When dogs with megaesophagus sleep, or lie down for a period of time, there may be a buildup of saliva and mucus in the flaccid, lazy esophagus. Additionally, if their LES (Lower Esophageal Sphincter), the “valve” between the esophagus and stomach, is lazy, food or fluid from the stomach can reflux back up into the esophagus. That material can then pass back up the esophagus and leak from the back of the throat down the trachea into the lungs. This can result in annoying gurgling, or worse, aspiration pneumonia. To minimize these episodes there are a few techniques that can be used to minimize this reflux.

1) a Pro-collar can be used to elevate the head available at Petco & other pet stores: http://www.bizrate.com/dogsupplies/oid623499541.html

2) If your dog sleeps in a crate, elevating one end, and encouraging him/her to lay w/ their head at the elevated end, is suggested. Here are some suggestions from a member: we used to deal with that [regurg] 5 nights a week! I just wanted to share what took us over 2 years to figure out. We cage her at night to reduce the regurg. We changed the size of Nahla’s cage that she sleeps in at night and have reduced her nighttime regurg by about 95%!! She used to be in a big cage that she had room to move around in, with a dog bed in there. We downsized the cage and it is a little smaller than the dog bed we have in there, so it forces the dog bed to go up the sides of the cage a little and it goes up in the front too. What we found is that it forms a cradle for Nahla and she stays in the same position all night with her head propped up (due to the dog bed bunching up at the front). I don’t know if this will work for others, but I was amazed at how nice it was to sleep through the night again after 2 years 😉 we just cover her bed in old towels, so if anything does come up, we just change out the towels and go back to bed. Anne and Nahla (ME,MG, dx 7/06, 10yr old, 33lb lab/cocker mix) ——– and, another: We have done basically the same thing with Olivia’s crate….she has several crates but for sleeping we used the smallest one. She can get in and turn around but then she is pretty much set for the night. In addition to her pillow, WE HAVE PROPPED UP THE FRONT of the crate up on a couple phone books and propped her pillow up in front with a towel. Since she really wants to have her head at the door, this elevates both her head and upper shoulders and helps with the pooling in the esophagus.-laurie g, sophie and olivia

3) A bed can be made w/ a wooden base, w/ one end elevated see: http://groups.yahoo.com/group/megaesophagus/photos/album/1082975248/pic/list Some dogs do best with a small meal before sleeping; some are best not fed within an hour or two of bedtime. Administering an acid-inhibitor prior to sleeping, may also minimize reflux. Giving sucralfate right before bedtime (must be given either 1 hour before feeding, or 2 hours after, and without any other medication) minimizes the regurg for some dogs.

Dr. Kathy 6/09