Wednesday, December 23, 2009

Meet and Greet

Happened to be at a nearby PetSmart when the local GPA group was there. Always nice to visit with the greyhounds and their owners. This is not the first time that we have meet some of these folks. There were 2 large male greyhounds there - very sweet dogs.

Got home and the difference between the males we met and Roland was scary. Roland's getting so skinny. His shoulder blades are prominent and his hip bones stick up. He looks alot like a puppy that hasn't filled out. The last couple of days everything he has eaten has come back up and he acts like he's constantly hungry. How much longer can this go on? Other than being hungry, he rarely seems in pain or very distressed. So, we wait........

Sunday, December 20, 2009

Merry Christmas

Photo is from the Greyhound Nationals in Lexington KY. Roland is the one with the blue blanket out in front and NO he was not given a head start. This photo was about 4 strides into the course.

Christmas is this week. As we put up our tree and hung a special greyhound ornament, we noted that this is probably the last Christmas that Roland will be with us. If he makes it until March, he will be 12 years old. This is not bad for a large male greyhound, even if the last couple of years have not been the best.

Roland's doing about the same, although he's really started to lose weight. He's down to 81 lbs - from his adult weight of 94-96 lbs. He's clearly lost muscle in his shoulders and rear end and his hip bones are starting to be prominent. He's having issues seemingly related to a reduced immune system. He's had ear infections in both ears and what looks like a yeast infection on his skin on his belly and between his back legs. He gets a special shampoo to control it. So, we are treating symptoms that make him uncomfortable, but we're not able to do much about the underlying condition. His rear is quite weak and he's fallen several times when his feet have slipped. He even has trouble riding in the car. He can't seem to keep his balance comfortably and has to lie down. Since his favorite part of the car ride is looking out the window, lying down is not fun.

This has been such a difficult road, but Roland's been such a trouper. Merry Christmas to all and best wishes to all canines and their families for the coming year!

Saturday, September 19, 2009

Sept and still living with mega-esophagus

Can't believe that we've made it this far with Roland. Things are pretty much the same.

Last night we did have an issue with our other dog - Maggie the whippet. After 3 hours at the vet today, she is starting to get better, but she has idiopathic geriatric vestibular disease. At it's worst this morning, she wouldn't even try to stand. By late this afternoon she was trying to stand and walk, but still not interested in food or water. She did get 350 cc of subcutaneous fluid at the vet's office.

Roland's regimen has not changed except that we now give him 10 mg of bethanechol at every meal (3 times a day). He still has good days and bad days. Last night was a bad night. It was especially bad for the humans in the family because we had to take care of 2 sick dogs. Roland had one of his bad events where he blurps repeatedly and looks quite distressed. He has recovered from this one fairly quickly. He ate a little breakfast and most of his dinner. He also wants to know why his sister is getting the good stuff. I don't think she has ever been sicker than him and he certainly doesn't get it. I'll admit that he's gotten spoiled with this illness.

Sunday, July 26, 2009

July update

Photo is from his first agility trial at age 2.

I can't believe how long it's been since I posted an update. Things have been relatively stable - although gradually getting worse. Roland blurps nearly every day. He had 2 of the episodes where he blurps repeatedly over several hours within a 2 week period. We thought it might be the end, but he recovered back to baseline after the second event fairly quickly. Recently he went almost 2 days without blurping, but emptied pretty well tonight. He's clearly lost weight, but is generally hanging in there.

Wednesday, May 20, 2009

Bad Day

Just a short update. Frustrating day. Came home to find blurps all over the house. Couple looked dry and old - like from early in the morning. A couple were mostly water with some grass. This suggests that he wasn't feeling well. However, when I got home from work he did not act like he was feeling bad. He ate dinner well and looks comfortable. Sure wish we knew what to expect with this disease.

Monday, May 11, 2009

May update

Things have been pretty status quo for about a month now. Back in April we had a very bad stretch of a couple of weeks. One of Roland's back toenails came off. Of course it happened just before bedtime on a Sun evening. It's been so long since a toe nail came off that I couldn't find all the stuff. Finally got the bleeding stopped and got to bed. The nail bled off and on for several days.

That Thurs we had an appointment with our vet. She thought he looked great. His weight is holding steady. We reviewed the dosing of bethanechol and discussed what the projectile blurping might be about. No real resolutions. I think we are all guessing at this point. His toe looked fine when she examined it.

The next day and over the weekend, Roland had a really bad time. He was blurping up almost everything that he ate and he did not look well. We also noticed that his toe was swelling some and bleeding again. We were soaking his foot, but it wasn't getting any better. I called the vet and she agreed to treat his toe with an additional antibiotic, which I picked up on Tues. For the next 10 days he got the antibiotic (cephalosporin) and I stopped his tetracycline. I was worried that his SLO might flare up, but cephalosporins don't work well when given with tetracycline. After a couple of days, the swelling in the toe went down and his blurping reduced in frequency and volume. By the end of the 2 weeks, he was back to his baseline.

The main outcome of this episode is that if Roland blurps more than once a day, I increase his sucralfate to 3 times a day. When he has the episodes of repeated blurping and panting it does appear that he has esophageal irritation and the sucralfate should help with this. We've also increased his bethanechol to a total of 20 mg/day - 5 at breakfast, 5 at dinner and 10 before bed. In the past month, he rarely goes a day without blurping but it is often predictable - when he is either excited or drinks a bunch of water, or gets too hot, etc.

A couple of weeks ago he did have one day when the blurp had a different consistency. Usually it is clear liquid with identifiable undigested food. This one day it was darker brown and more even in consistency - more like stomach contents, but without bile.

In our case, as the saying goes - No news is good news. We cannot believe that we lived with megaesophagus for 17 months, but we'll take every day that we can have.

Saturday, March 14, 2009

Update mid-March

Photo is Roland at age 9.

Nothing really new to report. Roland seems about the same. He had done well for several days and then a couple of nights ago, he got us up in the middle of the night to clean up a couple of blurps. Last night - no problems. He's also not blurped during the day for over a week. He's due to go back to the vet for a checkup. It will be interesting to see what he weighs. I don't think he's lost any weight.

Thursday, February 19, 2009


Just another update. Roland's had a bad week so far. Came home from work yesterday to find a trail of blurps to the doggy door. They were all small spots, but we haven't seen that since the night we took him to the emergency clinic. However, he didn't seem distressed and slept through the night without blurping. It's so hard to figure this disease out.

Another strange thing has happened lately - 3 times to be exact - in about a 3 week period. He's had episodes of what I would have called projectile vomiting, but it's mostly clear liquid and a little bit of kibble. So, I guess I should call it projectile blurp, but that doesn't make sense. The liquid comes out with force and a clear stream. In fact, it splashed. For a dog that's not supposed to have any motility in his esophagus something sure contracted or spasmed. We've discussed this round and round. Perhaps his dose of bethanechol is too high, maybe he has another condition in addition to the megaesophagus or maybe something that we haven't thought of. The third time this happened it was first thing in the morning and he had not eaten yet - or had his pills. Our conclusion is that it's not caused by too much bethanechol. If so, you would expect the symptom to happen shortly after a dose, not right before the next one. Who knows though? Anybody out there with any experience with this??

Monday, February 16, 2009


Photo is from an agility trial when he was about 5.

It was a holiday weekend, which are often not good around here. However, Roland did quite well this weekend. I thought he'd get through the whole day today without blurping, but had one small blurp this evening. He desperately wanted to play/interact, so I got a handful of training treats. Thought I'd try to train a new behavior. He got so excited that he blurped. Not unusual, that's why we try not to get him too excited. But, he's hard to resist when he wants attention. For an old guy, he's still one cute dude. I'm going to have to figure out how to upload photos to the blog.

Sunday, February 15, 2009

Current Regimen - update

OK. Back to Roland's current treatment. Morning meal between 7:30 and 8:00 am every day - even weekends and holidays. Meal consists of 1 and 1/2 cups of medium sized kibble with several spoonfuls of canned food, plus a long squirt of LipiDerm and one 500 mg capsule of tetracycline. These are for his symmetric lupoid onychodystrophy (SLO). Interestingly, the vet thinks that the chronic tetracycline might have contributed to his longevitiy with the megaesophagus. Don't know how to determine this and we are not going to stop the tetracycline to see if he gets worse. Oops... back to his morning meal. He also gets one sucralfate ground up and suspended in NutriCal, plus 5 mg of bethanechol.

Around 5:30 pm he gets a smaller meal of 1 cup kibble with some canned food, with one tetracyline and some LipiDerm along with 5 mg of bethanechol. Late night meal, around 10 pm, is 1 cup kibble with another 5 mg of bethanechol.

If you read the earlier summary of Roland's treatment regimen, you'll notice one difference. He was getting 10 mg of bethanchol with the latest meal and none at 5 pm. Last week was a rough week with repeated blurping epsiodes in the early evening. We didn't really want to increase to total dose, so tried giving 5 mg as soon as we got home from work. Too soon to really tell if this is helping. Overall, our feeling is that the disease is progressing and this is just breakthrough symptoms. For now, we can tolerate the blurping. Yesterday he blurped twice. Once early in the morning - almost a cough and only a small quantity. Around 5 pm a second blurp of moderate quantity, but fairly dry. He's hungry and eating well. I've also reduced the sucralfate to once a day. Since the blurping is much less frequent, I don't think it's really doing much. I've also reduced the NutriCal for now since he's eating so well. Soon we'll need to get back to the vet so that she can see how well he is doing. She's not seen him since we started the sucralfate and bethanechol.

Sometime along the way, before starting the sucralfate and bethanechol, we had stopped the niacinamide (part of his SLO treatment). Clearly it tasted bad and nutrition was a major concern. We decided that we would tolerate loss of a nail or two in order to have a dog with good nutritional status. He's eating well now, so we'll leave things alone for now. It does take weeks to months to see an effect on his toenails, so we'll wait and see.

Saturday, February 7, 2009

Initiating Bethanechol

We started the bethanechol by giving 5 mg with the morning and evening meals. As previously mentioned, after several days we noted that 3 days in a row Roland blurped at 5 am. So we started a late evening snack and moved the evening dose of bethanechol to between 9 and 10 pm. So, his morning dose was given around 7:30 and the evening dose was 9:30. Not an even 12 hours apart, but it seemed to work.

The blurping was significantly decreased in volume and frequency. The matter in the blurp was grainier - more small pieces like it was partially digested. Not sure the meaning of this, but we noticed this within the first weeks. It was, of course, hard to determine the effectiveness of the bethanechol because of the clustering and inconsistency of the pattern of his blurping. However, I was doing a lot less wash of throws and rugs, etc. We also were buying many fewer rolls of paper towels.

The vet had instructed us that the range for the dose was 5 mg twice a day all the way up to 15 mg three times a day, so we were at the low end of the potential dose range. Initially, the 5 mg twice a day worked, but gradually we started seeing more blurping again in the early morning. So after about a month we increased the evening dose to 10 mg. He has done well on this dosing regimen. He still has these episodes of worsening blurping with increased respiratory rate that lasts about a day. He looks, and acts, like he doesn't feel well during these times. Seems to happen about once a month, or maybe every 3-5 weeks. We really should keep track to see if these episodes are happening more often. Occasionally, we increase his dose of bethanechol during these times, but again we're not sure how effective it is in this instance. As opposed to before bethanechol, during these episodes he will eat and never looks as seriously ill as the evening when we took him to the emergency clinic.

We continue to wonder what effect the bethanechol is having on Roland's symptoms. However, one night, just as we're falling asleep, Roland blurped a large quantity several times in a half hour. This hadn't happened for ages. I asked Mr. Whippettx how much bethanechol Roland had received that night and he admitted the Roland had not gotten a dose. This was only 1 trial, but the result was impressive enough that we have no plans to skip another dose. We are believers that the bethanechol is reducing the symptoms of his megaesophagus. But, remember that Roland has idiopathic megaesophagus and clearly has some motility in his esophagus.

Wednesday, February 4, 2009

New Vet and New Treatment

About a week after our trip to the emergency clinic, we finally had a first visit with our new vet. She reviewed his history and agreed that he has megaesophagus. We had blood drawn for testing for myasthenia gravis and hypothyroidism. After the results came back negative, we returned to discuss other options and for her to get to know all of us better. We also reviewed all of the things that we have tried. She said that she would look into some other options and ideas. Several days later she called and said that a friend had suggested sucralfate and bethanechol. Things were getting so bad that we were willing to try just about anything. Just the week before, Roland had had one of his really bad episodes and there were streaks of blood in his blurped material.

I decided to try one new medication at a time, so we started with the sucralfate. Sucralfate is used to protect the lining of the GI tract in people with ulcers. Therefore, it should reduce the irritation in Roland's esophagus. After one week, there was no difference in the frequency of the blurps, but we've continued it and we've not seen blood in the blurp again. The sucralfate is supposed to be given 2 hours before meals, but Roland gets frequent meals and there's never a 2 hour period before a meal. However, since the food he eats sits in his esophagus, we've always assumed that the sucralfate has plenty of time in contact with the lining of his esophagus. Or, it may be doing nothing.

After a week, we started the bethanechol. I waited until a Sat to begin it, so that he could be watched for several hours after the first dose. Bethanechol is used in people to treat urinary retention after surgery. It is a cholinergic agonist, so it binds to cholinergic receptors and causes smooth muscle contraction. For it to work the nerves that connect to the smooth muscle do not have to be functioning. We were really concerned that there would be urinary or intestinal side effects of the bethanechol, since these tissues are also smooth muscle with the same receptors. So, the first morning Roland received 5 mg. He had no obvious effects of this dose, so he received another 5 mg that night. We continued with 5 mg twice a day. We didn't notice a dramatic effect, but towards the end of the week we observed that he was blurping around 5 am every day. Happened 3 days in a row - with no blurping at any other time. So... we tried giving him the evening dose between 9 and 10 pm (from 5-6 pm). It worked. No more 5 am blurps. By the end of the week, we'd gone from blurping daily to rarely blurping. It was a miracle.

Emergency Clinic

Our first (and, hopefully only) visit to the emergency clinic was on the evening of May 1, 2008. We had not yet found a vet, although we had a list of potential vets from other greyhound owners. On May 1st, I came home from work and found Rolland outside the dog door looking quite unhappy. There was a trail of small blurp spots inside the house across the room to the dog door. Clearly he did not want to come in past the mess - he has always been a very clean dog. I let him inside and cleaned up all the messes.

As the evening went on he blurped several more times and refused to eat anything. In the early evening, he started looking very distressed with panting and holding his head up high. He also refused to lie down, preferring to stand. He looked so uncomfortable and we had no vet to call, so off to the emergency clinic we went. There they agreed that they thought he had megaesophagus and they presumed that he had aspiration pneumonia. However, he did not have an elevated temperature or any rales or wheezes. We gave permission for a chest x-ray, knowing that he would need sedation. He was given a single 4 mg dose of oxymorphone and a chest x-ray was obtained. Moderate consolidation was noted in the left lung and he was sent home with Reglan and antibiotics (Baytril and Clavamox). Although he was wobbly from the sedation, we took him home at 1 am.

He slept through the night, but we each woke up repeatedly checking to see if he was still breathing. The next morning I went to work and worried the whole time I was there. I came home just after lunch after my husband went to work. Roland was still completely out of it. He hadn't gotten up all day, hadn't eaten, hadn't urinated, hadn't blurped. We didn't think he would live through the night. That next night, I don't think either of us slept. However, Roland was still with us in the next morning (Sat). He actually looked a little brighter, so we carried him outside and he peed and sniffed. When he tried to eat some grass I ran into the house and got a can of dog food. He ate several spoonfuls of dog food then and again every 2-3 hours through the day. By evening he was looking at 75% of normal energy level. By Sun he was back to baseline. We finally started giving him the antibiotics on Sun since he was now eating.

The clinic had given us some metaclopramide (Reglan). We also gave this a try starting Mon morning. The clustering of his blurping and variability of the episodes makes it hard to determine whether a treatment is really making a difference. But, the metaclopramide made no difference, so we've never tried it again. Within several days of this episode at the emergency clinic, we were back to baseline. We also decided that he will never again get sedatives or go back to the clinic. We are prepared for him to have an acute worsening and understand that he has a terminal condition. We are just not going to put him or us through this again.

Roland has had episodes like the one that sent him to the emergency clinic several times. He blurps repeatedly over a few hours and looks very distressed - panting and holding his head up. After several hours he starts to relax again and by 12 hours he's generally back to normal. In retrospect, the sedative slowed down his recovery from the episode. It seems that the smooth muscle in his esophagus is having repeated spasms during these episodes. We have no way of knowing whether this is the case, but that's what it is like. Seems like it happens about once a month, although again we can't predict when it will happen.

Tuesday, February 3, 2009


Photo by ShotonSite.
I've mentioned a couple of times that we give Roland NutriCal every day. We started using NutriCal years ago with a previous dog. He participated in flyball and lure coursing, but when we traveled he did not eat well. Someone suggested NutriCal. It looks like liquid fat mixed with molasses and comes in a tube. It supplies lots of calories in a small, very tasty, volume. It was great for keeping our earlier dog's energy level up for competition.

So, when we were reading that megaesophagus causes malnutrition, we immediately thought about getting some NutriCal. We buy it by the case from an on-line distributor so that it's about half the price of local stores. We started giving it to Roland in late March of 2008. There is no way to know how effective it is, but we're guessing that it doesn't hurt. Certainly, the blurped material does not appear to have NutriCal in it. Even when he blurps soon after eating, the matter that comes up is clear fluid with undigested kibble. Sometimes it's possible to see some of the canned food, but we've never seen a tetracycline capsule or a fat capsule (back when we were giving the capsules) and we've never seen the NutriCal.

When Roland was started on the sucralfate for his megaesophagus we had a choice of tablet or liquid, but the tablets were much less expensive for the dose needed. We were instructed to break up the tablet and mix it with water, then squirt it into his mouth. I tried this a couple of times with different volumes of water. He was a trooper, but I was a klutz. One time I actually squirted it out the other side of his mouth. I didn't want to mix the powder in his food, since the food is mostly dry and he doesn't lick out his bowl. After a couple of experiments, I discovered that the NutriCal picked up the sucralfate quite easily. Now I crush the tablet into a powder then squirt about 1.5 inches of NutriCal into the plastic cup and mix it around. Then this blob is dropped on top of Roland's food. He generally eats this second after the peanut butter covered pills, so it must not taste bad.

Bad times

Rollie blurped a couple of times last night just after midnight. He was OK this morning, but has blurped again tonight about 6 times. He hasn't been able to keep anything down and is hungry. It's been so long since he's had a bad day, that it's really frustrating. We certainly hadn't forgotten how to clean up blurp while half asleep, but it's been long enough that it has us really worried. We talk alot about what will come with this disease in our dog. Will his underlying disease manifest and be the cause of his death? Will he get aspiration pneumonia and die? Will his megaesophagus progress to the degree that the bethanechol can no longer control the blurping and he is no longer getting sufficient nutrients? We are thankful for every day that we have him, but we'd really love a crystal ball on this.

Sorry about the sidestep from his story. I know we haven't gotten up to present day, but I just wanted to share our worries and frustrations.

Friday, January 30, 2009

Disease Progression

Roland starting blurping in Dec. 2007. At first it was quite rare - a couple of times in 2-3 weeks. It was always episodic. In other words, it would come in clusters. He'd not blurp for a week or more and then blurp 4-5 times over a 2 day period. This made it quite difficult to determine whether the food (size, dry vs wet, etc) made any difference. Also in early 2008, we were preparing to move to another state. We finally moved the dogs - a 2 day drive across the western US. Roland did not blurp once on the trip. We were so afraid that we'd be cleaning up a hotel room or the car, but we made it safely. However, now we have a sick dog in a new city with no vet. Plus, trying to unpack, start new jobs, get the dogs settled, etc. Life was quite hectic. However, Roland was reasonable stable and not losing weight.

The blurping was gradually increasing in frequency. Early on it was days between blurps, sometimes a week or two. Then he might go a few days without blurping. Then he might skip a day. Then it was nearly every day. We did notice that he was more likely to blurp on weekends. Took a while to figure out, but it seems that he is more active when are around and clearly increased activity increased the likelihood that he'd blurp. When we're at work, he sleeps all day.

We also noticed during this same time period that he was getting weaker in his rear. The new house had 2 steps up to the backdoor and he was clearly not as strong as when he was younger (but who is?). He was also losing muscle mass, mostly, in his rear. We consulted with a veterinary internal medicine specialist, who also happens to be a greyhound breeder, and she told us that this a fairly common in older, large male greyhounds. We don't think this weakness is related to his megaesophagus, but it has clearly affected his treatment. He is too weak to sit for more than a few seconds. Greyhounds are not big sitters anyway - prefering to lie down or stand. Early in 2008, we tried having Roland sit for a few minutes after eating, to improve esophageal emptying, but his rear quivered so much we gave up on that approach.

Monday, January 26, 2009

Past Medical History

Roland was born in March 1998. His whole litter was sick at about 9 weeks, but recovered nicely. We picked out Roland at 10 weeks and brought him home at 12 weeks of age. He was a wonderful puppy -easy to train, housebroken in 1 trial, and generally a really good guy. We began training him for the breed ring, for flyball, for agility and for lure coursing. He grew to be 29.5 inches tall at the withers and weigh between 92-95 lbs.

In Jan of 2000, I came home from work to find him quite ill. He was vomiting bloody stuff and having bloody diarrhea. We rushed him to the emergency clinic where hemorrhagic gastroenteritits was diagnosed. He was treated and released. The bleeding seemed to stop, but he was not better the next day. So, off we went to our regular vet. Our vet was afraid that Roland had an obstruction in his bowel. So after more than 2 liters of fluids, Roland had surgery for a potential bowel obstruction. The vet was able to reduce an obstruction in his colon without opening up the bowel. Roland recovered well from the episode, although it did take quite a while to gain back the weight that he had lost. He had to be on an "intestinal diet" for more than a week and it was hard to give him enough cans of the stuff for a dog of his size (about 75 lbs at the time). The whole episode did give him a real preference for chicken and rice canned food. It also gave him an aversion to pills or the threat of a pill. This is presumably related to the awful taste of the Flagyl (metronidazole) that he was given.

Roland grew into a handsome and healthy greyhound. He finished his championship in the breed ring and became an outstanding lure courser. He won the lure coursing competition at the national specialty one year - the same year his father won the breed competition. Later that year he finished his AKC lure coursing championship. He also earned enough points to become a flyball dog champion and was chosen for a spotlight on Animal Planet as a breed champion that plays flyball. He was such a trooper during the filming of the flyball runs with cameras all over the place. He was not so good at agility because he was too easily distracted, but he did love to run and jump. He finished his novice agility standard title and also his open jumpers title. He was oh so close to excellent jumpers legs on several occasions, but never quite got there.

Then, on Oct. 28, 2005 2 of his toenails fell off. The next day 2 more fell off. He had symmetric lupoid onychodystrophy (SLO). Over the next 2 months, he lost all of his nails. SLO is not an uncommon disorder that affects all breeds of dogs. It is thought to be due to an immune reaction to a protein in the nail bed. The nail comes loose and then separates from the quick. It is quite painful and frequently bleeds as it separates. Until all of his nails had fallen off, Roland hated to walk in the grass or on any uneven surface. We became quite adept at soaking his feet in cold water to stop the bleeding and to numb the toes a little and then wrapping his foot until the nail came off. It was a challenge to keep him comfortable and to keep the blood stains to a minimum.

Treatment for SLO is to start with high doses of tetracycline, niacinamide and lipids (fat). If this doesn't control the disease, then steroids can be used. The disease will never be cured and the nails will always be soft and misshapen. Untreated, the nails will grow in and then fall off again. Roland was started on tetracycline 500 mg 4 times a day, niacinamide 500 mg 4 times a day, DermCaps at 3 times the dose used to treat skin conditions and 1 scoop of unflavored gelatin. We keep that up until all of his nails had fallen out. However, it was difficult to maintain a treatment 4 times a day when both of us work full-time day jobs. So by the end of 2005, this regimen had been tapered to tetracycline and niacinamide twice a day. After about 6 months we tapered the niacinamide to once a day. It was the only pill that was not available in capsule form and it must have tasted awful, because it was difficult to get Roland to eat it. The tetracycline capsules were, and still are, covered in peanut butter. For the lipids, we used a combination of DermCaps (capsules) and the liquid formulation. On this regimen, Roland's nails grew back with only one really deformed. The SLO forced his retirement from doggy activities.

Between Oct. 2005 and Dec 2007, Roland lost only 3 toenails and these happened with minimal distress. Therefore, he was maintained on tetracycline 500 mg twice a day, niacinamide 500 mg once a day, DermCaps (total of capsules and liquid = 3 times the dose recommended for skin conditions) and 1 scoop of unflavored gelatin with his evening meal. Because of the pills, he was being fed twice a day. Because of his height, he was always fed with his dish on a chair or table.

In Dec. 2007, he regurgitated clear liquid and mucus two or three times. There was no food or bile in these 'blurps', and he did not retch when it happened. The first time was odd. Neither he nor I could figure out what happened. The second time he was trotting across the backyard and barely hesitated when it happened. Over the Christmas and New Year's holidays, we spent alot of time on the internet and discovered megaesophagus. The description matched exactly.

Wednesday, January 21, 2009

Current Protocol

So, what is life currently like with Roland - our greyhound with megaesophagus? First, his treatment. He gets 3 meals a day. That's the most we could handle with both of us working full-time. He's fed from an elevated level, a kitchen chair. His water bowl is elevated and is taken away after his late evening meal. As others before us, we have experimented with different foods - kibble versus canned versus moist versus dry, etc. Currently for the morning meal he gets medium sized kibble with some spoonfuls of canned food, a squirt of LipiDerm, plus one 1 gm pill of sucralfate ground up and mixed with NutriCal. The NutriCal is a high calorie food supplement, which we were giving anyway, and it conveniently holds the sucralfate. Then he also gets one 5 mg tablet of bethanechol and one 500 mg capsule of tetracycline, both covered in peanut butter. For his 5 pm meal, he gets another 500 mg capsule of tetracycline and another gm of sucralfate. At his 10 pm meal he gets 10 mg of bethanechol with about a half a cup of kibble. He has been on this regimen for about a month now and only regurgitates a few times a week, mostly when he gets excited or drinks alot of water all at once. He's also more likely to regurgitate early in the morning. He's maintaining his weight and has not had pneumonia.

As an aside, we call his regurgitation 'blurping' and I'll use that word from now on. That is what is sounds like. There's no retching, like there would be if he was vomiting. Also as an aside, I once checked the pH of the regurgitated stuff and it was right between 5-6 (using pH strips), suggestive of saliva and not stomach acid.

Tuesday, January 20, 2009


So what is mega-esophagus? If you are reading this you have probably already done a fair amount of research, so I won't bore you with all of the details. Basically, it is loss of motility of the esophagus, which is a tube of smooth muscle that connects the mouth to the stomach. There is a similar disease in humans, but since we have gravity to assist, the disease is quite different.

There is a congenital form of mega-esophagus. In this case the condition is present from birth and presumably there is a genetic basis or it is a birth/developmental defect. The other form is called acquired and this is the form that our dog has. There are two treatable conditions that can lead to acquired megaesophagus - hypothyroidism and myasthenia gravis. Our dog was tested for both and found not to have either one. There may be some other disease that our dog has that has resulted in the megaesophagus, but, if so, we don't know what it is. The only way to halt the progression of the megaesophagus is to identify the underlying disease and treat it early. Generally, dogs diagnosed with secondary acquired megaesophagus live about 6 months from the time of diagnosis. The main causes of death are malnutrition and aspiration pneumonia. The malnutrition results from the food never getting to the small intestine for absorption. The aspiration pneumonia results from inhaling small amounts of the regurgitated 'stuff.'

General recommendations are to have the dog sit for 15 minutes after each meal, to feed multiple small meals and to feed in small balls. We tried most of these with varied success. Since, it's now been over a year since his first symptoms appeared, I guess that we are doing something right. In our on-line searches most of the success stories have been about dogs with congential megaesophagus or dogs with myasthenia gravis. Rarely do you see a story about secondary acquired megaesophagus, especially a story with an effective treatment.

Monday, January 19, 2009


Our 11 year-old greyhound dog has mega-esophagus and has had it for a year now. When he first had symptoms we searched the internet for information about this disorder. We found it somewhat limited, so have decided to start this blog about our experiences with this condition.

DC Gerico's Wild Goose Chase, SC, FDCh, OAJ, NAJ, VC..... AKA Roland is now 11 years old. He first had symptoms of mega-esophagus in Dec of 2007. He is currently on sucralfate (1 gm twice a day) and bethanechol (5 mg in the morning and 10 mg at night) for his mega-esophagus. It is now Jan. of 2009.

We don't know what in his history is important to the story, so over the next few weeks or months we'll record his medical history and update his current progress. Thanks for reading and we hope this information will help someone else with their pet.

UPDATE: 12/29/09: It has now been 2 years since the first symptom.