What causes this mucus to develop:
1)Because the esophagus is paralyzed, any saliva that is swallowed, or that develops, just sits in the esophagus. Once enough builds up, it comes out.
2) Some dogs have so much mucus that they drool. Also, esophagitis (inflammation or irritation of the esophagus) can cause excess mucus to form.
3) If Antibiotic Responsive Gastritis (ARG) is present (can only be diagnosed via endoscopy, but, empirical treatment is appropriate, as it can do no harm), there can be excess mucus.
What can we do to minimize the mucus:
1)Elevating the front end of the pet, while it sleeps, either using a Pro collar (and/or, something else around the neck to keep the head elevated) and/or elevating the front end of a crate, or having the dog sleep on a front-end-raised platform may help.
2) Liquid Carafate will bandage the esophagus (can be given with ANY food or other meds. Must be given no sooner than 1 hour before, or 2 hours after feeding or meds).
3) There are some natural mucilages (anti-mucus) products that may be helpful.
4) If ARG is present, treating with Amoxicillin, Metronidazole, Carafate, or another similar protocol, can be useful.
Mucus can develop in 2 places in dogs with megaesopahgus:
1) From the esophagus: when acidic fluids reflux from the stomach into the esophagus, the esophagus responds by making mucus.
2) From the lungs: when fluid from the esophagus (which can come from the stomach) is aspirated into the lungs, mucus is formed.
There are several more things that can help minimize mucus formation once it develops:
1) Nebulization with saline and albuterol may thin the secretions in the lungs.
2) Coupage/percussion therapy to break up anything that is stuck in the lungs.
3) Sleep with front end elevated.
4) 3 view chest x-rays may be a good idea just to make sure that there is no aspiration pneumonia.
5) Oral N-acetylcysteine may help thin the secretions.
6) Prilosec at night may help better than Pepcid. Think about this, why are there so many acid neutralizers? It’s because only one doesn’t treat every patient.
7) For bad pneumonias…if well covered with antibiotics…2-3 days of low dose pred (.05mg/kg) will reduce excessive inflammation, which will decrease mucus.
8) In people with cystic fibrosis, nebulization with 7 percent saline (versus 0.9% saline, which is the usual saline used for nebulization) can help break up the mucus which develops in those lungs).
That thick, nasty mucus – what CAN be done about it, and why does it build up:
Because the esophagus in these dogs is paralyzed, it cannot push the slime that normally builds up in the esophagus into the stomach. Additionally, if there is esophagitis (best treated with liquid Carafate (Sucralfate), the esophagus makes more mucus.
1.) Licorice root (Glycyrrhiza glabra). Studies have shown that licorice accelerates healing of intestinal ulcers. It’s anti-inflammatory and very soothing to mucus membrains. To use for heartburn or reflux, choose a special kind called DGL (deglycyrrhizinated ) licorice. It’s just as effective as regular, without affecting the body’s sodium-potassium balance. Typical dosage: for mild heartburn, drink 1 cup tea after meals as needed (steep 1-2 tsp dried, chopped root in 1 cup hot water 10-15 min); for moderate to severe symptoms, use 1/8 to 1/4 tsp powdered root of liquid extract dissolved in 1/4 cup water after meals and at bedtime; OR 1-2 tabs DGL licorice chewed thoroughly just after eating or as needed, up to 8 tabs per day.
CAUTION: DGL may cause diarrhea in some people. Whole licorice should not be used if you’re pregnant or nursing, if you have heart disease, liver disease, or diabetes, or if you are taking heart or blood pressure drugs. Limit use of whole licorice to 6 weeks unless under the supervision of a qualified health practitioner. DGL CAN be taken by people with high blood pressure and those who take blood pressure and heart medications. If you have a medical condition such as those, however, it may be best to use this herb under the guidance of a qualified health practitioner, or simply choose a different herb.
2.) Aloe (Aloe Vera). Aloe gel contains very large sugar molecules. These special sugars have been shown to help heal burns, ulcers, and inflamed intestinal walls. Side effects are uncommon, but be sure to obtain a pure source of aloe pulp and not the rind. Rind can cause stomach cramps and diarrhea. Many commercial aloe juices contain citric acid, which can aggravate reflux, so beware! The best form of aloe for treating heartburn is a food grade freeze-dried powder. Typical dosage: 1/4-1/2 tsp in 1/4 cup water just after meals or any time symptoms occur. Increase dose to 1 or more tsp if necessary.
3.) Cabbage (Brassica oleracea). Cabbage juice isn’t just a folk remedy. A medical study has shown that regular consumption can heal stomach ulcers, and the active ingredient is an amino acid, L-glutamine, which appears to work by nourishing cells lining the esophagus and stomach so they repair themselves. It also contains cancer-preventing agents. Typical dosage: 4-8 oz. fresh or bottle juice after meals. If taking the juice gives you gas, instead take 1/2 to 1 tsp L-glutamine mixed in 1/4 cup water, just after eating.
4.) Calendula (Calendula officinalis) . A time-honored remedy for wounds, mouth sores, ulcers, and gastritis, it is so gentle, it’s often given to children for an upset stomach. Its astringent and anti-inflammatory properties make it particularly useful for treating heartburn and reflux. Typical dosage: 1-2 cups tea as needed (steep 1-2 tsp dried flowers in 1-2 cups hot water for 10-15 min); OR 15-30 drops tincture 4 times per day after meals.
5.) Chamomile (Matricaria recutita). This lovely, old-fashioned herb promotes healing, decreases inflammation in the stomach, and can ease the anxiety that may be perpetuating the ulcer. Typical dosage: 3-6 cups tea per day (steep 1-2 tsp dried herb in 1 cup hot water for 10 min); OR 1/4-1 tsp tincture or glycerite 3-4 times per day.
6.) Peppermint (Mentha x piperita). Any member of the mint family is good for indigestion, so if you don’t care for the taste of peppermint, try lemon balm (Melissa officinalis). Mint acts as a muscle relaxant and can calm an overactive digestive tract. Typical dosage: 6-12 drops essential oil in water 3 times per day; OR 1-2 caps 3 times per day after meals (if IBS is a factor, use enteric-coated caps); OR up to 3 cups tea per day (steep 1.5 tsp dried leaf in 1 cup hot water for 10 min); OR 10-20 drops tincture in water after meals.
CAUTION: Because peppermint can relax the valve between the stomach and the esophagus, it can worsen heartburn. If this is one of your symptoms, don’t use peppermint.
7.) Meadowsweet (Filipendula ulmaria). This remedy for the GI tract contributes to ulcer healing by decreasing inflammation, protecting, and soothing the stomach lining, and reducing excess acidity. It is also mildly astringent. Typical dosage: 3-6 cups tea per day (steep 1-2 tsp dried herb in 1 cup hot water for 10 min).
CAUTION: Avoid meadowsweet if you’re allergic to aspirin, as it contains a chemical relative of aspirin.
8.) Marshmallow root (Althaea officinalis) . When water is added to this soothing root, a rich mucilage, or slippery substance, forms that helps it coat and soothe an irritated ulcer. Typical dosage: 3-6 cups tea per day, sipped frequently throughout the day (steep 1-2 tsp dried root in 1 cup hot water for 10 min OR steep same amount in cold water overnight); OR 1/4-1 tsp tincture or glycerite 1-4 times per day.
CAUTION: The mucilage in marshmallow may absorb other drugs taken at the same time, so if you are using other drugs, ask your practitioner’s advice about a dosage routine, or avoid this herb altogether and choose a different one.
9.) Slippery Elm (Ulmus rubra). The bark of this tree is another herb that forms mucilage to protect, soothe, and heal the stomach lining. Typical dosage: 3-6 cups tea per day (steep 1-2 tsp dried bark in 1 cup hot water for 10 min, OR steep same amount in cold water overnight); OR 1/4-1 tsp tincture or glycerite 3-4 times per day.
10.) Mallow (Malva sylvestris). Another mucilage-former, this herb can be prepared the same way as marshmallow or slippery elm. Typical dosage: 3-6 cups tea per day (steep 1-2 tsp dried bark in 1 cup hot water for 10 min, OR steep same amount in cold water overnight); OR 1/4-1 tsp tincture or glycerite 3-4 times per day.
11.) Plantain (Plantago major). A common garden weed that grows almost everywhere in the world, it has soothing, astringent, and wound-healing properties. Typical dosage: 3-4 cups tea per day (steep 1-2 tsp dried leaves OR 1 Tbsp fresh herb in 1 cup hot water for 10 min 12.) Angelica (Angelica archangelica). The fruit, leaf, and root of this herb stimulate digestion, help dispel gas, and calm nerves. It’s especially good when bloating or cramps are part of your indigestion. You might see it included with other bitter herbs, such as dandelion, in commercial bitters preparations. Typical dosage: up to 3 cups per day, taken 30 minutes before meals (steep 1 tsp dried root in 1 cup hot water for 10 min); OR=2 010-40 drops tincture up to 3 times per day. CAUTION: May cause sun sensitivity. Avoid during pregnancy and nursing.
13.) Ginger (Zingiber officinale). Ginger stimulates digestion and dispels gas. It also helps move food through the intestinal tract and reduces irritation. Studies show it can prevent motion sickness. Typical dosage: up to 8 500-600 mg caps per day; OR 1/2-1tsp fresh ground root per day; OR 10-20 drops tincture in
water 3 times per day.
14.) Fennel (Foeniculum vulgare). Fennel relieves gas and stimulates the digestive tract. If you expect to eat a vegetable that you have trouble digesting, such as cabbage, try adding fennel seeds to your recipe. Typical dosage: up to 2 tsp raw seeds eaten after meals; OR 1 cup tea per day (simmer 2-3 tsp crushed seeds in 1 cup hot water for 10-15 min); OR 30-60 drops tincture in water up to 4 times per day.