How to Care for a Dog with Megaesophagus

Three Parts:Feeding a Dog with MegaesophagusTreating Your Dog's Condition MedicallyUnderstanding Megaesophagus

The esophagus is the muscular tube that connects the mouth to the stomach. When a dog eats, food is swallowed and pushed down this tube by coordinated muscular contractions which milk it into the stomach. In the condition, megaesophagus, this process does not work smoothly and food either sits passively in the esophagus, or else it accumulates in a dilated pouch upstream of the entrance to the stomach (the gastric sphincter). Fortunately, feeding your pup properly and experimenting with his diet can alleviate the symptoms of this condition and make meal times worry-free.

Part 1
Feeding a Dog with Megaesophagus

  1. Image titled Care for a Dog with Megaesophagus Step 1
    Feed your dog from a raised bowl. The normal feeding posture for a dog is standing on all fours with his head down in a bowl on the floor – this won't work for a dog with this ailment. The simplest remedy is to get gravity to work for the dog by feeding him from a raised up bowl. The optimum angle is to have the dog's backbone and neck running at a 45-90° angle to the ground.[1]
    • To achieve this, place the food bowl on a chair or low table, depending on the size of the dog. Thus for a Labrador putting the food on a surface elevated two to three feet from the ground is desirable. At this height the dog is may need to put his front paws on the surface in order to reach the food, and this is an advantage because it elevates all the forequarters, and the stomach will lie in a lower position.
    • In anatomical terms, when eating "normally," the food he swallows passes uphill from his mouth to his stomach. A dog with megaesophagus lacks the muscular contractions necessary to milk the food upwards against gravity and push it through the gastric sphincter guarding the entrance to the stomach.
  2. Image titled Care for a Dog with Megaesophagus Step 2
    Elevate his paws and head after eating. In addition, after finishing a meal, the dog should rest in a similar position with his paws and head elevated. Food does not pass instantly into the stomach; by maintaining this posture for a ten to twenty minutes after eating, it gives gravity a chance to help.
    • To do this, get your dog situated on a couple of pillows or blankets. In time, you can train him to sit like this after eating so he'll do it even when you're not around.
  3. Image titled Care for a Dog with Megaesophagus Step 3
    Consider giving him a liquid diet. A dog with a vascular ring anomaly often has a narrow, but patent, lumen in the gullet and can often drink fluids and keep them down. This is because liquid can pass through the narrow lumen but food gets stuck and dams back. If surgery is not feasible for whatever reason, these dogs should be fed from a raised up bowl (see above) and be given a liquid diet.
    • Special high calorie, prescription diets are available which are pate-like in the tin, but when mashed with a fork (and without the addition of water) become liquid. This is an effective way of providing a balanced diet that the dog can cope with.
    • Another option is to feed him a regular diet but put it through a blender prior to serving, so that the food is a gruel-like, or porridge type, consistency.
  4. Image titled Care for a Dog with Megaesophagus Step 4
    Experiment with different food textures. Apart from a liquid diet, it is worth experimenting with different textures of food from dry to kibble, to bulky wet food, to a gruel or porridge like consistency. There are no set rules as to what texture a mega esophagus can best handle. Sometimes fluids slip down well, other times giving the muscles of the gullet something to grip on, such as a bulky food, can maximizes whatever contractility is present.
    • What seems to work for some dogs is preparing "meatballs" made of dry biscuit kibble and tinned food, rolled into a ball. These are then hand fed, one at a time, to the dog. Perhaps the round shape gives the gullet something to grip on, or maybe it is because the animal is hand fed and eats more slowly, but for some dogs this recipe does seem to help.
  5. Image titled Care for a Dog with Megaesophagus Step 5
    Pay attention to your dog's weight. As well as regurgitating undigested food, a dog with megaesophagus may lose weight because he is not getting his full daily caloric requirement. If you've changed your dog's diet and means of intake and your dog is still underweight or losing weight, contact your vet immediately. Adequate nutrition is essential to your dog's health.
    • The key to caring for a dog with megaesophagus is to feed him in such a way that it maximizes the chance of food passing successfully into the stomach. If that doesn't work, you may have to explore your medical options.

Part 2
Treating Your Dog's Condition Medically

  1. Image titled Care for a Dog with Megaesophagus Step 6
    Consider surgery. In some dogs there is normal motility, but an anatomical irregularity, such as a vascular ring anomaly, preventing the food from passing all the way along the gullet. In the hands of a skilled thoracic surgeon this condition is correctable. The abnormal blood vessel can be surgically tied off and sectioned, which frees the esophagus from the ring constricting it.
    • A vascular ring anomaly is a congenital condition that occurs in the fetus when a blood vessel grows in the wrong place and encloses the esophagus. This has a similar effect to putting your foot on a hosepipe, in that it forms an obstruction and prevents fluids (or food) from traveling along the gullet successfully.
  2. Image titled Care for a Dog with Megaesophagus Step 7
    Ask your vet about a gastrostomy tube. Some dogs are so severely affected that they are unable to meet their daily calorific requirements and lose weight. In extreme cases, some dogs struggle to even get fluids into their stomachs and can become dehydrated. In these cases, it may be necessary to have a gastrostomy tube fitted.
    • A gastrostomy tube is a feeding tube that gives direct access to the stomach. It is fitted under general anesthesia and involves placement of a soft rubber tube inside the stomach, which is anchored in place and then passed out through a surgical incision in the body wall. They are only suitable for liquid feeds, but the advantage is that nutrition can enter directly into the stomach.
      • However, gastrostomy tubes require constant care and rigorous hygiene in order to prevent infection around the stoma site. Food needs to be liquidized in order for it to pass through the gastrostomy tube. After each feed the tube needs to be flushed with water to remove food contamination which could harbor bacteria. Obviously, since the tube empties into the stomach, this cannot be done with disinfectants, but must rely on copious flushing with water. Needless to say, it is a huge commitment on the part of the owner.
  3. Image titled Care for a Dog with Megaesophagus Step 8
    If applicable, treat the underlying condition. In a small percentage of cases, the megaesophagus is a symptom of another health issue such as an underactive thyroid, or myasthenia gravis.[2] Treatment of this underlying condition can help maximize esophageal motility.
    • However, in the majority of cases no predisposing factor is found and it is a case of control rather than cure. Sadly, there is no effective drug treatment that promotes muscular contraction in the gullet.
    • A medication called metoclopramide is sometimes uses for its prokinetic properties on the stomach and end part of the gullet. The drawback is that this drug also increases the tone of the gastric sphincter, so although the esophagus may work harder, it is effectively pushing against the closed door of the gastric sphincter, so you are back to square one.

Part 3
Understanding Megaesophagus

  1. Image titled Care for a Dog with Megaesophagus Step 9
    Learn why your dog has megaesophagus. This condition can happen for three reasons:
    • The muscles of the tube don't contract properly and fail to massage food down into the stomach
    • The muscles lack tone and a baggy pocket forms, trapping food
    • The esophagus is caught within a ring of blood vessels (a vascular ring anomaly), and is physically constricted at a point in its length (imagine putting your foot on a hose). This stops food from passing along.
  2. Image titled Care for a Dog with Megaesophagus Step 10
    Recognize the difference between vomiting and regurgitation. The most common symptom a dog with megaesophagus will display is regurgitating food on a regular basis. Regurgitation is a passive process whereby the dog may only need to lower his head to the ground and food that was sitting in the esophagus spills down into his mouth because of gravity. This food usually is undigested because it hasn't made it as far as the stomach, and has been sitting passively in the pouch.
    • It can be difficult to tell the difference between regurgitation and vomiting, but there is a subtle difference between the two events. Vomiting involves food that has entered the stomach and requires forceful muscular contractions, often involving the diaphragm and stomach muscles, to void the stomach of its contents. Vomitus is usually partially, or fully, digested depending on how long food has been in contact with the digestive acids in the stomach.
  3. Image titled Care for a Dog with Megaesophagus Step 11
    Be on the lookout for complications, like secondary pneumonia. Your pup is also at greater risk of accidentally inhaling food or fluids down into his lungs. This can cause secondary pneumonia, in which case the dog will be lethargic, cough, breath heavily, and refuse food. Dogs with a secondary pneumonia tend to be very ill, may run a fever, go off their food, and progress to a state of collapse over four to five days. The associated cough tends to be moist and rattle-like.
    • If the dog breathes in at the wrong moment as he regurgitates, he inhales food or fluid, down into his lungs. This sets up an "aspiration pneumonia" which can be serious and needs prompt treatment with antibiotics. Be vigilant for any coughing, and always seek prompt veterinary attention should your dog seem breathless, off color, or cough.


  • Tube infections, or infections where the gastrostomy tube is inserted into the skin are common. Should this happen then antibiotic cover is required, and should the infection be severe the tube has to be removed until it is brought under control, and then a new one fitted under general anesthetic.

Sources and Citations

  1. Megaesophagus in the dog: a review of 50 cases. Boudrieau RJ. JAAHA 1985;21:33-40
  2. Megaesophagus in the dog and cat. Guilford WG. Sem Vet Med Surg (Small Animal) 1990;5:37-45

Article Info

Categories: Feeding Dogs