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ME can be idiopathic (no known cause), or a result of a secondary disease. The most common secondary diseases causing ME are Persistent Right Aortic Arch (PRAA), which is most commonly seen in puppies and can sometimes be successfully treated with surgery, and Myasthenia Gravis (MG), which is a neuromuscular condition that can be treated with medication.
Megaesophagus is a disorder of the esophagus. The esophagus is the tube which connects the mouth to the stomach. With megaesophagus, the esophagus is enlarged (dilated) and there is a decrease in peristalsis. ME dogs have a dilated esophagus due to lack of muscle tone. This causes food to sit in the esophagus, unable to travel to the stomach and sometimes forming pockets. When this happens a dog “regurgitates” the food that is stuck in the esophagus.
One of the main symptoms of Megaesophagus is regurgitation. Regurgitation is different than vomiting. When a dog regurgitates, it does not usually require much effort from the dog, and the food comes out looking a lot like it went in (undigested), sometimes in a tube shape (like the esophagus).
FEED ME UPRIGHT
The most important management technique for ME is Vertical Feeding. Since the esophagus isn't working correctly in an ME dog, gravity is needed to get food to the stomach.
You can use a “Bailey Chair," a high chair, a laundry basket, ANYTHING that keeps your pup vertical! After each feeding, have your dog remain upright in the chair for at least 10 minutes. Some dogs may need more time upright than others -- this part is trial and error.
WHY NO WATER
Many ME dogs do not do well with water, so water is added to their food (in addition to the softer easy-to-swallow consistency of softened food, it's a great way to incorporate water into your pup's diet). Dogs that eat meatballs can get their water with something called Knox Blocks -- basically jigglers for your pup! Other dogs may do well with a large hamster style bottle mounted high enough to keep the throat in an elevated position.
These devices help to elevate your dog's head while reclining. Keeping your dog's head elevated helps keep any food that's still in the esophagus, or saliva (face it, that's always there), from being regurged. Some dogs take a while to get used to this large fluffy collar -- This elevates your dog’s head off the floor when they are laying down. You can find inflatable Pro Collars at Petsmart or Petco. The Neck Hug from Wag Tail Farms is a stuffed elizabethan collar.