Megaesophagus

Megaesophagus is a condition in cats, dogs, and other pets that is also common in humans. In this condition, the esophagus is generally enlarged, and failing to perform the process of peristalsis. The esophagus is the tube connecting the mouth and the stomach. Peristalsis is the muscular contraction process that pushed food down the esophagus, and into the stomach. When peristalsis fails, there is the likelihood of regurgitation.

Most people have some trouble distinguishing when an animal regurgitates or vomits. However, there is an important difference. And, there is even a third process which is easily confused with these first two. We will break down the differences here.

Regurgitation is the expelling of content from the esophagus, or pharynx (back of the throat). Because of its compaction and interrupted process, it may appear as tube-like in form. Since the matter has not reached the stomach, it is unlikely to contain stomach bile. However, accompanying the food or liquid there may be saliva, and possibly mucus.

Vomiting, on the other hand, involves the expulsion of matter which includes content from the stomach and sometimes the first part of the small intestines. Vomit most often is identifiable by a distinct yellowish or orange tinged fluid, which is evidence of stomach bile. However, a lack of bile does not mean the expelled matter is not vomit. Before the expulsion in vomiting, the animal will likely experience a series of potentially violent contractions generating from the abdomen, and then be followed by the expulsion.

Another event that is quite similar to vomiting and regurgitation, is when your animal expectorates. It usually involves the animal coughing several times, then expelling a blob of mucus. This is the process whereby your animal eliminates a mucus build up in the throat, and is nearly always preceded by coughing.

Being able to distinguish regurgitation from vomiting and expectorating in your dog or cat is important for recognizing the symptoms which can help in achieving a professional diagnosis. A veterinarian will ask several questions in order to better understand what is happening to your pet. Perhaps the best way to give your vet an accurate impression of the problem is to record the pet as it regurgitates or vomits on a digital camera or smartphone. This will provide a view that is not dependent on verbal description only or interpretation, and will lead to faster, more accurate diagnosis.

Dogs, cats, and other pets are like humans, in that certain processes, such as swallowing, are handled by reflex, and the design of muscle interacting with parts of the body are automatic. As with swallowing, pets and humans also have the reflex of muscle that prevents breathing while swallowing so that they will not inhale food or liquids. Because of the malfunctioning of these muscle reflexes in the esophagus, food and liquid cannot process as they normally would, resulting in regurgitation.

One of the adjacent concerns with megaesophagus is that the regurgitation process can expose the animal to the risk of aspiration pneumonia. This is a potentially life-threatening condition caused by an animal inhaling while regurgitating, bringing food and other stomach content into the lungs, resulting in lung infection. So it is important to understand that while taking time to diagnose the apparent condition of your animal, other complications can be developing,  and the threat to the pet’s life may increase.

What causes Megaesophagus?

Megaesophagus is often attributed to congenital preconditions, but the condition is also commonly acquired after birth. Cats with this condition are uncommon. However, Siamese, and closely related breeds, seem to be predisposed.. Certain breeds of dogs are also predisposed to congenital megaesophagus, and included in these breeds are German Shepherd, Great Dane, Labrador, Irish Setter, Newfoundland, Fox Terrier, and more.

Acquired megaesophagus is generally categorized as primary, or secondary. Primary is more rare, and often from non-traceable origin, which categorizes the disease as spontaneous in origin, or designated as having unknown pathogenesis. Secondary conditions are described as resulting from a medical issue. These issues can range from blockage from a foreign object, heavy metal poisoning, esophageal tumor, neuromuscular disease, or parasites.

Symptoms and Signs:

The most common sign in recognizing potential megaesophagus is regurgitation. Therefore, it is critical to understand the difference between regurgitation and vomit. There may be other visual cues to alert you, and complications such as aspiration pneumonia.

• Regurgitation of food and/or water – sudden; unexpected
• Loss of appetite
• Weight loss
• Respiratory distress
• Excessive salivation
• Puppies with Congenital Megaesophagus – regurgitation on change to solid food
• Aspiration pneumonia – includes coughing, difficulty breathing and/or swallowing, nasal discharge, lethargy, fever, weakness, and blue-tinted skin

Some things, such as regurgitation, are obvious, and hard to miss. To recognize other symptoms may require a careful, watchful eye, and a deeper understanding of how your pet acts when it feels good, and how it acts when in distress. The best thing to do is seek professional help as soon as you suspect something is wrong.

Diagnosis:

A proper diagnosis can only be achieved by consulting a trained professional. Hence, setting an appointment with your vet is essential. As mentioned earlier, video recording the pet’s condition while regurgitating or performing questionable activity is most helpful in a professional consultation. Blood and urine testing is the next stage. To better understanding the problem, and get a more accurate view, a vet may order x-rays, and possibly use a more advanced technique called esophagoscopy.

Treatment:

Although there is no known cure for the disease of megaesophagus, Irvine Compounding Pharmacy has assisted veterinarians in designing the right dosages and care plans with promising results. We recommend Cisapride as a consideration, and applied in the right conditions may contribute to a major improvement in quality of life for both dogs and cats diagnosed with megaesophogus.

This condition being more predominant in dogs, there is more data in regards to options, and more procedural strategies and tools for dogs. However, it is generally agreed that diet is a main concern, and adjusting diet is a must. Some cat owners opt for switching to a liquid diet, which they find is easier for the cats to assimilate. Smaller portions and more frequent meals delivered in elevated containers or by hand while, again, elevated, facilitate better consumption.

For dogs, many recommend a sitting position, and holding that position for at least ten minutes after finishing eating. The “Bailey Chair” was developed in response to megaesophagus in dogs, and is designed to hold the dog in the sitting, or begging position. In this way, gravity can assist the passage of food down the dog’s esophagus, and into the stomach.

Any animal with megaesophagus must be watched and treated with special care, and early diagnosis assures that we can begin that special care at the earliest possible moment. With this, animals with these issues stand a better chance at living long, healthy, and happy lives.