meganutritional

Megaesophagus Nutritional Challenges and Rewards

Monica Segal

Dietary Recommendations
Dietary recommendations for Megaesophagus are easy to provide (low fat, low fiber) but can also lead to frustration. That’s because what works well for one dog may not work as well for your dog. Owners of newly diagnosed dogs, have likely never even heard of megaesophagus, much less be in a mindset to attempt a learning curve. “Seasoned” owners may feel frustration and worry, so let’s decipher some of the issues that these dogs can have, and give you a few practical pointers.

My experience in working with these dogs is that many (perhaps more than are readily recognized) also have food allergy or intolerances. Let’s clarify the difference. The immune system protects the body by identifying and reacting, sometimes very aggressively, to anything it perceives as harmful by releasing histamine and other chemicals that cause inflammation. Any food may be a potential allergen but the most common foods that dogs fed commercial diets react to are corn, wheat, dairy products, beef, pork, egg and fish. Since these are the most common ingredients in dog foods, repeated exposure to the same foods can trigger a reaction. Feeding foods that the dog has never eaten before can calm the body down. Since the dog has never been exposed to these foods, chances are that s/he will not have an allergic reaction, although it is possible for a new food allergy to form. Feeding a diet with the least number of ingredients is a consideration. Should food allergy develop, there would be several new foods to consider. Conversely, if this dog is fed numerous foods and then develops an allergy, the challenge to find something new becomes greater.

A food intolerance doesn’t involve the immune system. Lactose intolerance is an example. The body simply lacks the digestive enzyme (lactase) responsible for breaking down milk sugar.

For practical purposes, the pet owner isn’t likely to care what we call it. The fact remains that when an adverse reaction to food exists, the dog is going to react. In the case of Mega-E, removing the food culprit helps to slow down regurgitation. Perhaps this is because there’s less irritation. Certainly, this is only my own hypothesis and not a science based explanation, but it’s difficult to deny what I’ve seen in working with these dogs for so many years. In fact, many of the dogs were later diagnosed with inflammatory bowel disease in which there is a strong inflammatory component and food allergy is prevalent.

If your dog isn’t doing well on his/her current food, I strongly advise an elimination diet. You’ll be feeding one novel protein and one novel carbohydrate source for 8-12 weeks, so be sure the foods are available and affordable for long term use. Remember that when I say “novel” food, I’m talking about something the dog has never eaten before – not even in a treat.

You can try a commercial diet with limited ingredients (fish and potato, rabbit and potato, etc), a truly hypoallergenic diet such as Purina HA or Hill’s Z/D, or a home-prepared diet. My preference, at least to start with, is a home-made diet. Emotional attachment to these diets aside, the fact is that you can take complete control over the ingredients in your dog’s meals, and that’s the biggest point when trying to find something that works. Once you know the dog does well on certain foods, you have the option of finding a commercial diet that includes only those foods. And don’t forget that even when a food agrees with a dog, a supplement may not. That’s another reason I favor home-prepared diets. We take control over the source of supplements as well.

Balanced Diets
An adult dog with a healthy feeding history has no problem eating an unbalanced diet for 8-12 weeks (the length of time an elimination diet is in place). However, adult dogs in poor health, and certainly puppies, aren’t expected to have the vitamin and mineral reserves required for such a plan. In these cases, opt for a commercial diet with limited ingredients. If, on the other hand, your dog has been eating fairly well for awhile, you can try fresh foods, but you still need to arrive at a balanced diet down the road. A veterinary nutritionist can help get you there by providing meal plans suitable for Mega-E.

Certain Food Items Are a Must to Avoid
Gluten Is At the Top of the List!
Some grains contain gluten and some dogs react to it. These same dogs may be quite able to digest gluten-free sources of carbohydrates which include: potato, sweet potato, rice, quinoa, buckwheat (not derived from wheat despite the name), amaranth, corn (not advised for some dogs – see notes above), and millet.

Supplements to Stay Away From
You may have heard of “miracle” supplements. Commonly, these are labeled as “blends” and may include alfalfa and other greens and/or digestive enzymes and probiotics. Although they may help some dogs, be very careful about adding anything that combines items. A dog can have an adverse reaction to just about anything. It only confuses matters when we add a product containing more than one ingredient at a time. You’re better off trying just one simple supplement and it’s a good idea to understand what the product aims to address. For example, there’s nothing magical about alfalfa powder. Probiotics may be beneficial but remember that we’re dealing with dogs – not people. The difference in species can translate to a different reaction and/or no benefit at all. Acidophilus is the best studied probiotic for dogs. Combinations of probiotics may work, but I’ve seen too many dogs react negatively to them. For my money, I stick to acidophilus and have never regretted it.

Food Consistency
The first “rule” is that we don’t want food to be liquid because this risks that the dog will lap hastily and end up with aspiration pneumonia. The second “rule” is that we don’t want totally dry food because some dogs can’t swallow very well or the food goes down incorrectly, and this too risks aspiration pneumonia. But many dogs haven’t read the rules! I find that the best thing to do is provide a food that has a similar consistency to a slushy (remember that childhood freezy type of drink that sometimes gave you a brain freeze?) Feed this when the dog is in an upright position, preferably sitting up like a baby in a high-chair. Feeding smaller amounts a few times daily usually works better than letting your dog gorge on large meals. If this food consistency doesn’t help your dog, you can try feeding canned food or a fresh food diet with the same consistency. Some dogs handle these foods best when they’re made into little meatballs that can be popped into the mouth easily. Be sure the dog’s chin is up!

Body Weight
Many dogs with Mega-E are underweight. This leads to worry and frustration for the owner, and usually the veterinarian as well. There are good ways and bad ways to try and get more weight on your dog. Large amounts of fat or feeding large meals are in the bad category. Feeding more often, not allowing your dog to run like the wind after eating (this can promote regurgitation) are in the good category. Also, speak to your veterinarian about adding Nutri-Cal or Ensure to the diet. Where these didn’t work well for a dog, I’ve used instant mashed potato flakes or instant oats (soaked in water or yogurt before being add to food) as an addition to canned food or a home-prepared diet. Both of these items can make a good binder for wet foods, packing in the calories without adding much volume. Oats add fiber, and we don’t want too much for these dogs, but it can work well when fed in small amounts in conjunction with other foods to create little meatballs.

Challenges and Rewards
I don’t believe in wearing rose colored glasses, and this condition isn’t easy on anyone. A diagnosis of Mega-E is challenging on many levels, but don’t lose sight of the bigger picture. Remember that your dog has you as his/her advocate, and don’t shrug off the importance of that. Your veterinarian is in your corner, and I know of dogs that are now 5-7 years post diagnosis, maintaining a pretty good weight and enjoying a full life. Both you and your dog need to keep chins up. You can do this!

Monica Segal is certified in Animal Health Care through the University of Guelph with studies in animal nutrition, physiology, diseases and parasites, as well as pet care. Monica authored a book called "K9 Kitchen, Your Dogs' Diet: The Truth Behind The Hype," published in June 2002. Her second book, "Optimal Nutrition" includes a foreword written by Ana Hill DVM, PhD and was published in 2007. Monica lives in Toronto, Canada, with her husband Morley and their dog Tori.

The above information is simply informational. It's intent is not to replace the advice of a veterinarian nor to assist you in making a diagnosis of your pet. Please consult with your own veterinarian for confirmation of any diagnosis. Your pets life may depend on it.