MEGA Tip of the Week 

July 27, 2020


Megaesophagus Management 101


While there are many tips for the management of Megaesophagus, which can vary with each dog, the basics are generally the same:


1. Utilize the vertical feeding process. Since the esophagus has lost its elasticity, it cannot process food as it should. Therefore, the vertical position will utilize gravity to propel food to the dog’s stomach. How your dog maintains vertical is up to you. A “Bailey Chair” is used for most medium to large dogs as it holds the dog in place. You may find other options for small dogs. (Please avoid using a bowl in a “recessed tray” as it forces the dog’s head into the same incorrect position as the dog eating from the floor.)


2. Your dog not only needs to eat in the vertical position, a “hold time” after eating is necessary. This varies somewhat for each dog, most likely due to the amount of functionality left in the esophagus. Over the years, we have found that the average hold time is 15-30 minutes, post meal.


3. Vertical eating and hold time will not be successful with dry/kibble dog food or “pieces” of any type of food. There is not enough weight in the food for gravity to work. Therefore, the three most popular food consistencies that have been successful are:


a. Blended, smooth consistency (Best obtained by processing canned food in a blender) – We utilized a pudding-like consistency as the weight combined with the smoothness slid through the non-functioning esophagus. However, some dogs do better with a lighter consistency.

b. Canned food, rolled into meatballs – Best swallowed whole to avoid particles sticking in the non-functioning esophagus

c. A slurry consistency – Obtained by mixing food with water. It is assumed that this consistency works best for dogs with some functionality in their esophagus.

4. Water is consumed in the vertical position as well. If you dog has issues with water, you may need a water thickening product for gravity to work.


While some dogs have been successful with food variations and semi-vertical positions, we do not recommend those concepts as they are the exception rather than the rule and most likely work based on some remaining functionality in the esophagus. Or they “appear” to work for a period of time when in reality, the food reaching the stomach may be minimal as food is headed to the lungs through the trachea or they are regurgitating.


As mentioned above, there are many tips beyond the basics in the list above. Those may vary per dog including but not limited to low fat food requirement, over the counter medications, a pro-collar for sleeping, etc. Contact us if you need immediate assistance. In addition, we will continue to provide those tips each week.

As with many of the management options for Megaesophagus, they may or may not work with your dog. However, over the years, those that will be mentioned here have been suggested and utilized with success by many. We suggest that you discuss them with your veterinarian.


Have a great week!



MEGA Tip of the Week 

July 20, 2020


Symptoms of Megaesophagus


Do you know the symptoms of Megaesophagus?


• Regurgitation of water, mucous or food. (Regurgitation is throwing up without any warning; "vomiting" is associated with retching. With regurgitation, the food is often in its original form.)

• Loss of appetite or refusal to eat.

• Sudden weight loss.

• Swallowing difficulty, exaggerated and/or frequent swallowing.

• They will also try to clear their throat frequently with a "hacking" sound.

• Sour and/or foul smelling breath.

• Many canines may be INCORRECTLY diagnosed with a gastro-intestinal problem.

• Aspiration pneumonia is a frequent complication.


If your dog’s condition fits the above symptoms, it is imperative to see your veterinarian immediately. If present, aspiration pneumonia must be treated. Simultaneously, it is an absolute necessity that your dog is fed in a vertical position and that they sit for 15-30 minutes in that same position so that gravity can propel the food to the stomach. No dry kibble and you will need to alter the food consistency.


It is also important to note, Megaesophagus can be confirmed with an x-ray. Or, if it is not extremely pronounced, a barium swallow study may be needed.


As with many of the management options for Megaesophagus, they may or may not work with your dog. However, over the years, those that will be mentioned here have been suggested and utilized with success by many. We suggest that you discuss them with your veterinarian.


Have a great week!







MEGA Tip of the Week 

July 13, 2020


 Aspiration Pneumonia / Nebulizer Treatments


If your Megaesophagus dog develops aspiration pneumonia, immediate medical attention from a veterinarian is necessary. Symptoms of Canine Aspiration Pneumonia: Coughing, fever, lethargy, loss of appetite and nasal discharge. (Your dog may have one or several of these symptoms.)


As part of your dog’s recovery, you may want to consider home nebulizer treatments. Many asthmatics or individuals with breathing issues own nebulizers. Thus, you might be able to borrow one for a short period of time. Canine masks can be purchased online or your fire department might have one in an emergency that you can replace later. You will need a prescription from your veterinarian for the medicine and proper instructions on how to administer the treatment.


Aspiration pneumonia is “the,” leading cause of death for dogs with Megaesophagus. (Food, water, saliva, etc. has traveled through the trachea into the lungs resulting in infection.) Therefore, your dog needs immediate and aggressive treatment to ensure their survival. If you have not been utilizing the vertical feeding method prior to the onset of aspiration pneumonia, you need to start feeding in this manner immediately. Home nebulizer treatments may add the additional support that your canine member needs to fully recover.


For more information on Aspiration Pneumonia and Nebulizer treatments, please see:

https://groups.io/g/megaesophagus/files


As with many of the management options for Megaesophagus, they may or may not work with your dog. However, over the years, those that will be mentioned here have been suggested and utilized with success by many. We suggest that you discuss them with your veterinarian.


Have a great week!










MEGA Tip of the Week 

July 6, 2020


 Ongoing Acid Neutralizers 


This week I’ve included information from the files of the Megaesophagus Yahoo Group, (now found in the Megaesophagus IO group), cited by Dr. Kathy Morris:


“In human medicine chronic acid-neutralizer administration can cause deficiency in Vitamin B12. Oral supplementation does not help those individuals. Therefore, we suggest that dogs who are receiving acid-neutralizers receive injections of Vitamin B12.” 


Since Roxie received a Pepcid in the a.m. and a Prilosec at bedtime every day, post diagnosis, we did start B12 injections the last year and a half of her life. They had a noticeable, positive effect on her energy level. 


Please note: this is not a requirement for dogs with Megaesophagus, but rather a tip to consider.

 

As with many of the management options for Megaesophagus, they may or may not work with your dog. However, over the years, those that will be mentioned here have been suggested and utilized with success by many. We suggest that you discuss them with your veterinarian.


Have a great week!





MEGA Tip of the Week 

June 22, 2020


  

Summer Treat


A great summer treat for a dog with Megaesophagus is what we fondly refer to as a "chickensicle." 


*You can purchase a popsicle maker from your local dollar store.

*Use the NO Sodium brand of chicken broth, purchased as a powder from your grocery store. (Wyler's is a popular brand.)

*Make the chicken broth in a mug, glass, small pitcher, if it’s the powder type.

*Fill the popsicle container slots and freeze.

When it's hot and your dog needs extra hydration, you can pop one out of the container, sit your pup in the vertical position/Bailey Chair, and hold the "chickensicle" for them to slick. Or, if your dog is a chomper, break it off the little plastic stick and put the pieces of chickensicle in their bowl. With most dogs, the "sit time" is far less for liquid to process through the esophagus to the stomach. So, it doesn't take that long to provide a cool treat and extra hydration.


(Another liquid option is “bone broth” that you can purchase at many pet stores. Pour this into the mold and in addition to the cool, flavorful treat, you have extra nutrients.) 


Roxie loved her chickensicles on those hot days. I would often include one or two at the end of her meal for extra hydration as she was already in her chair. It made her feel great to have a treat; which, obviously made me feel good too! 


As with many of the management options for Megaesophagus, they may or may not work with your dog. We suggest that you discuss them with your veterinarian and consider what is best for your dog.


Have a great week!



MEGA Tip of the Week 

June 15 2020


  “MEGA” proofing your house


The most common cause of death in a dog with Megaesophagus is aspiration pneumonia. Which, can be caused by eating ANYTHING, while in a non-vertical position and of the wrong consistency. Therefore, just as you would “baby-proof” your house for a toddler, you need to “MEGA proof” for a dog with Megaesophagus. 


• Does, or can, your dog counter surf?

• Do you have a cat with food and/or a litter box accessible to your dog?

• Does your dog have access to the trash can?

• Are pieces of food dropped on the floor by a small child?

• Do they have access to water bowls for other pets? (This may not be a problem if they receive enough water/fluid during their meals. Please monitor until you are positive it is not a problem.)

• Do they have access to clothing or other items that food may have been spilled or dropped on?

• Do they have access to children or adults who are not aware of their condition that might give your dog treats or food? (Groomers, vet techs, neighbors, family members who think they can have “just one little biscuit, etc.)

• In your yard, do they have access to a garden? Dog poo? Will they eat grass or plants?

• Do you have a sign/notice in your vehicle in case you’re in an accident and unconscious?

• Do they wear a medical alert tag? 


These are just a few questions to answer regarding your house and daily life with your dog. I can confirm that they can and do happen. Roxie stole cat chow and raided the litter box when I slipped up twice. And, one time I left her chair cushion in her Bailey chair while I was gone for hours. Unfortunately, she had slobbered some of her food on the cushion during lunch. While I was gone, she ate a large section of the foam cushion with just a taste of the food on it. (At that point in her life, she was not starving for food but rather, was behaviorally starving to eat other “stuff.”) It was a miracle that the cat food, cat poo, or the “great foam incident” did not result in aspiration pneumonia. (They were all regurgitated over and over and over…..) 


I can say, most of the time I was absolutely neurotic in checking for pieces of food or any of the above items that could be ingested. I also supervised all of Roxie’s time outside. However, if that is not possible, some owners utilize a basket muzzle while their dog is outside so that they are not eating freely. (Note: Roxie never contracted aspiration pneumonia post diagnosis.) 


In summary, be aware of your dog’s surroundings. It can be the difference between life and death! 


As with many of the management options for Megaesophagus, they may or may not work with your dog. However, over the years, those that will be mentioned here have been suggested and utilized with success by many.


Have a great week!




MEGA Tip of the Week 

June 8, 2020


 

Cooling Options


Previously, we have mentioned how important it is to keep your Megaesophagus pup cool during the hot summer months. The following ideas can help:

1. A cooling mat, such as the one pictured in the photo, will provide hours of comfort. This specific cooling mat does not need to be soaked in water and is pressure activated. For super cooling effects, it can be refrigerated prior to use, but is not necessary. This brand is Cool Pet Pad and can be purchased from our friends at the Fun Time Dog Shop.... www.funtimedogshop.com. There are other brands available on other sites that sell dog products as well.

2. A dog cooling coat/vest is another idea. You can find these in an option similar to the mat described above or there are also versions that you need to soak in water. It all depends on your preference. They can be found on many websites as well that sell dog related products. 


Both of these ideas can obviously work for your pup with or without Megaesophagus! 


As with many of the management options for Megaesophagus, they may or may not work with your dog. We suggest that you discuss them with your veterinarian and consider what is best for your dog.


Have a great week and stay cool!



MEGA Tip of the Week 

June 1, 2020


 

Fluctuations


Has the daily regimen that you developed over time for your dog with Megaesophagus suddenly stopped working? Sometimes fluctuations happen.


Maybe it is a change in the weather that has caused it or there could be some other temporary cause. Maybe their esophagus previously had some elasticity but now that is changing. Or, sometimes our dogs with Megaesophagus just go through an unexplainable change. 


Back track through your daily routine and check the major maintenance points:


1. Do you need to try a different food consistency?

2. Maybe a different type or brand of food? (Not all but many dogs with Megaesophagus need low fat food.)

3. Do you need to speak with the veterinarian regarding acid reducers and / or inhibitors? Some dogs need one of each. Roxie’s protocol included Famotidine with the morning meal and Omeprazole with her bedtime snack.

4. Is someone else feeding one or more of the meals now? Maybe they are not familiar with the exact routine. (Over the years I’ve heard of more than one well meaning family member or friend that would include a dog biscuit or piece of whole people food as a special treat, not knowing it would not propel through the esophagus even with vertical feeding.)

5. Is you dog out more now because the weather is nicer and they’re cleaning up the yard?

We suggest checking these points first. If you would like a second set of eyes to look through your dog’s regimen, we are always here to help with suggestions. 


As with many of the management options for Megaesophagus, they may or may not work with your dog. However, over the years, those that will be mentioned here have been suggested and utilized with success by many. We suggest that you discuss this with your veterinarian and explain your specific needs and circumstances. 


Have a great week!








MEGA Tip of the Week 

May 25 2020


Summer Heat 


Now that some areas of the U.S. have experienced summer heat, you may have noticed an increase in regurgitation with your MEGA dog. While I love summer, I soon learned with Roxie’s care that summer could bring a few changes in her management plan. 


Increased heat can bring about increased “panting” with your dog. (Dogs can’t deal with heat as well as animals that can sweat.) Increased “panting” will increase the amount of saliva they produce which can then pool in their esophagus. And, without a working esophagus, the extra saliva will then cause regurgitation. 


To help manage the natural effect of summer heat, keep your dog as cool as possible. You may also want to provide extra hydration and vertical sit time as this will help the saliva move through the esophagus. Or, if the saliva is extremely heavy, possibly a small snack of the food consistency that works for them while sitting in the vertical position. You might also need the “pro-collar” that has been mentioned here previously. (Send us a note or email if you need information on the pro-collar and help with obtaining one.) 


As with many of the management options for Megaesophagus, they may or may not work with your dog. However, over the years, those that will be mentioned here have been suggested and utilized with success by many. We suggest that you discuss them with your veterinarian.



MEGA Tip of the Week 

May 18, 2020


Meal Timing 


Most dogs with Megaesophagus need smaller meals thus requiring that they eat more often. With Megaesophagus, it helps if the stomach is not over full, thus creating more issues with acid reflux and regurgitation. I like to think of it as: Breakfast, Lunch and Dinner, just as most people function better with those meals. 


In addition to smaller, more frequent meals, it can also help to keep a routine schedule for the meals. Roxie’s schedule was 8 a.m., noon, 5 p.m. and a 10 p.m. “snack” before bedtime. * I found that once I started the day with her first meal, I could only alter a meal by an hour either before or after the “scheduled” time. If I pushed it further than that, she regurgitated. I do not know if she just became upset or if the emptiness in her stomach caused the issue. On those occasions where I was out on an errand longer than expected or we were traveling and it was not possible to stop yet for a meal, she was consistent – she regurgitated. Since eating that fluid can also cause aspiration pneumonia, I tried extremely hard to not alter the schedule. 


*Note: There are some dogs who need a small amount of food in their stomach to keep from regurgitating overnight. That was the case with Roxie, determined by experimentation. Once we had a routine where she was regurgitation free during the day, we problem solved to determine what would help her through the night. The 10 p.m. “snack” noted above solved the issue.

We realize that the increased number of meals may not be possible for everyone. Over the years we have worked with those who cannot feed a lunch time meal due to work. Some dogs do well with 2 meals a day. Some have been fortunate to be able to enlist the help of a family member, neighbor, or dog sitter. Life is not perfect, and we do what we can within our schedules. These are just tips to help you problem solve and develop your dog’s regimen. 


As with many of the management options for Megaesophagus, they may or may not work with your dog. However, over the years, those that will be mentioned here have been suggested and utilized with success by many. We suggest that you discuss them with your veterinarian.


Have a good week!



MEGA Tip of the Week 

May 11, 2020


Exercise 


During the past 12 years, we have often been asked if exercise would harm a dog with Megaesophagus. 


Since Roxie had lost 30% of her body weight within two weeks, she was very weak the first few months. However, I realized that she was becoming depressed as she had enjoyed an active life prior to the onset of Megaesophagus. So, I started with short dog walks. And, I mean short – to the end of the driveway and back. I increased the distance in very tiny increments. She was so happy to get out of the house which, of course, made me happy too. As the story goes, five months post diagnosis she ran in the 2008 national agility competition. Her return to the activity she loved truly gave her the will to live and she became stronger each time she ran. 


Over the past 12 years, dogs with Megaesophagus have competed in obedience, rally, weight pull, agility, conformation, and many other performance events. Jake, a Labrador retriever, was an active hunter with his dad. Please note: swimming requires extra caution as you need to guard against the dog swallowing water; which could lead to aspiration pneumonia. The basic concern, both inside and outside the house, with or without activity, is to guard against anything that your dog might ingest. 


Thus, once you have developed a maintenance plan for your dog with this condition, they should be able to live a quality life with basic exercise. (Obviously, if your dog develops an issue while exercising, you will need review your plan and revise the activity.) But, as one caller said to me, “I just want Rover to be able to play fetch again in the back yard.” That should be attainable! 


As with many of the management options for Megaesophagus, they may or may not work with your dog. However, over the years, those that will be mentioned here have been suggested and utilized with success by many. We suggest that you discuss them with your veterinarian.


Have a good week!



MEGA Tip of the Week 

May 4, 2020


Beware of Self-Appointed Experts


This obviously applies to life in general, not just Megaesophagus. It is something that most of us have encountered by our early adult years. However, when we are dealing with something uncommon, like Megaesophagus, we may forget that not everyone “out there” is equal in their expertise. As with other topics in life, there are even those who have never dealt with this condition that are advising others. Sad to say, the advice can cause a negative impact on our canines with Megaesophagus. 


So, just a reminder: Do your research. It could mean the difference between saving your dog’s life or unintentionally harming it. 


As with many of the management options for Megaesophagus, they may or may not work with your dog. We suggest that you discuss them with your veterinarian and consider what is best for your dog.


Have a good week!



MEGA Tip of the Week 

April 27, 2020


Safe Travels: 

While we're not traveling at the moment, now is good time to prepare for the day when we can be "out and about" again. Thus the following thoughts: 


Since Roxie and I traveled so much for agility, I started to think about “what would happen if we were in an accident and I became unconscious?” The first responders might try to feed her treats or if need be, have her taken to a boarding facility if I were transported to a hospital. And, who there would know that she had Megaesophagus? 


Thus, I prepared a note that I attached in more than one location in the vehicle. It stated: 


A. She was a special needs dog with a condition called Megaesophagus.

B. Do NOT feed her anything without calling the emergency contacts.

C. Three emergency contact phone numbers were listed. These were people who had knowledge on how to care for her condition.

D. Her “feeding chair” must be taken with her from the car. 


The bottom of the note stated that if she were not cared for by trained individuals, she would most likely die. (I didn’t give the details but, of course, I meant die from aspiration pneumonia.)

Obviously, this would not guarantee that my instructions were followed. However, it certainly gave her a better chance of survival than if I had not taken the time to prepare the note.

If you travel with your dog in a kennel cab / crate, you could attach a laminated note there for high visibility. 


Another good idea might be a medical alert tag for your dog’s collar, engraved with Megaesophagus. Or, there are collars/harnesses that can be stitched with names so why not have a medical alert message instead? 


As with many of the management options for Megaesophagus, they may or may not work with your dog. However, over the years, those that will be mentioned here have been suggested and utilized with success by many. We suggest that you discuss them with your veterinarian.