MORRIS HOSPITAL for VETERINARY SERVICES
26684 Grand River
Redford, MI 48240
phone 313-537-6100 fax 313-537-1060 email MorrisVet1@aol.com
Originally written September 20, 2005
Dear Veterinarian(s) and Staff Members-
Mega esophagus is a disorder that I have had the misfortune to personally diagnose only twice since graduating in 1974. The lectures, refereed journal articles and textbooks do not BEGIN to give us practitioners “in the trenches” an adequate picture of how to successfully manage many of these patients. I don’t think that ANY of us, even the gastroenterologists, have enough of these cases under our belts to offer pet owners the wide variety of options to treat these dogs. Unfortunately, many pets have been euthanized because of the inability of the owners to understand/manage the disorder, AND our lack of and experience to guide them.
To that end, I would like to suggest that you peruse the megaesophagus support group http://groups.yahoo.com/group/megaesophagus/. This is a group of megaesophagus dog-owners who have a wealth of knowledge and “experience” with hundreds of these pets. And, as a bonus, they do not practice “vet-bashing.”
They offer advice, always with the caveat to “check with your veterinarian.”
They have literally dozens of suggestions as to how and what to feed these dogs, always explaining that no two patients are alike – some dogs can have liquid diet, some semi-moist; some can get all of their water from moistened food, some require Jell-O, some need subcutaneous fluids (most should NOT be
allowed to drink free-choice); some can be fed 3-4 times daily, some require more frequent feedings; some (most) require H2 blockers or Proton Pump Inhibitor antacids, as well as a promotility drug such as cisapride or metoclopromide (I know, I know, the books say that they doesn’t work – not true). THE most important part of management seems to be VERTICAL, not just elevated, feeding.
On the main site there are dozens of photos of how the dogs are held vertically after feeding (in school and even in recent lectures, I was taught to have the pet stand on a step, with the food bowl raised – that will not be successful for many pets). One of the moderators (Donna Koch – 661-255-5337, or cell 213-399-5001) have designed a feeding chair and will send pet owners a DVD on how to construct one for their own pet.
The added benefit of suggesting that a pet owner investigate this website is that these folks are truly a dedicated bunch, and some “haunt” the site on evenings, holidays and weekends, to answer questions or suggest a visit to the emergency room – when WE are not available. If there are ANY concerns the owner
will be encouraged to seek veterinary care immediately.
FYI, Dr. Diane Shelton, the neurologist at the Comparative Neurology Lab, University of California, San Diego, has the megaesophagus website, and photos of the Bailey chair on her website. Also, I have posted information on the Veterinary Information Network (VIN) regarding the suggestion to consider that all of these dogs do not have to have a “doom and gloom” prognosis. Some of the internists are now referring to this site and have opened their minds to the potential of a good life for these pets.
[Addendum: as of October 2012 there is a Megaesophagus Information Center on VIN (Veterinary Information Network)that can be accessed by member veterinarians. It offers suggestions for diagnosing and managing this disorder.http://beta.vin.com/members/cms/document/default.aspx?id=5269755&pid=5095&catid=&said=1 Veterinary Partner also has a management article that is offered at no charge to pet owners:http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=3480]
Thank you for your consideration, I hope this information proves to be helpful to you and your patient.
Dr. Kathy Morris-Stilwell – University of Illinois 1974