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Young dog needs food smoothies due to esophagus issue

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Food-Feeding Fido

Dogs with megaesophagus can tolerate eating small meatballs one at a time or food with a milkshake-like consistency. But the most important aspect of feeding is that the dog be in a vertical position, or sitting upright.

Q: I have an 11-month-old American Bully with megaesophagus. He was skin and bones when I got him at 3 months old. The breeder was going to take him to the shelter where they said he would inevitably die because of his inability to keep food down.

I thought I would try and help the little fella survive and survived he has! I began with a puppy milk diet feeding him in a standing position several times a day. Once he gained some weight, I began making "meat smoothies" with ground-up kibble, canned puppy food and warm water. He eats in a standing position and licks his food about a cup at a time until he consumes nearly three cups of smoothie. He is fed twice a day and is thriving. He is very strong and sweet.

I've been told that there isn't a cure. What is your opinion of megaesophagus and any corrective surgery?

A: First let me (Perry Jameson) explain what the esophagus does when working correctly. It propels food and liquids from the mouth into the stomach, immediately with no delay. Dogs eat in a horizontal position so they are totally dependent on the esophageal muscles to get food into the stomach.

Megaesophagus is a term used to describe a visibly dilated esophagus on chest X-rays. This can occur from a failure of the muscles themselves or from an obstruction. The difference can usually be determined on X-rays as obstructions usually cause dilation of only a portion of the esophagus while muscular failure dilates the entire esophagus. Both forms can be seen in young dogs such as yours.

Dogs can be born with a blood vessel (persistent right aortic arch) that wraps around the esophagus at the heart base. This narrows the esophagus only allowing liquids to pass. This is why they do fine while nursing but become symptomatic when switched to solid foods. This condition can be treated surgically and most of these dogs go on to live a normal life.

Bones, toys and chewies are foreign bodies that if swallowed in large pieces will get caught in the esophagus. They often can be removed with an endoscope or, in rare cases, require surgery.

Older dogs can develop tumors that, as they enlarge, block the flow of food and liquids into the stomach.

For those with loss of esophageal muscle function, we do not know the cause yet. Some dogs are born with a flaccid esophagus at birth or develop one later in life. The terrible thing is that it is often a permanent, irreversible problem. If your dog’s entire esophagus is dilated, this would be my worry for him.

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Less commonly, the disease is secondary to another problem that causes muscle weakness. Symptoms can vary where the esophagus is the only affected muscle to the dog being weak all over and unable to stand. Even though rare, I feel it is important to look for these diseases because if treated, sometimes esophageal function will return. Even though these are seen more in older dogs, I would still test your puppy.

Low thyroid hormone (hypothyroidism) can affect nerve and muscle function, and since the esophagus is a primarily muscle, it may be affected. If the adrenal glands do not produce adequate cortisol (Addison’s disease), in rare instances they will develop megaesophagus. With hypothyroidism and Addison’s disease, once supplemented with the hormone they lack, the esophagus will often return to normal.

Another acquired form is from the condition myasthenia gravis. With this disease, the nerve cannot stimulate the muscle to contract. It can involve only the esophagus or be so extensive the dog cannot stand. There are medical treatments that can be used to reverse the muscle weakness. In many dogs the condition will spontaneously resolve.

The major problems for dogs with megaesophagus are aspiration pneumonia and weight loss. Vomiting is a normal body function to remove something from the stomach like sneezing is to flush out the airway. When a dog vomits, the airway closes to prevent aspiration. The regurgitation that occurs with megaesophagus is not normal. It occurs suddenly and the airway does not close spontaneously. This makes aspiration pneumonia the major complication and the major reason dogs die from this disease.

Modifying how they eat and what they eat is the best and only therapy for many of these dogs. Some dogs do best with food the consistency of a milkshake, as it will flow down the esophagus quickly into the stomach. Others do better with small meatballs they can eat one at a time.

The most important thing of all is while eating they need to be in a vertical position, or sitting upright. A food and water bowl raised to the level of their head is not enough. Also they need to stay in this position for 20-30 minutes after being fed.

Dog parents have built many different devises to help with this. The Bailey’s chair is a device one family developed that works well (baileychairs4dogs.com).

To prevent regurgitation while sleeping, they should sleep with their head higher than their feet.

The prognosis for dogs with megaesophagus is poor. Most dogs only live for 3-6 months once diagnosed, and if aspiration pneumonia is present at the time of diagnosis, this shortens their expected survival. I have had dogs live for years with this condition when the parents strictly followed my feeding recommendations.

Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs@postandcourier.com.

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