Vertical (Upright): For numerous people whose dogs have ME and the veterinarians who are working with them have referred to the “vertical” positioning as “upright”. We now try to make sure they understand that upright means vertical with proper ME protocol. Here is synonym reference providing that information.


at right angles to a horizontal plane; in a direction, or having an alignment, such that the top is directly above the bottom.
“the vertical axis” · [more]
upright · erect · perpendicular · plumb · straight (up and down) · on end · standing · upstanding · bolt upright · upended · sheer · steep · sharp · precipitous · bluff · vertiginous · [more]

From the author –  IMPORTANT:  “I am NOT a veterinarian, but am well versed with and by degree very familiar with anatomy, the systems that run the body, and the positions required for certain movements and actions. You should discuss this thoroughly with your veterinarian to better understand how critical it is that your dog be in the correct position for gravity to carry the food to its stomach.”

“I am placing these pictures here is hopes if you are not familiar with what the dogs digestive system looks like you can now picture this in your head. There were only pictures showing actual dogs with what I wish to explain  which would not be fair or just for those owners so will only use descriptive verbiage below.  When we feed our ME dogs, if their bowl is not also in proper position, their esophagus will be bent (and sometime in half) with potential for food to get stuck and/or not pass through that bent area. Picture a garden hose and normal water flow through it. If you bend it even slightly, the flow gets less so not as much gets out. Same with the esophagus if their head is down (i.e., such as a bowl sitting much lower on a tray and/or inside a hole cut in that tray). Even if it is higher, your dog will still have to bend its head (esophagus too) down to eat giving chance for food not to be able to fully get through. This could in turn cause it to regurg with possibility of aspirating.

We use a chair that has a tray table, but never a hole cut in it. We hold Gretyl’s bowl at a slant and a bit higher so her esophagus is in much better position for her food to move down. This also helps us control her eating speed since we sit right beside her. We prefer having Gretyl’s  paws resting on the tray and having the door with cut out lower for our particular girl, but you will have to decide what might work best for you.

I am not saying this happens to everyone who uses that method, but the risk at which you place your dog is much greater than other safer ways. Remember, each of our ME dogs is different so what works for you may very well not work for others safely so we demonstrate best possible protocol and let each of you find what works best…but safest…for your dog.”

Anatomy of dogs digestive system showing esophagus:


Warning on feeding positions
Statement made by an ME dog owner: “I feed from only a slightly elevated position.”

Answer from a DVM very experienced with ME: “It’s great that you have figured out how to successfully manage your 9 month old GSD. For those newbies out there, though, I’d like to warn that elevated feeding is not sufficient for most megae dogs, and would warn against starting with this feeding method. Depending on how “floppy” the esophagus is, there can be hanging pouches which cannot empty by just elevated feeding. Most of the time vertical feeding is required to maximally take advantage of gravity. Unfortunately, we frequently have owners who “elevate feed,” who come here after some time, with a report that their dog has aspirated. Not that vertical feeding totally prevents this from happening, it’s just that it seems to be the best way to handle most of these patients. Each dog is different and may require a variety of management techniques – some simple; some more complicated.”