Megaesophagus: Deadly Doggy Illness the AVMA Needs to Do Better On


On February 13, 2023, I said goodbye to my Popeye, the most loving, gentle, and sweet doggy I’ve ever known. I had to help him across the rainbow bridge that day, with the aid of Dr. Sara from Lap of Love, because he was suffering terribly from a disease I’d never even heard of until January, even though I was raised with dogs and had been volunteering around them for years.

Popeye’s downward spiral began last October, when he started coughing for no apparent reason. He was diagnosed then by his regular vet with “simple” lung inflammation, and treated with antibiotics and steroids. But he didn’t get well, so we went back, and upon re-examination and more X-Rays, he was diagnosed with full-blown pneumonia, and put back on a course of stronger antibiotics. He seemed to get better, and I was relieved.  Sadly, on December 2 he had a terrible fit of coughing and threw up a strange white foam. Unlike vomit, it contained no food residue, was bright white, and so thick that paper towels couldn’t mop it up. But he was diagnosed again with pneumonia, probably “aspiration pneumonia” which results when food particles get into the lungs. After spending a very difficult day in the ER, the vet there said he needed hospitalization, and off we went. He spent two nights and two days there on IV antibiotics and fluids. Happily, the hospital called, said he was eating small amounts of food and keeping it down, and was cleared to go home. I picked him up, his tail was wagging, and once again I was relieved…and exhausted.

But I still had no diagnosis as to what had caused his newest symptoms. Fast forward to early January, and Popeye was once again retching up that white foam at least every other day, and went back to the ER. There we saw a different vet, who ordered yet another (now the 3rd) set of chest X-Rays; she told me he had AP pneumonia again, and was put on antibiotics.  She also said she was referring us to an internal medicine specialist, who actually wouldn’t join the practice until the following week.  So nine days later, my baby and I went back…again. After several hours including an examination and a review of his previous X-Rays, the Internist told me that Popeye had Megaesophagus (ME), a disease that can be very hard to treat and often has poor outcomes especially in a senior, as Popeye was. I was gobsmacked. The doctor strongly suggested we test my boy for Myasthenia Gravis (MG), which can cause ME, but two weeks later–the blood sample had to go all the way to the west coast (honestly, no other lab?)–the results were negative. That was actually a letdown, because MG is evidently more treatable. And the blood tests also showed no thyroid problems, which can also cause ME. His illness was “idiopathic”– no known cause.

I was despondent but determined to do everything I could to manage this thing and keep him with me. The vet had recommended giving him liquid Sildenafil, literally doggy Viagra, before meals, which in some pups is thought to help manage ME.  I tried giving it 30, 15, 10, and 5 minutes before, but in almost every case he still regurgitated, sometime as much as 2-3 hours after eating. Another recommendation from the Internist was a “Bailey Chair” which I bought online, and assembled using my very meager mechanical skills. Bailey chairs keep the pup sitting upright while they eat and for some time after, allowing gravity to do its work moving the food through the esophagus into the stomach. But I just couldn’t get my stubborn boy Popeye to sit in it without forcing him, which I could never do.  One other thing I noted in my research was that some ME pups have Persistent Right Aortic Arch (PRAA), but that’s a congenital problem that would have showed up years earlier, and he wasn’t a candidate for surgery in any event.  

In the end, my sweet boy couldn’t keep anything down–he started regurgitating every single meal. He’d always loved to eat, but now wouldn’t even approach his food bowl. Then he even stopped drinking water. He wouldn’t leave the apartment, which he’d always loved, too, and just splayed himself on the couch, sleeping and exhausted. Not knowing what to do, I arranged a video call with a Hospice Veterinarian, also through Lap of Love, and after an hour conversation and a 35-question evaluation, we decided that his quality of life was very poor and it was all but impossible that it would improve. Popeye was at least 13, and had other health problems when I adopted him, including Horner’s Syndrome on the left side of his face, which already made eating more difficult. And now he was just worn out, and his body had given up, though I’m sure his spirit was intact. I knew I had to let him go.

It was the most painful decision of my life. And it still hurts. I hate this damn disease. And I am angry that he presented with symptoms, including loud, retching regurgitation of the telltale white foam of Megaesophagus right in front of three different vets, two of whom were happy to take thousands of dollars in treatments from me but with no diagnosis. Not even a mention of the word, which is also indicated by the aspiration pneumonia he had three times.  Even the internal medicine specialist who finally diagnosed him never mentioned a half-dozen drugs and supplements other humans are giving their ME pups with often good results.

I don’t want to be harsh but I think the veterinary medicine community needs to get its act together far more on this terrible disease, which is suddenly and mercilessly taking the lives of otherwise healthy pups, young and old alike.

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If you want more information about ME:

There is a wonderful support group on Facebook with kind, knowledgeable people who have ME pups or have lost them; more information here from PetMD.