Acid neutralizers: Consider Pepcid AC or Prilosec given to minimize the acidity of material refluxing from the stomach up into the esophagus. Some pets need these all the time or intermittently.

B12 injections: Pets who receive acid neutralizers chronically can develop a B12 deficiency. It does seem that many dogs with megaesophagus, even if not receiving an acid neutralizer, benefit from B12 injections. They do not seem able to absorb oral B12, therefore injections are advised. The usual dosing is once weekly, according to their weight, for 6 weeks, then monthly, although giving an injection weekly makes it easier not to forget. B12 cannot be overdosed as excess is removed from the body by the kidneys.

Dyne: Boost your pal’s daily calorie count without adding more food with the PetAg Dyne High Calorie Liquid Dog Supplement. Specially formulated to provide additional calories, this easy-to-feed gel liquid provides energy and extra nutrition for pets that need it most, including puppies, pregnant and nursing moms, performance and working dogs, dogs recovering from stress or illness, older pups, and even picky dogs who don’t eat enough. The added calories go toward maintaining your pal’s ideal weight, providing energy, and supporting overall health. Plus, thanks to its delicious flavor of vanilla, even the pickiest pups will have a hard time turning it down. Adding it to your pal’s diet is easy―simply wet your pet’s kibble, mix in with wet food, or give with an oral syringe. Mixed with water, it’s also an ideal solution to combat dehydration.

Fortiflora: Uses a probiotic strain which has been proven to promote intestinal health and balance. The live active culture in Fortiflora is microencapsulated, guaranteeing a beneficial amount will reach your dog’s stomach.

Probiotics: Culturelle, Fortiflora or Prostora are really good probiotics. However, there is some concern that giving probiotics at the same time as antibiotics will “kill” the probiotics, so, giving them separated by several hours is probably best. One tablet of Prostora is equivalent to 2 1/2 containers of Activa, so that’s why I like it. Giving a variety of probiotics, not just one kind (ie. Acidophilus, lactobacillus, Bifidius – sp?, Probios) is also a good idea.

“Probiotic products are subject to variations in quality control, and the safety profile is still under investigation. The regulatory situation is similarly unclear because the FDA considers Probiotics products labeled with medical indications for animals to be unapproved drugs. However, it is increasingly clear that manipulation of the ecology of the gastrointestinal tract has powerful systemic effects. Use of probiotics clearly enhances immune function in a number of species, including dogs and cats, and appears to have a role in the treatment of animals with certain gastrointestinal conditions. Other clinical effects (such as prevention of recurrent urinary tract infections, prevention and treatment of allergies, and treatment of pancreatitis, oxalate urolithiasis, and other conditions) have been investigated in humans, which suggests a range of potential benefits in veterinary patients.”

“Probiotic bacteria are not resistant to antibiotics [ie. antibiotics kill probiotics]. For this reason we advise giving them between doses of antibiotic and for several weeks following antibiotic therapy. Studies have shown in humans that it takes long periods of time for the GI mucosa to regain normalcy after just short courses of antibiotics. Frankly it is the damage to the GI mucosal border that causes the most severe and long lasting issues by disrupting the Gut Associated Lymph Tissue (GALT) and allowing for immune disfunction.”

Sterile Saline: Use in the nebulizer. Obtain intravenous saline from your veterinarian or purchase saline made specifically for use in nebulizers. Do NOT use contact lens saline.

Slippery elm bark:  May soothe the esophagus. Can be tried instead of sucralfate or if pet doesn’t tolerate sucralfate. ½ cup of powder in 2 cups water and simmer down to 1 cup. It will be consistency a bit thicker than salad dressing will just take 3 minutes. Give a few tsp – tablespoons 3 times daily. Give 1 hour before or after any other meds to minimize inactivation of those meds. Can be refrigerated for up to 2 days. Give at room temperature.

Per Dr. Kathy – I did some research and also found this suggestion:
Powder: Mix two cups boiling water to one tablespoon of powder, three times a day. Simmer down to 1 cup.
It does need to be prepared fresh, each time it is to be used. Slippery elm may interfere with the way that other medications or herbal remedies are absorbed by your body. To avoid this, take slippery elm several hours before or after taking other medications. When slippery elm preparations are taken internally, they cause reflex stimulation of nerve endings in the GI tract, leading to mucus secretion. Can get slippery elm bark syrup from some health food stores: Roughly 1/4 tsp per 15-20 lbs.