It’s Megaesophagus Awareness Week!
Megaesophagus is a condition in which the muscles of the esophagus lose their tone and are no longer able to propel food into the stomach. This condition can be idiopathic (unknown cause) or it can be secondary to an underlying disease such as we see often in our neurology department, myasthenia gravis.
A recent case we have seen at Animal Neurology, Rehab & ER Center is that of Charlie, a 2.5 year old boxer mix. When Charlie was only a year and a half in July of 2014 he was experiencing an acute onset of muscle weakness in his rear limbs. This is a common neurological symptom that can actually be caused by many different neurological disorders. Upon examination, Dr. Adam Moeser, a board-certified neurologist, determined a possible diagnosis of myasthenia gravis.
When myasthenia gravis occurs certain chemicals in the body are not reaching their specific muscle receptors, this means there is a failure in the communication between the brain and the muscles, a loss of connection. When the brain tells specific muscles to contract and a pet has myasthenia gravis, that message may never be received causing muscle weakness or a muscle not to react how they are supposed to.
Dr. Moeser was able to confirm this in a few short minutes with a Tensilon Test. This is an injection of a medication that when given to myasthenia gravis patients it can alleviate many of the symptoms in about a minute. Only a specific blood test can confirm a myasthenia gravis diagnosis. When Charlie reacted positively to the Tensilon Test, Dr. Moeser ordered the blood test to confirm.
One of the muscle groups we see affected most often by this disease is the esophagus. The signal is not reaching the muscle to contract and propel food to the stomach, the condition known as megaesophagus. Myasthenia gravis can be managed with medications but only resolves in about 90% of the cases. The connection damage is often permanent so the megaeophagus only resolves in about 50% of the cases.
The next step for Dr. Moeser was to determine if Charlie was also experiencing megaesophagus, an x-ray confirmed this diagnosis. It showed the dilation of the thoracic portion of the esophagus. Thankfully there was no evidence of pneumonia.
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 mis-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 the same vertical position so that gravity can propel the food to the stomach. Please see the Canine Megaesophagus website at www.caninemegaesophagus.org for additional tips and resources. The proper food type, consistency and some medication is also necessary.
Charlie was then started on medications for his myasthenia gravis and given instructions on vertical feeding methods as well as food consistency to aide with the symptoms of megaesophagus. Charlie responded very well to the medications and after a few months his myasthenia gravis went into remission. At that time there was also no evidence of megaesophagus. Charlie experienced no permanent damage from his myasthenia gravis and made a full megaesophagus recovery. Charlie has been doing great since February 2015!
For more information on megaesophagus head on over to Roxie’s MEGA Mission! You can share your story with others, hear stories from families caring for their own megaesophagus patient as well as tips on coping with megaesophagus.