Read Wiley's Story
Wiley's Update (November 2000)
Wiley's Update (December 2001)

Megaesophagus is a condition most often seen in either very young puppies
(evident once they are moved to solid foods) or in older dogs as a secondary
condition of another ailment (thyroid problems are common).  Food /water
travels into the esophagus, but does not move into the stomach.  The food
will sit there, and eventually the dog will tip his head down and out comes
the food.  The esophagus becomes enlarged, further compounding the problem.
In young puppies it is thought to be genetic, and has been proven to be so
in several breeds.  Any dog with megaesophagus should be spayed or neutered
at an appropriate age.

Wiley came to us at 7 weeks old from his breeder in Nova Scotia.  As we live in Washington State, this was a long flight for him, but we were assured that he would sleep most of the way and it was a direct flight.  After patiently waiting at the cargo area, Wiley was finally delivered to us, safe and sound as promised.  He seemed none the worse for his trip, and he came out hungry!  We appeared much smaller than our other Toller had at this age, but we just chalked it up to a poor memory for how small Scotch must have been.  From the very first time we fed him, he spit it right back up and then ate that back down.  Sometimes he repeated the cycle a few times before the food would finally stay in him.  I thought at the time that it was just normal puppy stuff - upset tummy, eating too fast, new environment, etc.  We fed him the softened Puppy Chow as instructed by his breeder, so we were a little surprised that he didn't keep that down.  I wasn't sure if I should let him eat back what he had just urped (my expression for what he does when his food or water comes back up), so I always let him eat some of it at least.

This urping of food went on for about week and a half when he took a dramatic turn for the worse.  On a Saturday he suddenly couldn't keep any water down, and got very lethargic at the same time.  His megaesophagus still had not been diagnosed at this time, so I rushed him to the Emergency Vet, thinking he had Parvo.  From that first ER visit, to his final diagnosis was about a week.  Initially they had no reason to suspect an esophageal problem, and thought it was a viral infection.  A night at the hospital on fluids seemed to do the trick.  His bland baby food diet, however, did little for his urping of food.  After another trip to the vet, an x-ray was taken to rule out a foreign body in his stomach.  The radiologist there was the first to diagnose megaesophagus.  A trip to our regular vet and a barium study confirmed the diagnosis. I have now learned the difference between vomiting and regurgitation.  Vomiting is when the dogs hangs his head and works to get the food up with heaving noises and effort.  Regurgitation is the stealth way to get food up - Wiley can urp at my feet and I don't know it until I get up to move - it can be silent.  It never made it to his stomach, so he just opens his mouth and out it comes.  To say I was distraught and devastated does not begin to describe my emotions that day when my vet explained to me what was wrong with Wiley, and that there was really nothing they could do for him.  I took my baby home with instructions on how to feed him and to watch for signs of aspiration
pneumonia.

Since that time, we have been back to the vet for his puppy shots and general check ups, and he is gaining weight and is in pretty good health.  He is still small for his age, which we now know was due to his lack of nutrition once moved to solid foods.  We have been to the Veterinary Hospital at Washington State University to make sure there was nothing else we could do for him.  All that did was confirm his diagnosis and rule out several other possible complications that could have caused the megaesophagus.  He has no idea that he is sick, and seems to enjoy being held after he eats now for 5-10 minutes.  99% of the time his food stays down, but water and foreign objects are another matter.  Water comes up almost constantly, and we are trying to hold him for a few minutes after he drinks to combat this.  Despite our efforts, he urps at least 8-15 times a day in various amounts.  It is better that he has a problem with water than food, as food inhaled into the lungs is what will likely cause aspiration pneumonia.  The lungs can absorb water, but not food.  I am on constant alert for any coughing, labored breathing, or excessive sneezing that could signal pneumonia.  There is a slight chance that he could outgrow this condition, but his is a very severe case.  I am hopeful that it will simply improve with our management of his food and water.

It is no fun to look at your puppy and wonder how long he will be on this earth and know that there is almost nothing I can do to prolong his life.  We have 3 other dogs, and they all know that Wiley is special.  There are no arguments when I hold him, and almost no attempts to snitch his food.  Wiley is the feistiest puppy I have ever had and he can send the bigger dogs scurrying to the corner if he gets a mind to.  He is happy and in no pain at all, and that is all that matters.  I can clean up after him for his lifetime, hold him for an hour a day to help his food and water go down, play with him, and take him for great romps with his brothers, but no amount of money can cure him.  I am grateful for every day I have with him and consider him every much a blessing as my other dogs.

The following is a list of information I have collected:

Tollers and Megaesophagus?
Megaesophagus is not often seen in Tollers (thank goodness!) and is more common in larger breeds, German Shepherds being a very afflicted breed. There are cases of Tollers, other than Wiley.  I know of one dog that is 4 years old and doing fine.  A breeder had almost an entire litter afflicted, and half grew out of it and half did not make it past 6 months.  It is often called a breeder's problem, as pups usually show signs of it as soon as they are moved to solid foods.

What to do if your pup/dog has megaesophagus?
* The first thing to do is get a correct diagnosis.  This is commonly done using a barium study.  Your vet can perform this easily.
* There are no medications that really work, although there are a few which can aid in digestion for older dogs.
* Elevate dog's food and water.  By elevate, I mean so their front feet are off the floor and resting up on the surface where the food/water is.  A stool works well, or even using stairs can work.  You will need to grow your platform as your pup gets bigger.
* Feed a watery slurry of dog food, or dry food.  Most vets recommend a slurry as that seems to go down better.  We initially had Wiley on dry, but we switched to liquid hoping that will move down easier.  To prepare his food we put his serving of dry food in a cup and add enough water to cover it and a little more.  Using a hand held blender we whip it up into a watery oatmeal type consistency.  He slurps it down and thinks it is a tasty treat! This also is a good way for us to keep water down him - when mixed with his food it seems to stay down better.
* Hold them upright for at least 5 minutes after they eat and after they drink if water is a problem.  Often Wiley will burp just like a baby. Your vet can tell you from doing the barium how severe your pup is, and that can help you determine how long you need to hold them upright.  Try to keep them quiet for a period after eating as well.
* Crate training is a must, unless you want to clean up messes in the middle of the night.  He doesn't often urp at night, but it can happen and changing towels from his crate is easier at 2 AM than the alternatives.
* Invest in paper towel companies!!  Fortunately, we had installed hardwood floors not long before getting Wiley, so clean up is quick and easy.  When he manages to hit the carpet, standard carpet cleaners seem to do the trick.
* Keep everything out of baby's mouth!  Mega dogs seem to be constantly hungry and Wiley will put anything in his mouth (including his own poops - yuck!).  All puppies tend to be mouthy, but he is worse and anything that goes down will undoubtedly come back up.
* Train for praise and love.  Most training treats won't stay down, so you will need to train pup to do it for love!  Koehler is one training method that does not use treats, but any method can be adapted to omit treats. Some dogs think a tennis ball is better than a treat anyway!  I have found that the fake chocolate drop treats do stay in him - they are small and must just slip on down into his tummy.
* Give them LOTS of love and affection!

Prognosis?
Some dogs outgrow the condition when it is seen in puppies.  Adult dogs that develop megaesophagus do not outgrow it.  The real killers of mega are malnutrition in young dogs, and aspiration pneumonia.  In advanced stages of the condition, some dogs are given a feeding tube so food is inserted directly into the stomach through the side of the dog.  This is a fairly drastic approach, and other methods of keeping food down should be explored first.  As noted above, aspiration pneumonia is cause by the regurgitation of food that gets inhaled into the lungs.  This foreign matter irritates the lungs, causing fluid and the onset of pneumonia.  Watch for coughing, elevated temperature and signs of labored breathing.  When in doubt, get a chest x-ray!  Some dogs can be sick without coughing or having a  emperature.

Wiley Update (November 2000)

I am happy to report that Wiley is coming up on his first birthday having had no major complications from his megaesophagus (knock on wood!).  He has grown to be about 30 lbs or so and no longer looks like such a tiny Toller as he did as a puppy.  We continue to feed him a blended kibble on an elevated feed station.  Holding him upright for 5 minutes has become routine, and he seems to actually enjoy it most of the time.  He rarely regurgitates his food; it is still water that will come back up frequently.

We are still battling other health issues with him, namely his inability to concentrate his urine.  Housebreaking has been nearly impossible, as sometimes he simply cannot hold it.  I do not think this is related to his mega, and we are continuing to seek an answer to his problem.  He is a very happy little guy, and always eager to play.  We've done some basic obedience and will start agility in the spring.  We have shown him once, for the socialization, and he did very well.  I don't think we will pursue that avenue much, as he will never be a candidate for breeding, and that is really the point of conformation shows.  He is an avid swimmer and has perfected the 4' leaping water entry.  He seems to do nothing in a small way - always a big splash for this guy!  He has no idea he is sick, and I am happy to keep him in the dark.  I hope his information has proven helpful for people experiencing megaesophagus.  Feel free to email me if you'd ever like to bend a sympathetic ear.  I'll update again next year!

Wiley Update (December 2001)

Wiley will be 2 years old in December - hard to imagine.  He is the picture of health, if you didn't know what was wrong with him on the inside.  He has great teeth, a gorgeous coat, and the typical Toller temperament (throw the ball now!!!).  My vet is amazed at how healthy he looks.  He is a typically sized Toller now - about 19-20" at the shoulder.  In fact, Wiley is FAT right now!  He is on a diet, as he steals food from the other dogs shamelessly and has increased his waist line dramatically!  We still blend his food and elevate it, but no longer hold him upright after eating.  With our new baby, time was a problem and I did not notice any change in the amount or frequency of regurgitation with the change.  We never did find a reason for his frequent urination, but that has seemed to get better.  He still has occasional accidents in the house when he is upstairs and suddenly stops playing - just like a puppy.  (we check him for urinary tract infections periodically just to rule them out).  I had him neutered this year and have seen no changes in him since then.  He and our other Toller had been scuffling a little more than I liked, and there was no reason not to neuter Wiley, so off to the vet he went.  Things have calmed down a bit now that Scotch is undisputed top dog (we also lost our Berner to cancer in September, and he had been top dog).  Wiley is the best cuddler we have and the best retriever.  No matter his problems, I am grateful every day for my funny little red dog.  I will plan on another update next year!

Val Whitman and Wiley

For more information see the following sites:

http://www.barkbytes.com/medical/med0028.htm

A personal account of megaesophagus in an older Golden
http://www.brightleaf.com/rusty/megaesophagus.htm

http://www.vetinfo.com/dencyclopedia/demegaesoph.html

A good question and answer page on megaesophagus
http://www.vetinfo.com/dogmega.html

A good site with an animated explanation of mega
http://www.marvistavet.com/html/megaesophagus.html

A diet suggestion
http://www.barkbytes.com/MEDICAL/med0053.htm