Megaesophagus: The Condition Requiring Dogs to Eat Upright

A condition known as megaesophagus affects the esophagus, preventing food from reaching the stomach due to a lack of muscular tone. This results in food accumulating in the esophagus and being regurgitated. Veterinary specialist Ana Benevides explains that the organ becomes dilated and loses the strength to push food downward.

A dog named Fantasma was diagnosed with the congenital form of this disease shortly after adoption. His owner, Raphaela Araújo Gutierres, noticed he was vomiting and suffering from gas. After a difficult diagnostic process, he was given a life expectancy of six months to a year. However, through specific care, including medication and a specialized diet, Fantasma has survived to 17 months of age.

The primary treatment involves feeding the animal in an upright position, often using a specialized chair or bucket, to utilize gravity to help move food into the stomach. While there is no cure for the congenital form, the condition can be managed to provide a good quality of life.

The esophagus functions as a tube connecting the mouth to the stomach, using automatic movements to push food downward. When this process fails, the food remains stuck or is regurgitated. Ana Benevides, a veterinarian specializing in nutrition for dogs and cats, describes the condition as a loss of strength in the tube, causing it to become wide and dilated.

According to the specialist, the condition can be congenital (present at birth) or acquired later in life. While some cases have a genetic predisposition, it is not always hereditary. When it develops later, it is usually linked to other underlying issues.

Potential causes for the acquired form include:

• Neurological diseases
• Muscular disorders
• Hormonal alterations
• Inflammations or intoxications

Raphaela Araújo Gutierres adopted Fantasma when he was 45 days old. Within two days, she noticed severe symptoms after eating. "He would feel very unwell, vomit, or have a lot of gas," she reported. As the days passed, his condition worsened, prompting a visit to a veterinary clinic in Sorocaba, SP.

Fantasma remained hospitalized for nearly two weeks while doctors performed numerous tests to confirm the diagnosis of megaesophagus. The disease was identified as congenital, meaning he was born with it. At the time, he was severely underweight and malnourished.

"They gave him a life expectancy of six months to a year," Raphaela said. Despite the prognosis, she decided to pursue every possible option to extend his life and improve its quality. She took him to veterinarian Ana Benevides to study the best medications and management strategies.

A radiograph of Fantasma revealed the severity of his condition. "In a healthy animal, the esophagus practically does not appear on the radiography because it is thin and collapsed," Benevides explained. "In Fantasma's case, it appeared as a wide tube along the thorax, following the spine, precisely because it was dilated." The image showed a white area indicating the dilated esophagus filled with retained food.

Managing megaesophagus requires significant changes to the animal's routine, particularly regarding feeding. Raphaela worked from home to monitor Fantasma closely. He required food every three hours during the day.

The feeding process involved specific steps:

1. Food consistency was altered; initially, he ate pasty food, and later, crushed kibble mixed with water to create a soup-like consistency.
2. He had to eat in a vertical position. Initially, a specialized chair was used, but as he grew, this was replaced by a bucket to keep him upright.
3. After eating, he had to remain in the elevated position for several minutes.

Through medication, proper nutrition, and constant care, Fantasma exceeded his initial life expectancy. At 1 year and 5 months old, he has improved significantly. "He no longer needs crushed kibble; he can eat the grains," Raphaela noted. However, he still must remain higher than normal dogs during meals to prevent the condition from worsening. The greatest risk associated with the disease is the aspiration of vomit or regurgitated food, so monitoring remains essential.

Diagnosing megaesophagus typically involves imaging exams, such as radiographs, which clearly show the dilated esophagus. In some instances, further investigation is required to determine the underlying cause.

The primary symptom is regurgitation, which Ana Benevides distinguishes from vomiting. "It is important to explain that regurgitation is not the same thing as vomiting," she states. "In vomiting, the animal makes an effort and feels nauseous. In regurgitation, the food simply comes back up, usually shortly after eating, and comes out almost whole." Other symptoms include weight loss, coughing, and difficulty gaining weight.

Regarding life expectancy, there is no fixed timeline. While some animals have severe cases, many live for years with a good quality of life if they receive proper care. "With early diagnosis, adequate nutrition, nutritional monitoring, and guidance for the owner, these animals can have a comfortable and active life," Benevides concluded. Although the condition is most common in dogs, it can also occur in cats and is rarer in wild animals.