Megaesophagus and Myasthenia Gravis

Lindy is a cute, 10 yr old Lab/ Cocker Mix who came to see us for vomiting.  After several radiographs were taken, we discovered an abnormally enlarged esophagus (blue arrows) and diagnosed her with Megaesophagus. The esophagus is the tube from the mouth to the stomach.  It is made up of muscle and squeezes food as the dog swallows.  Megaesophagus is the failure of the esophagus to squeeze food into the stomach and it becomes weak and floppy. This causes regurgitation.  In severe cases, patients can accidently aspirate some of the regurgitated food and develop pneumonia. 

Megaesophagus has several different causes.  In Lindy’s case it is due to a condition called Myasthenia Gravis.  This is an abnormal immune response by the body that attacks the nerves on certain muscles, one muscle being the esophagus.  It is diagnosed with a special blood test.  Megaesophagus is treated using a special chair.  Named the “Bailey Chair”, these can be built to support the patients in an upright position.  It uses gravity to get food into the stomach, and then keep it there to prevent aspiration.  In severe cases, some patients require a stomach tube to help maintain their nutrition.  There is no direct medication to treat the Myasthenia Gravis, but some medications are used to support the muscle function if needed. 

The good news is that this condition usually self resolves on average in 8 months.  Until then, Lindy will need to eat from her chair.  Lindy’s mom did a great job building and personalizing her chair!  We are happy to report that Lindy has adjusted well to her new feeding routine and she is doing great.  We will see Lindy periodically for radiographs to monitor her esophagus and lungs for any infection.


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