Guide to Megaesophagus

Updated on June 11th, 2019

What's In This Guide?

    Disclaimer: Before You Read

    It is important to know that your genes are not your destiny. There are various environmental and genetic factors working together to shape you. No matter your genetic makeup, maintain ideal blood pressure and glucose levels, avoid harmful alcohol intake, exercise regularly, get regular sleep. And for goodness sake, don't smoke.

    Genetics is a quickly changing topic. Read More.

    The condition known as megaesophagus is when the tube that connects the throat and stomach, called the esophagus, decreases in mobility. The mobility is what brings the food to the stomach, and when that is limited, it can result in serious malnutrition and other health complications.

    Megaesophagus is a condition that mainly affects dogs, but it can also affect other animals and humans as well. A diagnosis of this condition is quite serious, and at YourDNA, we’ve compiled our research together to help our readers learn more about it.

    What Is Megaesophagus?

    Megaesophagus is not one single disease, but a variety of conditions that cause food and liquid to accumulate in the esophagus due to a loss of mobility. With a healthy esophagus, liquids and food in the mouth stimulate the swallowing reflex, which carries the food.

    Megaesophagus is when the food never makes it to the stomach, causing regurgitation, or the food coming back up.

    To understand this condition more, it’s helpful to first understand dog esophagus anatomy to see how everything is connected and how everything is supposed to function. For the digestive tract to work correctly, food and liquid must be able to travel down the esophagus to reach the stomach.

    Megaesophagus will affect a dog drinking water and eating food because it’ll prevent it from being digested. Eventually, this condition will lead to weight loss and more serious complications.

    Acquired megaesophagus in dogs can sometimes occur alongside other conditions as a secondary illness. Myasthenia is approximately 25% of the secondary cases.

    Achalasia is a rare disorder that affects humans, similar to megaesophagus, that causes the esophagus to become impaired 1. With this condition, the lower esophageal sphincter does not open up after swallowing foods and liquids, causing these foods to become backed up into the esophagus.

    This condition affects approximately 3,000 people in the United States per year.

    In humans, megaesophagus is a complication that can occur with Chagas disease 2. This complication occurs in about 20 to 30% of patients with Chagas disease during the chronic phase.

    Patients can also develop other gastrointestinal issues, including an enlarged colon, or megacolon.

    Causes of Megaesophagus

    Many cases of megaesophagus are congenital, which means they’re born with it. The other cause is that it’s acquired at a later point in life, most often due to unknown causes. This condition is known to be genetic, affecting specific dog breeds more than others.

    Megaesophagus can come at any age, but generally, when puppies have it, it’s due to genetics or a condition called Persistent Right Aortic Arch or PRAA.

    Megaesophagus is something that can be prevented, especially when it comes to animals. One of the easiest ways to prevent other animals from getting the condition is to stop breeding affected animals.

    Siblings and parents of the dog or cat should also be tested for the condition to prevent further occurrences.

    Symptoms of Megaesophagus

    Megaesophagus can affect different species, including humans and felines, but it’s most common in canines. Megaesophagus cat symptoms are generally the same.

    The condition can be difficult to fully diagnose, but some signs you want to look out for include:

    • Nasal discharge
    • Loss of appetite and refusing to eat
    • Coughing
    • Regurgitation
    • Excessive drooling
    • Louder than normal respiratory noises
    • Rapid weight loss
    • Poor growth
    • Sour smelling breath

    If your pet experiences any of these symptoms, you should give their veterinarian a call. With megaesophagus, dog coughing is an important symptom that shouldn’t be overlooked, especially when it’s accompanied by regurgitation.

    These symptoms may not necessarily mean your pet has megaesophagus, but they should be addressed to rule out the disease.

    Megaesophagus symptoms in humans are often different than those with canines and other animals, but some of them are similar. Some symptoms of this condition in humans are:

    • Heartburn that cannot be treated with heartburn medications
    • Weight loss
    • Discomfort in the chest, which is caused by food and liquid buildup in the esophagus
    • Regurgitation
    • Trouble swallowing food and liquid
    • Sharp pain in the chest caused by unknown reasons

    If you’re experiencing frequent discomfort after eating and/or drinking, a doctor can help determine the cause of this and rule out anything serious.

    Who Does Megaesophagus Typically Affect?

    Megaesophagus is most common in dogs but can affect humans, cats, and even horses. The dog breeds most affected by this disease include:

    • Labrador retriever
    • Irish setter
    • Greyhound
    • Newfoundland
    • German shepherd

    Megaesophagus in Great Danes is also common, especially among puppies. This condition is not usually noticed when puppies are still nursing because it’s easy for the mother’s milk to move down into the stomach.

    When there is megaesophagus in French bulldogs, the most common cause is esophageal inflammation.

    Megaesophagus can also affect certain cat breeds, which include:

    • American shorthair
    • Siamese
    • Persian

    This condition can also affect horses, even though it is considered to be a rare occurrence. When it does occur in horses, it’s most common in Friesian horses and is considered to be congenital.

    It’s usually something that’s diagnosed when the foal is able to start eating solid foods.

    Other Conditions Associated With Megaesophagus

    Dysphagia is a condition that makes you feel like you have food sticking in your throat. This condition, like megaesophagus, prevents the food and liquid from successfully making it through the digestive system.

    This condition can affect people at any age, and display some of the same symptoms as megaesophagus.

    Diagnosis of Megaesophagus

    One of the most important methods doctors use to diagnose megaesophagus is a physical examination 3. This is especially important because it will help doctors rule out if there are other conditions causing these symptoms. The veterinarian will ask many questions, and it is important that these questions are answered as accurately as possible.

    There are many things doctors will look for during the examination. Some patients will exhibit excessive weight loss, and there may be swelling present in the ventral neck.

    A canine megaesophagus specialist may use a survey thoracic radiograph to be able to see if there is food or fluids in the dilated esophagus, which would indicate this condition is present 4. X-rays are also helpful diagnostic tools that can help pinpoint the problem.

    There are currently no blood tests available that would diagnose megaesophagus. There are blood tests available that would help determine if there are other underlying conditions, though.

    Even with physical examinations, diagnostic tools, and other testing methods, megaesophagus can be misdiagnosed. There are clinical signs of megaesophagus that can make doctors think the condition is Myasthenia Gravis, which is another condition that affects the esophagus.

    The symptoms of megaesophagus can often get mistaken with other gastrointestinal disorders because of how similar the symptoms are.

    Genetic Tests for Megaesophagus — Are they available?

    Is megaesophagus genetic? There are certain dog breeds that are affected more by the acquired form of this condition. In other breeds, such as the German shepherd and Irish setter, the condition is acquired by having a predisposition to this condition due to their genetic makeup.

    At this time, the genetic markers for this condition are being studied, which makes genetic testing for megaesophagus, not something that’s possible yet. It’s possible that in the future, after further research, there will be tests available to determine if you or your pet are at high risk of inheriting this condition.

    Megaesophagus Treatment Options

    The most important factor in treating megaesophagus is trying to find the underlying cause of the condition. Treatment of this disorder is mainly focused on managing the symptoms and trying to prevent regurgitation.

    When regurgitation is prevented, food can move through the gastrointestinal tract for digestion.

    There is a megaesophagus chair designed to help prevent regurgitation because it keeps the dog upright during and after feeding. The Bailey Chair is an important key to helping the food pass through the esophagus and into the stomach.

    This type of equipment was designed to support canines comfortably while they’re eating a meal and for 15 minutes after they’re done. It can be used for puppies and older dogs.

    This megaesophagus feeder relies on using gravity to guide the food down. The upright position helps to prevent the food from coming back up as well as preventing the dog from choking.

    What the dog is fed can also make a difference because dietary changes can help reduce regurgitation. It can help to avoid feeding the dog firm and crunchy kibble and focus on feeding them softer options.

    Homeopathic remedies for megaesophagus can prove to be successful but do include trial and error. Sometimes dietary changes and exercises can help curb the symptoms of the condition, making it easier to live with.

    For humans with megaesophagus, it is helpful to take antacids to help an upset stomach.

    Megaesophagus treatment in humans greatly varies because it’s dependent on why someone has the condition. There are herbs, such as licorice, slippery elm, and marshmallow.

    Before starting herbal and other homeopathic remedies, it’s important to consult a healthcare professional. Herbs do have the capability of causing side effects and negatively interacting with certain medications.

    Surgery for Megaesophagus

    There are surgical options available to help treat megaesophagus. The surgery involves the removal of the narrow part of the esophagus.

    This treatment option is most effective when it’s performed at a very young age, especially between the ages of two to six months. Early on is the best because it needs to be performed before there are issues with emaciation and growth damage.

    Two types of surgeries are available for dogs, including classic thoracotomy and minimally invasive surgery thoracoscopy. Megaesophagus surgery cost depends greatly on the facility, but it can run anywhere from $2,000 to $6,000.

    There are pros and cons to each option, and a specialist will be able to determine if either one is the right option for your puppy.

    The Prognosis for Megaesophagus

    The prognosis for megaesophagus, even with treatment such as an E-tube, or gastrointestinal catheter, is generally poor 5. Megaesophagus dog death is possible, mainly due to aspiration pneumonia and malnutrition.

    Aspiration pneumonia is when food or liquid gets accidentally inhaled into the lungs. When food is aspirated into the lungs, symptoms such as coughing, difficulty swallowing, breathing difficulties, nasal discharge, and increased heart rate can occur.

    Weight loss that leads to malnutrition is something that occurs because the food is coming back up and is not being digested. Sometimes pet owners have to make the difficult decision to euthanize a dog with megaesophagus because there are no proper treatment options available and the dog is suffering.

    A specialist will help you determine if this is the best option available, and will explore all other available options before coming to this decision.

    One of the main reasons why megaesophagus dog life expectancy is low because there are many complications that can arise from this condition that are difficult to treat. It is possible for puppies to outgrow the condition, but acquired cases of the condition are generally not reversible.

    Sometimes, when the animal is not able to eat on their own, a feeding tube can be placed, which can increase the life expectancy. An E-tube is a feeding tube that goes directly into the esophagus from a tiny incision in the neck.

    This tube does not go into the stomach, but it allows food to enter the stomach.

    Some medications, such as metoclopramide, are available that work to relax the muscles around the esophagus to cause muscle contractions that will help promote swallowing.

    With the help of a skilled veterinarian, it is often possible for your dog to live with megaesophagus, especially when respiratory infections are treated right away. A veterinarian will suggest the best type of food for your pet, as well as allowing them to eat smaller, more frequent meals.

    Referenced Sources

    1. Achalasia.
      NORD – National Organization for Rare Disorders. 2019.
    2. Detailed FAQs.
      Centers for Disease Control and Prevention.
    3. Diagnosis and management of megaesophagus in dogs (Proceedings)
      By Kate KuKanich, DVM, PhD, DACVIM CVC IN KANSAS CITY PROCEEDINGS. 01 Aug, 2011.
    4. Student Case 1.
      Case submitted by: Debra S. Gibbons, DVM, MS, DACVR, VCA Alameda East Veterinary Hospital, Denver, CO.
    5. Long-term management of a dog with idiopathic megaesophagus and recurrent aspiration pneumonia by use of an indwelling esophagostomy tube for suction of esophageal content and esophagogastric tube feeding.
      Yuka KANEMOTO, Kenjiro FUKUSHIMA, Hideyuki KANEMOTO, Koichi OHNO, and Hajime TSUJIMOTO.