Megaesophagus in Dogs: Symptoms, Causes, and Treatment

Does your dog seem to regurgitate their food after they eat?  

If so, they may be suffering from megaesophagus in dogs.  

This can be a congenital disease, meaning it’s inherited and we can see megaesophagus in puppies, or it can develop later in life.  

If your dog seems to struggle swallowing or food keeps coming up, talk to your vet about megaesophagus. 

What Is Megaesophagus in Dogs?

Megaesophagus in dogs is a common condition that decreases mobility in the muscles of the esophagus, the tube that connects the mouth and stomach. This decreased muscle function leads to esophageal dilation, or enlargement. 

Normally, when dogs swallow a piece of food, the food stimulates the muscle in the esophagus to contract, pushing the food from the mouth into the stomach.   

In dogs with megaesophagus, the muscles in the esophagus can’t properly coordinate this swallowing movement. 

As a result, food and liquid accumulate in the esophagus, causing it to stretch. This prevents nutrients from being properly absorbed in the stomach.   

A dog with megaesophagus can have a great quality of life with veterinary care and management. 

Large breed dogs are genetically predisposed to developing acquired megaesophagus, including German Shepherds, Great Danes, and Labrador Retrievers. Puppies and adult dogs are the most affected. Miniature Schnauzers and Fox Terriers are also genetically predisposed to megaesophagus.  

In rare cases, megaesophagus can be reversed. However, most cases are permanent and require life-long care.  

Types of Megaesophagus in Dogs

Primary Megaesophagus

Primary megaesophagus is a disease that affected pups are born with. It’s an inherited disease and affected dogs should not be bred. Symptoms usually become apparent to pet parents around the time of weaning. 

Sometimes these pups have a vascular ring anomaly, which means that when they were developing, a vessel from their heart grew around the esophagus and is pinching it so that food can’t move through normally. 

Secondary of Acquired Megaesophagus

Acquired megaesophagus develops later in life, usually in dogs that are middle aged to seniors. Sometimes megaesophagus can develop secondary to other underlying endocrine diseases, infections, toxins, or inflammation in the esophagus. 

Most often, acquired megaesophagus develops secondary to myasthenia gravis. Myasthenia gravis is an auto-immune disease that causes extreme muscle weakness, and the esophagus is lined with smooth muscle that helps move food from the mouth down to the stomach. 

Some dogs that get myasthenia gravis and acquired megaesophagus have a tumor called a thymoma in their chest. 

Symptoms of Megaesophagus in Dogs

Symptoms of megaesophagus in dogs include: 

• Regurgitation 

• Difficulty swallowing 

• Excessive drooling 

• Cough 

• Nasal drainage 

• Aspiration pneumonia, because of regurgitation 

• Ravenous hunger 

• Thin, weak body condition 

• Small bulge in the neck  

Regurgitation vs. Vomiting in Dogs 

Regurgitation is different from vomiting in dogs. 

Vomiting is an active process that involves gagging, retching, and the body actively (often forcibly), ejecting the contents of the stomach. 

Regurgitation, in contrast, is a passive process.   

Typically, dogs will open their mouth, and food or liquid appears to fall out without any heaving or stomach contractions. Regurgitation frequently occurs many hours after a meal and typically does not have bile, because the contents were never in the stomach. 

Causes of Megaesophagus in Dogs

Causes of megaesophagus in dogs include: 

• Genetics 

• Congenital defect, like a vascular ring anomaly 

• Myasthenia gravis 

• Thymoma  

• Infectious disease, like botulism, tetanus, neospora, or distemper virus 

• Toxins, like lead, snake venom, or organophosphates 

• Esophageal foreign material or inflammation 

• Unmanaged Addison's disease 

• Dysautonomia 

• Polymyositis 

• Idiopathic (unknown cause) 

Diagnosis of Megaesophagus in Dogs

To diagnose megaesophagus in dogs, veterinarians will recommend several tests, including:  

• Radiology. Megaesophagus is routinely diagnosed through X-rays. The esophagus is not normally seen on X-rays, but the mass of food and/or air can be detected, which may lead to a diagnosis. 

• Fluoroscopy. This test is like an X-ray but is performed in real-time when a dog is swallowing to assess the esophagus’ ability to contract.   

• Esophagoscopy (video scope into the esophagus) 

• Blood tests 

• Muscle biopsies 

Treatment of Megaesophagus in Dogs

Treatment for megaesophagus in dogs requires addressing the underlying condition. 

Some forms of megaesophagus can be reversed or cured, though this isn’t guaranteed—especially depending on severity and length of time. Even if the underlying disorder is treated, the damage done may be irreversible.   

For most pups affected by megaesophagus, treatment usually involves a combination of diet therapy, elevated feedings of smaller, more frequent meals, and daily medications. 

Sometimes surgery can be pursued. In most cases, surgery is done to help make management easier.  

It’s not curative, and most pet parents will still need to be mindful of their pet’s diet, meds and elevated feeding routine.  

Your vet may recommend a procedure called balloon dilation to help stretch open the lower sphincter of the esophagus. 

If there is a vascular ring anomaly, it may be corrected surgically. 

Managing Megaesophagus in Dogs

There are several ways pet parents can manage megaesophagus in dogs. 

Diet

For dogs with this condition, management centers on making sure they get their nutritional needs met. Your vet may recommend the following for your dog’s diet: 

• Changing the form of food based on the dog’s specific needs. This may mean changing their diet to gruel, canned (wet) food, or even liquid. Dog food such as Hill’s Prescription Diet i/d Digestive Care with Turkey may be recommended.  

• Providing smaller, more frequent meals throughout the day.    

Elevated Food Bowls 

Your vet may recommend raising food and water bowls to let gravity help with your pup’s digestion.  Food bowls should be at head height to move food down the esophagus and prevent regurgitation.

• Omeprazole is often prescribed to reduce stomach acid and make the regurgitated contents less irritating to the esophagus. 

• Sildenafil may reduce the number of regurgitation episodes by relaxing the lower esophageal sphincter. It can lead to weight gain as a side effect. 

• Antibiotics, like Clavamox, may be prescribed to treat aspiration pneumonia  

Prognosis for Megaesophagus in Dogs

Though megaesophagus in dogs requires strict management, prognosis for affected pets is good. Dogs can lead happy and relatively normal lives with this condition. 

Dogs typically have better outcomes the sooner megaesophagus is diagnosed. Prognosis also improves if a dog has not experienced aspiration pneumonia.  

Pet parent dedication, patience, and close monitoring with a veterinarian are key to managing megaesophagus dogs successfully.   

Veterinarians will want to frequently examine these dogs to monitor weight, body condition, and blood work, in addition to screening for signs of aspiration pneumonia.