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MEGASOPAHGUS
 


Our Beautiful boy Bailey died on the 26/5/2013, he was diagnosed with  megasohagus(ME) April 2013, but before we could work out a routine on feeding that suited him, he passed away, the following information is to educate others who may find their dog has been dignosed with ME or MG.

printed with Kind permission jackie donaldson

 Megaesophagus:

Megaesophagus is a condition in which the muscles of the esophagus lose their tone and are no longer able propel food into the stomach. The esophagus is a tube which connects the mouth to the stomach. In normal function wave-like contractions, called peristalsis, move the food which enters the esophagus down into the stomach. When megaesophagus occurs the esophagus dilates, or enlarges, due to the lack of muscle tone. This causes food to just sit in the esophagus, unable to continue into the stomach to be digested.

Causes of Megaesophagus

Megaesophagus can be a congenital defect or acquired as an adult. In cases where megaesophagus presents in young dogs it can be caused by vascular ring anomalies, a persistent right aortic arch, or it may be idiopathic (unknown cause). In acquired cases seen in adult dogs megaesophagus can be primary or secondary. The cause of primary megaesophagus is idiopathic, while secondary megaesophagus is a result of another disease. The most common cause of secondary megaesophagus is the disease myasthenia gravis. Secondary megaesophagus due to an underlying disease is not normally seen; in most cases there is no known cause for the development of megaesophagus.

Symptoms of Megaesophagus

The most common symptom of megaesophagus is regurgitation. It is important to understand the difference between regurgitation and vomiting. Vomiting is an active process associated with retching and heaving, where the body forcefully removes contents from the stomach. Regurgitation is a passive process where food or water basically just falls back out of the mouth or throat with no warning. Regurgitation is associated with megaesophagus because food is not able to be moved into the stomach and so it sits in the esophagus until it eventually is removed from the body by the process of regurgitation. Another sign can be weight loss. Because food is not making it to the stomach it cannot be broken down or the nutrients absorbed. This can result in malnourishment and weight loss. A very common complication associated with megaesophagus is aspiration pneumonia. Because food remains in the esophagus it can easily get into the lungs. This causes pneumonia which can be fatal if not treated. This is most often the cause of death in dogs with megaesophagus.

Diagnosing Megaesophagus

Megaesophagus is diagnosed by radiographs. The x-ray can show air, food, and/or fluids in a dilated esophagus. In some cases a contrast study may be done to enhance the image to make a more conclusive diagnosis. In the study barium is given with the dog's food and then an x-ray is taken to show the structure of the esophagus. Radiographs can also be used to determine if aspiration pneumonia is present and too look for underlying causes.

Treating Megaesophagus

There is currently no cure for megaesophagus and surgery has not proven to be helpful in treating the condition. Medical therapy has been helpful in some cases and shown no effects in others. The main treatment method for the condition is life style management. Food consistency should be the first issue addressed. No one type of food has been found to be the best. You must determine what works best for your dog. Some options are liquid diets, dry food, canned food or any combination of the three; when you find a food that works well for your dog stick with it. Feedings should be given in frequent, small meals as opposed to few, large meals. Elevated feeding should be practiced as this uses gravity to pull the food into the stomach keeping it from just settling in the esophagus. This can be done my using a step ladder or a Bailey chair. To use the step ladder food should be placed on the 3rd or 4th step. The dog's back legs should remain on the floor. This places the dog in a position to allow gravity to work. A Bailey chair is a specially designed chair that allows the dog to sit upright (like a begging position) while eating. In whatever set up you choose or find that works best for your dog, always keep them in the elevated position for at least 10 minutes to allow all the food to make its way into the stomach. Another option for managing megaesophagus is to have a feeding tube inserted. In this practice a tube is surgically placed into the stomach allowing the animal to be fed while bypassing the esophagus completely.

There are a few medications which may be given to treat megaesophagus. Metoclopramide helps increase the muscle tone of specific areas around the esophagus, antacids help minimize the damage to the esophagus, and nausea medication may help the dog feel better overall. Cisapride has been known to be helpful in cases of megaesophagus but is not available in the United States. One should always remember that medical therapy may or may not be helpful to your dog.

Care for dogs with Megaesophagus

Caring for dogs with megaesophagus requires changes in your dog?s eating habits, but in most cases will allow your dog to live a long, happy life. Managing the condition involves starting the treatment techniques listed above.Step One: find the type of food that works for your dog the best.Step Two: determine the easiest elevated position for your dog to eat in and stay in for at least 10 minutes after eating.Step Three: feed small, frequent meals.

Along with the feeding adjustments, owners must be able to recognize the signs of aspiration pneumonia. This potential complication of megaesophagus can be fatal if not treated, and is the most common cause of death in megaesophagus dogs. Signs of this pneumonia include coughing, fever, and lethargy.

Myasthenia gravis (MG) is a neurological disease that makes the  dog weak and incapable to contract his muscles. The cause of this neuromuscular  disease is the incapacity of the AChRs (nicotinic acetylcholine) nerve receptors  to function at a normal rate. The disease may occur in any breed of dogs, but some breeds are genetically predisposed (i.e. Jack Russell terrier, smooth fox terrier and springer spaniel). Older dogs may get this disease also.

 

Causes of Myasthenia Gravis

The disease is thought to be genetic in certain dog breeds such as Jack  Russell terriers, springer spaniels and smooth fox terriers.

Myasthenia gravis can also be acquired as the dog  gets older (regardless of breed), being also considered an immune system  mediated disease.

 

Symptoms of Myasthenia Gravis

The symptoms of myasthenia gravis will differ from dog to dog. The typical  signs of disease include general weakness, the inability to properly contract  the muscles and lethargy.  Some dogs will only be unable to contract certain groups of muscles, while other  dogs may be affected more, involving all the muscles. The disease will be active after the dog has performed activities, leaving him nearly immobilized; immediately after a resting period, the dog will look normal and can contract  his muscles.

In older dogs that acquire the disease, the disease may start with the  enlargement of the esophagus resulting in swallowing difficulties and vomiting.  Aspiration pneumonia can occur and this is a dangerous condition. The dog may  also lose weight, being unable to eat properly.

Diagnosing MG

If you notice signs of weakness in your dog, especially after physical  activities, you should visit the vet.

Also, if your dog has difficulties in swallowing, you should consult the vet.  If the vet finds that the esophagus is enlarged (megaesophagus), the dog will be tested for MG. On the  other hand, if the dog is diagnosed with MG, the vet will perform an x-ray to  check the esophagus to establish if it has been affected.

MG can be diagnosed through injecting a small amount of edrophonium hydrochloride (Tensilon), which should improve the ability of the dog to  contract his muscles for a short period of time.

There are also other blood  tests that can be performed to diagnose MG

Treatment Options

MG is a manageable disease and dogs that acquire the disease later in life  have a favourable prognosis.

Anticholinesteras drugs (i.e. Pyridostigmine  bromide) are administrated to dogs with MG. In severe cases of MG, the dog  is given neostigmine in injection form or corticosteroids.

It is important to prevent the occurrence of aspiration pneumonia. A dog with  MG should get food bowls that at the level of the dog’s mouth, so that he won’t  have to bend down, risking to throw up the ingested food. The dog should also  remain standing at least 10 minutes after eating, so that all the food is  properly swallowed.

The dog must rest more and he shouldn’t perform strenuous activities.  Whenever you notice weakness, you should calm your dog down and encourage him to  rest.

The dog must be monitored and routine checkups are necessary to prevent any complications.

 

Read more:  Canine Myasthenia Gravis - VetInfo Treatment Options

MG is a manageable disease and dogs that acquire the disease later in life  have a favourable prognosis.

Anticholinesteras drugs (i.e. Pyridostigmine  bromide) are administrated to dogs with MG. In severe cases of MG, the dog  is given neostigmine in injection form or corticosteroids.

It is important to prevent the occurrence of aspiration pneumonia. A dog with  MG should get food bowls that at the level of the dog’s mouth, so that he won’t  have to bend down, risking to throw up the ingested food. The dog should also  remain standing at least 10 minutes after eating, so that all the food is  properly swallowed.

The dog must rest more and he shouldn’t perform strenuous activities.  Whenever you notice weakness, you should calm your dog down and encourage him to  rest.

The dog must be monitored and routine checkups are necessary to prevent any  complications

Read more: Canine Myasthenia Gravis - VetInfo

 

Read more:  Canine Myasthenia Gravis - VetInfo Diagnosing MG

If you notice signs of weakness in your dog, especially after physical  activities, you should visit the vet.

Also, if your dog has difficulties in swallowing, you should consult the vet.  If the vet finds that the esophagus is enlarged (megaesophagus), the dog will be tested for MG. On the  other hand, if the dog is diagnosed with MG, the vet will perform an x-ray to  check the esophagus to establish if it has been affected.

MG can be diagnosed through injecting a small amount of edrophonium hydrochloride (Tensilon), which should improve the ability of the dog to  contract his muscles for a short period of time.

There are also other blood  tests that can be performed to diagnose MG

Read more: Canine Myasthenia Gravis - VetInfo

 


 
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