This condition is OVERWHELMING, and, every dog  different, so there will be specific things you will use that no one else does and vice versa. Read as much as possible then ask questions.

For an extensive description of management techniques for pet owners:

Here are some high points/BASICS that you may find helpful:

1.       Feed VERTICALLY and remain so for 20-30 minutes

2.      Elevated” food and water is not enough. MOST megae dogs need to be fed and given water, and held VERTICALLY, so that food and water can fall into the stomach. So many newbies try to get by with NOT doing so, only to finally relent when THEIR way doesn’t  work

3.      Metoclopromide pills or injection, or oral cisapride (requires compounding), might promote emptying of the stomach, allowing more space for food/water to fall into the stomach without resistance

4.     Bethanechol can help the activity of the esophageal muscles in some dogs

5.     Many of these dogs have ESOPHAGITIS, which requires treatment with oral liquid carafate (one hour before food/meds or two hours after; it binds to many materials, so if given with most food or with other meds, both may be inactive)

6.     Additionally, esophagitis is painful, so could be making them restless and miserable

7.     Antibiotic Responsive Gastroenteropathy (ARG/IBD/SIBO) seems to be common in these dogs and to be responsible for increased regurgitation
–   Treatment with a combination of amoxicillin, metronidazole and carafate, +/- cerenia, for nausea, or similar combination
–   For 2-4 weeks, may result in decreased regurgitation

8.     Nausea can be helped with injectable or oral Cerenia, or oral Zofran (may be given subcutaneously, although not labelled for such)

9.     Keep well hydrated, especially if they are bringing up a lot of fluid (causes dehydration) and might need to learn how to administer subcutaneous (under the skin) fluids

10.  Many dogs benefit from using an acid-neutralizer (Zantac, Pepcid AC, Prilosec, etc. – NOT Tums or Tagamet) to reduce the acid that refluxes up into the esophagus from the stomach

11.  Having the pet either sleep on an incline with the front elevated and/or wear a Pro-collar (neck hug) to elevate the head while lying down or sleeping, will also minimize “micro-aspiration” of refluxed material from the stomach

12.  If your pet has aspiration pneumonia (AP), go to for info on management
–  Pneumonia in normal dogs may be treated for a few weeks
–  It is suggested that dogs with megae may benefit from 4-6 weeks of antibiotic treatment
–  Coupage (percussion therapy) can also be helpful

13.  If your pet is not eating, or is unable to keep food down, consider placement of a feeding tube SOONER RATHER THAN LATER
–  Too many owners wait too long

14.  Consider keeping a journal of what works and doesn’t work, and/or a day by day report that you and your dvm can refer to.

15.  If your veterinarian  belongs to VIN, here is some info available for professionals;