Regurgitation: Megaesophagus in Dogs | Daily News

Regurgitation: Megaesophagus in Dogs

The esophagus is the tube connecting the throat to the stomach to pass food to stomach. Esophageal motility is required for moving food and liquid down to the stomach. Megaesophagus is a generalized enlargement of esophagus with a decreased to absent motility.

Megaesophagus is seen more often in dogs as compared to cats. Some breeds are born (congenital) with this problem; for example, wire haired fox terriers and miniature schnauzers. Other breeds reported to be predisposed to this condition include: German shepherds, dachshunds, great Danes, Irish setter, Labrador retriever, pug, and Chinese shar-pei.

Vomiting Versus Regurgitation (Sub Head)

Most of the owners do not realize that there is a difference between vomiting and regurgitation. Vomiting is an active process. There is gagging, heaving, and retching as the body actively expels its stomach contents. Furthermore, there is an associated sensation of nausea allowing for some warning of what is about to occur. A nauseated dog looks uncomfortable and may drool or lick his lips prior to the vomiting motions.

Regurgitation, on the other hand, is passive. When the esophagus loses all tone and dilates, it cannot coordinate the movement of food into the stomach properly. As a result, food tends to simply roll around in the esophagus according to gravity and ultimately tends to be regurgitated back onto the floor.

Causes

Megaesophagus can either be congenital in nature (born with) or acquired later in life. The congenital form is typically due an unknown cause; and acquired form is also commonly idiopathic, but may also be due to: Neuromuscular disease, Esophageal tumor, Foreign body in esophagus, Inflammation of esophagus, Toxicity and Parasitic infections. The patient with idiopathic megaesophagus is usually age 5 to 12 years in age and a large breed dog.

Myasthenia gravis

Myasthenia gravis is considered the most common cause of canine megaesophagus and is the first condition to rule out. Myasthenia gravis is a condition whereby the nerve/muscle junction is destroyed immunologically. Signals from the nervous system sent to coordinate esophageal muscle contractions simply cannot be received by the muscle.

Signs

Regurgitation is considered the hallmark (compulsory) sign of megaesophagus. Other common symptoms include: aspiration pneumonia, vomiting, cough, nasal discharge, increased respiratory noises, weight loss , extreme hunger or lack of appetite, excessive drooling, bad breath and poor growth.

Diagnosis

Your veterinarian will first ask you for a thorough history of your dog’s health. He or she will then perform a complete physical examination on your dog and attempt to differentiate, with your description, whether it is regurgitating or vomiting, which is important in ruling out underlying diseases that cause vomiting. The shape of expelled material, presence of undigested food, and length of time from ingestion to vomiting (or regurgitation) will also help differentiate between these two issues.

Routine laboratory tests, X rays and esophagoscopy also will help the vet to diagnose the megaesophagus situation very clear. Most of the Veterinary clinics in Sri Lanka do have such tests facilities.

Treatment

Your vet may give medical treatment according to the course of megaesophagus. These drugs may include anti emetics, anti acids etc. But as the dog continuously vomits you have lot more homework to deal with its diet.

Food

Because so much nutrient material is lost in regurgitation, megaesophagus patients tend to be underweight. Adding a protein supplement such as whey protein powder can assist in maintaining a normal weight

Food Consistency

The first step is to determine if the dog does better with a liquid or solid diet. Increase the frequency of giving food in small amounts also will help food accumulation in the esophagus and regurgitation.

Giving water

If liquids are a problem, water can be provided in gelatin, mixed with a thickener or given as ice cubes.

Elevated Feeding

To minimize the effect of gravity on the food (and thus minimize regurgitation) one must train the dog to eat in an elevated position. The food is placed on the top platform and the dog must eat with his forefeet on one of the upper steps and his rear feet on the lower steps. Ideally, the pet should be kept in this position for 10-15 minutes after the meal.

Bailey Chair

The Bailey Chair was invented by the owners of a megaesophagus dog named Bailey. The chair which allows not only for vertical feeding but also confines the patient for the post-feeding waiting period. The more vertical the feeding, the less regurgitation or it stops completely.

The Feeding Tube

If elevated feeding is not providing adequate nutrition for the patient, the gastric feeding tube is an alternative. The tube allows food to be delivered directly into the stomach, skipping the diseased esophagus.

(The writer is a Veterinary Surgeon and holds B.V.Sc; M.Sc Poultry 

Science; Master of Public Administration and Management)


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