurs, the animal is unprepared to close off the opening to its windpipe and can inhale food or water, which can result in pneumonia, the leading cause of death in animals with megaesophagus. 

What causes Megaesophagus?

Megaesophagus can be caused by many underlying diseases. Your veterinarian may test for myasthenia gravis, hypothyroidism, hypoadrenocorticism, toxicities, infectious disease, or other neuromuscular diseases. In puppies, the cause is often congenital but, in some cases, the esophagus can be constricted by an abnormal blood vessel formation. Surgery may be an option in such instances. In most adult dogs, the cause is often unknown.

How is megaesophagus treated?

Treatment is focused mostly on underlying conditions contributing to the disease and managing food and water intake and home environment. Since medical therapy options are limited, the owner’s dedication, attention to detail, and consistency are key to keeping a dog with megaesophagus healthy at home.

Food, water, and medications must be offered when the dog is in an upright position. The Bailey chair is a great option for most dogs, especially larger breeds, and smaller breeds can often be held in an upright position by their owners. Some dogs may do well standing on a ladder or step stool. Dogs may need to stay in this upright position for 10 to 30 minutes or more to allow material to move through the esophagus and into the stomach

If my dog has megaesophagus, what symptoms should I be concerned about?

Some dogs may regurgitate daily or weekly, while others may go months between episodes. If you notice the amount of regurgitation worsens this could indicate something has changed or their management plan needs to be adjusted. Some dogs may require changes in food consistency throughout their lifetime.

Also monitor for signs of pneumonia such as:

  • lethargy
  • inappetence
  • increased breathing rate or effort
  • breathing with head or neck extended
  • pale or blue gums/tongue
  • pale or blue gums/tongue
  • coughing
  • fever
  • other concerning changes in behavior

If these are noted or if your dog is not acting normal, contact a veterinarian immediately.

Many dogs also struggle with saliva accumulation, as saliva will not move down to the stomach. This can cause coughing, sneezing, regurgitation, and possible aspiration. A neck hug or inflatable e-collar to keep their head elevated while at rest will help drain saliva away from the throat and may help prevent aspiration.

How do I provide my dog food and water?

One of the first things to determine for your pet is which food consistency works best for them. This varies from pet to pet and you will need to experiment with different food. Possible choices include a blended slurry, canned food, meatballs, or soaked kibble. Animals with megaesophagus are unlikely to be able to eat a normal dry kibble.
Remember even water cannot be consumed normally. Some dogs may require thickeners to be added to their water or may need to consume gelatin cubes to supplement water intake. In dogs that cannot tolerate any water consumption, fluids can be given under the skin to maintain hydration. Dogs should not have free access to a water bowl. Be sure to ask your veterinarian how much water your pet should receive daily.

Can my dog have treats?

Treats should ideally be avoided except when offered in the vertical feeding position. Good options are Gerber Graduates puffs or yogurt melts (or equivalent), which dissolve immediately in the mouth or lickable treats such as PetSafe Lickety stik or Leanlix. Consult your veterinarian if you are unsure if treats are safe for your dog.

What is the long-term outlook for dogs with megaesophagus?

The prognosis for megaesophagus has long been considered to be quite poor. It is uncommon for the condition to resolve spontaneously, except with specific underlying diseases. However, with a better understanding of the disease and advancements in how it is managed, animals can have a normal lifespan. Discuss all underlying conditions and the severity of your pet’s condition with your veterinarian to better determine what prognosis can be expected for your pet.

Supplies to have at home

Bailey Chair – These can be built at home or purchased online.

Inflatable e-collar or neck hug – These collars help elevate your dog’s head while they sleeping and may cut down on regurgitation and possible aspiration.

Where can I get help if my dog has megaesophagus?

Our board-certified veterinary internists can help you get an accurate diagnosis and develop a treatment plan. Call 509-335-0711 to schedule an appointment or visit our internal medicine website for more information.

This information is not meant to be a substitute for veterinary care. Always follow the instructions provided by your veterinarian. Washington State University assumes no liability for injury to you or your pet incurred by following these descriptions or procedures.