I’ve had a foster dog for a month, an 8 year old female with mega-esophagus and some sort of undiagnosed back end wonkiness. I’ve taken her to the vet 3 times in the month I’ve had her. This is the breed rescue vet, not mine. We’re both new to the dog. Brief history.
Dog is amazingly weak behind, falls over frequently if her balance is compromised. Vet finds soreness in her upper hind legs on palpation, thought bone cancer…but xrays were negative, vet prescribes Rimadyl. Dog is still lame and tippy, but seems to be pain free and much more energetic. Mega-esophagus issue seems to be managed ok…dog has some re-gurge episodes, but not daily. Tuesday the dog started re-gurging, continued on through the night with coughing and puking. It’s not digested food, it’s definitely regurgitated and has a very mucousy consistency. i took the dog to the vet on Wed. Vet took chest xrays to rule out pneumonia, did blood work. Blood work had slightly elevated white blood cell counts, xrays show no pneumonia. Temp is “slightly elevated”, somewhere around 102. Vet basically acts like it’s just a mega E problem & has us leave with a medication to ease the irritation she may have in her esophagus which I have to “slurry” and syringe. Dog was still re-gurging yesterday and now not eating. Yesterday when I put her feed in her bowl, she nosed around & lifted her bowl up but wouldn’t eat it. I was able to get her to eat about 1/2 of a grilled cheese sandwich if I hand fed her bite size pieces one by one, but she lost interest quickly. I called vet, because now she’s not eating, she’s a Ridgeback and they always want to eat!! 
The the vet prescribed another medication… metocloperamide & prilosec… The metocloperamide is supposed to be given with food, but I can’t because she still won’t eat. This morning I tried to give her rice & chicken broth, and I came home from work for lunch and made her scrambled eggs but no dice. 
I’m frustrated - I feel like the vets aren’t listening to me. I don’t think it’s the Mega-E… she’s just not right. To compound the issue, she’s not keeping anything down & the vet said no Rimadyl so she’s really sore and sad. A friend who’s an animal vet says it sounds like stomach cancer, he wants us to bring the dog to him…but it’s not our dog… I just feel bad for her… she’s a bit of a trainwreck, but she’s a sweet thing. I just want her to feel better or if she can’t…to have her pts.
Does the rescue mind you taking the dog to a different vet if you do it at your expense?
I haven’t asked…I suppose I could, theoretically, but why should I be financially responsible? It’s not my dog.
They provided you with a vet that they use for the rescue that might give them a discount or whatever. You are wanting to take the dog to a different vet. I can totally see them saying that is at your own expense.
I’m sorry, chism. It does sound like the old girl is struggling. Her symptoms do sound consistent with Megaesophagus. There is a good yahoo discussion list on this, with tons of files that have good info about how to manage it. It is not uncommon with older dogs to have acquired mega.
But, this is a condition that requires intensive management, feeding elevated and keeping elevated afterward. The meds you mention, the sucralfate slurry, metaclopramide, and Prilosec are commonly used, and must all be timed with the feedings,you may feel you need a spreadsheet to keep track of what needs to be given when. Usually the dog must either eat a slurry, or canned food made into meatballs that do not adhere to the esophagus, which usually has very compromised motility. There is a special “Bailey Chair” that can be made to hold her verticle after feedings, some need to stay in it for 30 minutes after feeding, which sounds like it might be a problem for her because of her rear end weakness. Some have had some sucess with feeding them on the stairs or a step stool. She may not be eating because she may have esophagitis, an irritation of the esophagus, which the sucralfate slurry will help heal. The Prilosec is so the regurgitated food is less acidic and irritating. Cerenia may or may not help with her regaining her appetite. Probably if the esophagitis heals, she will feel more like eating. I bet it hurts her now.
Aspiration pneumonia is a common complication with this, and can be very debilitating for the dog. Combined with the rear end weakness…is the rescue group certain that re-homing is in the best interest of this dog? It would take a very committed new owner, and her quality of life might be quite compromised, and she would definitely take a great deal of maintenance.
This may be a situation where there is no good solution. I wonder if the rescue might consider euthanasia, considering her situation.
If you do want to keep her going, a test for Myesthenia Gravis, which can cause Megaesophagus and is treatable in dogs, might be in order. Seems to me the MG test was about $300, it goes to a lab at UC Davis. The rear end weakness would be consistent with Myesthenia Gravis, so if you do keep her, that might be worth doing. If treated, it often can resolve in dogs, and the Megaesophagus can resolve too.
I am sorry you, and she, are having to deal with this!
As usual Trub, you and I are speaking different languages. I didn’t say I wanted to take her to my vet…just that I was frustrated that they can’t figure out what was going on & the girl was suffering. You asked if the the rescue minded if I took her to my vet, so I answered your question.
Houndhill - Thanks for your thoughtful post. I have read a lot about MegaE and Myasthenia Gravis in the last month, and it does sound like she has MG. She has a very mild case of ME and has done very well with her feed/reflux until this last few days & nothing has changed in her management. I have wondered if the MG (f she has it) has affected more parts of her body. In regards to her being adopted…this is a dog that has been in foster care for 2 1/2 years…she really isn’t adoptable with her issues. Her long term foster parents were relocated & couldn’t take her with them to company housing. Their plan is to bring her down with them once they buy a house…but it’s not looking good right now.
Do you think her long-term foster home and/or the rescue might chip in to pay for the MG test? It might be worthwhile, if it is positive you would have some treatment options…if negative, that might help with decision making too.
Another possibility is to post on the yahoo mega list about her, if her other foster home is unable to take her. Surprisingly (to me), there are people who have had or now have mega dogs, who adopt dogs with mega, and know what they are getting into, and how to manage them. Bless their hearts!
Unfortunately these cases do sometimes deteriorate for reasons we do not understand. It seems there is sometimes a feedback loop where more regurgitation further compromises the esophageal function and it can be difficult to break the cycle.
i’m taking her back to vet this afternoon for fluids and anti nausea meds. it appears that what little she does eat is not moving past her esophagus. it comes back up in the same form it goes in. she is still not eating…and refuses even yummy chicken. Rescue coordinator and i have had the conversation. if she doesnt improve in next 24 hours or so…we will seriously consider euthanasia.
Have you considered degenerative myelopathy?
Sheilah
Oh, I am so sorry!!!
I know you will make the best decision for her. It is always a hard thing.
Has myasthenia gravis been ruled out?
[QUOTE=Ghazzu;7180895]
Has myasthenia gravis been ruled out?[/QUOTE]
it’s interesting…this vet office never would really say. I brought it up several times with them … the dog was new to their care & mine. As far as I know, the mobility issues started within the last few months. I’d never heard of Mega E before we received this dog. As soon as I heard about it…I started reading. I’m no vet…but since Mega E and MG quite often happen together, it seemed like a no brainer to me. They said “it could be” or could be something else… they couldn’t be sure. I wondered if it was MG if it could have been affecting her esophagus and stomach…there seemed to be no motility. The vet we saw today (3rd vet…same practice )said maybe it could be part of the problem, but they couldn’t be sure. Her temp was now 103. 2, she’s very dehydrated She went south so quickly… she was pts this evening because they said they couldn’t do anything for her, and referred her to Tufts. The Rescue coordinator and I both felt that wasn’t in her best interest. To add to the puzzle, after she passed, she released a large amount of a mucousy liquid from her nose. But xrays said no pneumonia? I’m feeling like something was missed…but we weren’t willing to prolong her suffering to find out.
RIP Miss Mandy… it was pleasure to know you. .
[QUOTE=IdahoRider;7180849]
Have you considered degenerative myelopathy?
Sheilah[/QUOTE]
Sheilah - It sounds like it could have been… With the Rimadyl she obviously felt better, but it didn’t improve her use of her back legs…it just helped her hop around on her front better.
Now, take this with a grain of salt - but this dog needs an internist, not a GP. There is obviously something going on that your rescue vet isn’t catching onto. Before she is put down, it may be worth a referral for a discussion…not necessarily workup. MG can be, in some cases, medically managed. Others don’t do well. Its at least one more ear to listen to you, and they can make your decision on euthanasia or treatment a little more of an educated one. Jingles for your foster dog.
ETA - Im sorry I didn’t realize she was already euthanized. Sounds like she had a person who really cared about her and ultimately a very selfless decision was made.
Aspiration pneumonia is frequently missed by vets, especially in beginning stages. If it makes you feel any better, you can request the radiographs be sent to a radiologist for interpretation. However, mucous can also come from other sources like the sinuses.
So sorry for your loss.
Sleep softly, Miss Mandy!
Sorry for your loss.
[QUOTE=SquishTheBunny;7181007]
Aspiration pneumonia is frequently missed by vets, especially in beginning stages. If it makes you feel any better, you can request the radiographs be sent to a radiologist for interpretation. However, mucous can also come from other sources like the sinuses.[/QUOTE]
Yes, I agree. On the yahoo mega list, and from lots of experiences with wolfhounds with aspiration pneunomia, it is not always apparent on the lung X-rays. With the fever and other signs, I would suspect she might have indeed had aspiration pneumonia.
The only reason I’m posting this, is if anyone else ever has a dog they suspect might have pneumonia, it is not always apparent with the X-rays, so if clinical signs suggest it, it might be advisable to institute immediate antibiotic therapy. I know of many IWs who were lost because of this.
OP, mucosy liquid does go along with Megaesophagus, they make a great deal of it, so I am not sure it definitively tells you much.
But certainly it sounds as if euthanasia was the best choice for Miss Mandy, I just mentioned this to possibly help others in the same boat.
I hope you have had some small comfort, know it is a hard thing always.
[QUOTE=chism;7180694]
Houndhill - Thanks for your thoughtful post. I have read a lot about MegaE and Myasthenia Gravis in the last month, and it does sound like she has MG. She has a very mild case of ME and has done very well with her feed/reflux until this last few days & nothing has changed in her management. I have wondered if the MG (f she has it) has affected more parts of her body. In regards to her being adopted…this is a dog that has been in foster care for 2 1/2 years…she really isn’t adoptable with her issues. Her long term foster parents were relocated & couldn’t take her with them to company housing. Their plan is to bring her down with them once they buy a house…but it’s not looking good right now.[/QUOTE]
Myaesthenia affects more of the body than the esophagus, most often. Weakness is a hallmark sign. A Tensilon test is easy to do and bloodwork (acetylcholinesterase antibody titers) are diagnostic. Mestinon isn’t terribly expensive, either.
I do agree, all things equal, that myaesthenia and megaesophagus aren’t diseases that many people want to “adopt into.” They can be managed, however, with a dedicated owner.
Might be worth sending out a serum antibody titer for acetylchloline receptors to test for MG. The University of California, San Diego is the only lab currently doing the test - information on how to submit samples is on their website.
http://vetneuromuscular.ucsd.edu/Services.html
