Megaesophagus by Hilary Brezinka

It’s noon, and Kiba comes over to where I’m working at my desk and sticks his cold nose on my arm nudging me. I look over at him into his sweet bi-colored blue and brown eyes and he chatters with an expressive smile reminding me it’s lunch time. I pet his scruff and ask if he’s hungry. This time he barks and his tail wags excitedly. Grabbing his and Max’s bowls from their Bailey chair trays I go into the kitchen, rinse the bowls and set them on the counter. In the freezer I find their pre-portioned raw meals. I pour 3/4 a cup of tap water into each bowl. I now have an audience of not only Kiba and Max but their big sister Zoey who’s very interested in what I’m doing. My fingers sting with cold as I work to empty nearly a pound of frozen ground raw prey model from the food storage baggies my husband has portioned them into. The frozen chunks cling as they fall into the metal bowls, one at a time. Kiba rushes over to his Bailey
chair—A chair specifically designed for dogs with megaesophagus. His chair has a paw print cutout on the door, and is padded with maroon and black colored vinyl stretched tight over top. He whines in anticipation and turns in circles as I open the door to his chair. Of his own volition he backs in and raises himself into an upright beggar position. I close the door then latch it on the side locking him into the upright pose. The bowl of food gets placed into the circle cutout on the Bailey chair tray, and he immediately lowers his face and starts lapping at the water, and soon starts gnawing at the frozen food, chewing, swallowing, and burping as he enjoys every last morsel. Max follows suit by getting into his Bailey chair appropriately displaying a cutout royalty crown on the door, he backs in to his chair, sits upright and is locked into place. He enjoys his food at a much slower pace than Kiba. After the meal is finished the
the boys settle in, with lazy looks of satisfaction upon their faces. I set a timer for 35 minutes, during which time the boys need to remain in an upright position so any remaining food and liquid in their esophagus goes down into their stomach with the help of gravity.
Megaesophagus (ME) is an enlarged and paralyzed esophagus. The esophagus is normally a thin tube, the muscles contract and propel food into the stomach. Dogs with ME benefit from more frequent and smaller meals, being upright or elevated at an angle, and consuming food/fluids of a certain consistency and smoother texture that go down better without irritation.
Pictured below is Max sitting in his chair during upright time—after he’s finished a meal.
Pictured above is a radiograph image of Kiba’s esophagus during a barium study when he was 2 months old. The esophagus is limp, and stretched out full of food that never made it to his stomach.
Symptoms of megaesophagus (when unmanaged symptoms will be extreme and possibly lead to death):
•Regurgitates. Food falls out of the esophagus and mouth, having never reached the stomach —different from vomiting.
•Excess phlegm. The esophagus creates phlegm to protect itself from irritants, usually the
food the dog eats such as dry kibble, but can also be caused by non-food items such as wood chips.
•Stretched esophagus (that can develop pockets within it). Get a Barium test at the vet to determine if the dog has ME. You may be able to see something called a “bullfrog throat” when the dog barks, burps or coughs, the throat will balloon out.
•Food and water can remain in the esophagus, sometimes rotting. This can lead to wretched smelling breath.
•Underweight, thin, frail.
•Failure to thrive.
•May develop a food aversion.
•Aspiration pneumonia (AP). Diagnosis of megaesophagus is usually made after a dog becomes sick with AP for the first time. AP is serious and must be treated immediately by a vet. AP occurs when the dog inhales regurgitation, usually containing food particles making it more serious.
For older dogs that come down with ME it’s a good idea to check for contributing diseases or causes such as Addison’s or Myasthenia Gravis (MG) just to name a couple. Max and Kiba were born with ME, so theirs is considered congenital or hereditary. Other dogs will have the idiopathic form, which means doctors don’t know why they have it. Then there are puppies born with PRAA (Persistent Right Aortic Arch), which is a congenital anomaly of the blood vessels of the heart that results in constriction of the esophagus. Prognosis is good once they have surgery to correct it.
Megaesophagus can affect any breed and any breed mix. It’s more common in deep chested, large breed dogs such as Great Danes and German Shepherds. It can be secondary to another disease, brought on through injury, poisoning or passed on genetically. For litters born with ME both parents should no longer be bred. The ME dogs, including siblings should not be bred either. There is no genetic test for ME at this point in time. Megaesophagus research is crucial as it is a problem facing the whole dog community.
Some research indicates that ME is on the rise, and there is a correlation between that and poor quality dog food. Nutrition should always be a top priority, ME dogs already have enough working against them. Do some research for yourself, don’t fall for the gimmicks of dog food advertising— which is a multi-billion dollar industry. With good nutrition you will give your dog a better chance at a happy and healthy life. Check out to find a good quality dog food.
Pictured below: Kiba and Max enjoy a meal of frozen PMR.
How do I care for a megaesophagus dog?
3 basic rules to managing ME:
1. Feed the dog upright or elevated, stay upright for a bit of time afterwards.
2. Get the food and water consistency right.
3. ME dogs should wear a neck pillows whenever they’re lying down.
Upright feedings
Many people use a Bailey chair to feed their ME dogs. You can also feed them in other containers that match their size. Use pillows and blankets to secure them. Others have success feeding elevated, like on stairs or the back of a couch.
Food and water consistency
It takes trial and error to find what works best for your ME dog. A couple of the more popular food consistencies are slurries or frozen meatballs. A slurry is kibble blended with water to a milkshake consistency. Meatballs are usually made with blended kibble and/or soft food, shaped into meatballs just small enough to swallow whole, and frozen beforehand. Popular water consistences are Knox Blox (flavorless gelatin), ice cubes, powdered thickener or water mixed into food.
Neck pillows are important
Many megaesophagus dogs have issues with lying down and regurgitating, sometimes aspirating the regurgitation which is dangerous. Even if their esophagus was clear after dinner during the night saliva is still produced and swallowed. Over hours it can pool in the esophagus, coming back up early morning. The neck pillow elevates the head enough that the dog can rest comfortably without feeling uncomfortable reflux or regurg. You can make a neck pillow or purchase one. makes excellent pillows called Neck Hugs!
(Max and Kiba wear homemade pillows)
Hope for a future
Megaesophagus is not a death sentence. They can live a full, happy life! Surround yourself with support, and knowledge in the ME communities. Support ME research, advancement and those that educate and spread awareness. Listen to your intuition when it comes to your dog, you are their advocate and protector.
The first couple months after diagnosis or care of an ME dog are the worst emotionally, physically and spiritually. You will be challenged and tested in new ways—and the lack of sleep doesn’t help. It’s not for the feint of heart, but you will come out stronger in the end. The bond you forge with your dog is indescribable and worth all the regurg stains on the carpet, the time spent preparing new types of food, the sleepless nights, the vet trips, the crying and the worry. One day you’ll realize you’ve found the right routine and tools to manage the ME. Life will go on, and soon the ME will fade into the background, your dog’s lovable character will be at the forefront, and they’ll be living life like any other dog—just a bit more special.
Please like Max & Kiba on Facebook: /maxandkiba Instagram: @maxandkiba
Join: Canine Megaesophagus support group & Upright Canine Brigade – Megaesophagus Awareness and Support.