Diary Entry #1 - 10/23/2009 - First Indication

Today Sammie started making a very strange noise and vomiting. The more she ate the worse things got. The vomiting became so violent that I thought she might be having a seizure. I took her to our Vet. He thinks perhaps she has a scratchy throat due to a cold or infection. He put her on an antibiotic which seems to help. He has ruled out a seizure.

Fast forward -- For the next week Sammie was normal. This was just shy of her 2nd birthday.

The Bailey Chair - Essential for successful treatment - Directions on how to build

The Bailey chair is essential for successful treatment of mega esophagus. It allows your dog to eat completely vertical and allows you to do other things while feeding and elevating your dog after feeding. I STRONGLY RECOMMEND THAT IF YOU HAVE NOT MADE YOUR BAILEY CHAIR, DO SO IMMEDIATELY. SHORT OF THE PYRIDOSTIGMINE MEDICATION, IT IS THE NEXT MOST IMPORTANT TOOL IN THE TREATMENT OF MG/ME.

Here is how to make a bailey chair this is a 1 hour process in all:

1. Have your dog sit on his/her butt vertically. Measure from the floor to the dogs shoulders. Add 4 inches.
   
2. Measure your dog from the shoulders all the way across and add 4 inches.
3. Measure your dog from back to front when she is sitting vertically again.
4. Now make a box with 3 closed sides and a base that your dog can fit in according to the measurements.
5. By a closet hanging rod and fasten that about 3 inches from the top across the open front.
6. Pad the box so your dog is comfortable.

This is pretty much common sense and none of the measurements need to be terribly precise. You are just trying to make a box that your dog can sit up in, comfortably, that supports her back. We used pine wood and sheet rock screws. We padded it with PVC insulation. We got the material at Walmart. My wife used a staple gun to secure the upholstery, which my daughter picked out at Walmart. The entire chair cost about $20 and took 1 hour to build. We are not carpenters, so if we can do it, so can you!

Here are some pictures:

My wife padded the chair so Sammie was comfortable. My daughter sat outside the chair and read books to Sammie for 30 minutes after feeding. Here is the chair in it's final version:

 My kids were so excited to show Sammie that we decked out her chair. Unfortunately, Sammie never got to use the newly decorated chair. See what went wrong to avoid this happening to your dog.

MG Remission

The only good part about MG is that your dog can go into spontaneous remission without any warning. A number of studies have the number at about 90%. My Vet believes it is much closer to 50%, but nobody really knows.

Remission normally occurs between 6 and 18 months after diagnosis.

For us, the earliest we can hope for is May of 2010.

Treating Aspirating Pneumonia

Your dog will almost certainly catch Aspirating Pneumonia. It is by far the biggest risk to your dogs survival. It is important to identify when the pneumonia sets in and treat it immediately. If your dog is lethargic and weak at all times and is running a fever (warm nose), they probably have a case of pneumonia. At this time your dog needs an antibiotic. We give our Scottie Zeniquin 50mg tablets once daily. If the pneumonia is too far along, you will need to check your dog into the hospital for treatment. This is expensive so it pays greatly to recognize the onset of pneumonia.

As a precaution I have been giving our dog 25mg of the Zeniquin once daily. This seems to keep the pneumonia at bay.

We also encourage her to clear her esophagus. Generally the dog will make a forced almost burping sound, similar to a seal, when they need to clear that esophagus. When she clears it, a puddle of thick, almost clear liquid will come up. We praise her when that happens.

Scotties are very smart dogs. We have encouraged her in every way to take care of herself. She will routinely clear her esophagus and when resting she will lay in an elevated position.

Pyridostigmine Bromide Treatment

Your dog must be placed on this medication. It comes in 60 mg tablets that can be mixed with the food. It also comes in a liquid form that may be more effective. This drug inhibits the destruction of acetylcholine by cholinesterase and thereby permits freer transmission of nerve impulses across the neuromuscular junction. It fights MG straight up and will buy your dog precious months or even years until remission sets in. It is available at most pharmacies and is not that expensive, a little less than $1 per capsule. Your vet can prescribe the medication.

ALLOW YOUR DVM TO DETERMINE THE DOSAGE OF THIS DRUG. YOU SHOULD NEVER ADJUST THAT DOSAGE WITHOUT YOUR DVM FULLY SUPPORTING THIS. BEFORE ANY DOSAGE REDUCTION, CHECK THE MEDICATION SIDE AFFECTS AND TREAT THEM BEFORE REDUCING THE DOSAGE. THIS IS CRITICAL.

MG Basics

MG is probably the worst disease that a dog can have short of terminal cancer. It is a disease that blocks successful transmission of neurons to target muscle groups. One of the most common of these groups is the esophagus. However other muscle groups are also commonly targeted including throat, eyes, legs and probably any other muscle in the body. If your dog does not have esophagus issues, then you are truly lucky. If your dog does, this site will describe effective ways to overcome those issues.

Clearly the biggest threat to a dog with MG is Aspiration Pneumonia. MG causes dogs to involuntarily regurgitate. This can be very startling to dogs and cause them to quickly breath in, which can suck matter into the lungs of the dog and cause pneumonia. If not treated with antibiotics the dog will die.

MG rears its ugly head when your dog has almost any physical exertion. Even something as simple as climbing stairs may cause involuntary regurgitation. With rest the MG calms down. When your dog is coughing or regurgitating involuntarily, they will calm down much faster if you lay with your dog and praise them. We spoon with our Scottie and tell her how tough she is and what a good dog she is. That causes the MG to calm down in a hurry.

MG is effectively treated with Pyridostigmine. This typically comes in 60mg tablets. It can be mixed in with the food. Without this drug, make no mistake, your dog will die. They will lose control of a variety of muscular functions and not be able to function.

If your dog has megaesophagus, you should build a Bailey Chair. This is the 2nd most important treatment tool. Building the chair is very simple.  Follow the link to see how simple. It is also very inexpensive.

Build a Bailey Chair

The biggest reason to fight this disease is there is an extraordinary chance your dog will go into spontaneous remission. Some studies have the number of dogs going into remission at 90%. The number is closer to 50% according to my very capable veterinarians.

Megaesphogus Drinking Technique

The greatest challenge for your dog will probably be staying hydrated. Using wet dog food is a great help and is in most cases mandatory. However, you will still need to provide your dog with water. You cannot have your dog just drink out of a water bowl. That will lead to water getting trapped in the esophagus, vomiting and eventually aspirating pneumonia.

It is very difficult to get the water to the stomach through a dead esophagus. Therefore you must give your dog the best chance possible.

We bought a "hamster" water bottle at Petco. They make in much larger sizes for dogs. When your dog is thirsty, have them sit in an elevated position and allow them to drink from the water dispenser. They will quickly get the hang of it. Always try and move the dispenser higher to straighten out your dogs neck and allow the water to drop straight down to the stomach. The water is more difficult because it does not have the weight of food.

When your dog has had enough, he/she will stop drinking by themselves.

Immediately after this, you must elevate your dog and burp and shake the dog to get as much water down as possible. Again this will be a greater challenge than eating because of the weight of the meatball compared to the water.

The best idea for drinking is try and get you dog to drink before eating. Then when the dog is eating the meatballs will take a lot of water down with them. Remember gravity is being used in place of an esophagus.

Megaesphogus Feeding Technique

UPDATED NOTE: I created this page prior to building the Bailey Chair. The chair is critical in treatment of MG/ME. Everything below still applies, but should be done in the Bailey Chair. See the following link for building the Bailey Chair:

Building a Bailey Chair

If your dog has megaesphogus as a secondary MG indication, then feeding is absolutely critical. Weight loss is a big concern for these dogs, but so is aspirating pneumonia. Therefore each feeding must be planned and executed properly. Here are the steps to a successful feeding:

• Only wet dog food can be used. I recommend that you use a lite dog food as well. That food is much easier to digest and spends the least amount of time in your dogs stomach. This is important, because when your dog regurgitates, you want as little food in there as possible. Usually the regurgitation will be a clear, thick liquid mixed with some dog food. That is good. The more dog food in the regurgitation, the more opportunity for aspirating pneumonia. We use the Royal Canin Digestive Lowfat LF.
  

• Roll the wet dog food into little meatballs.

•  Feed the dog by hand in an elevated position. This is most important. Gravity will take the place of the faulty esophagus. The more elevated, the quicker the food will make it to your dogs stomach. Because the food is in round meatballs, it should be able to get through the esophagus. The meatballs should be as smooth as possible. Any little pieces that fall off the meatball will probably get stuck in the esophagus and could be aspirated into the lungs when the MG rears its ugly head.

• When done feeding, the dog must be elevated and "burped". The burping should take place for at least 5 minutes. Imagine a ketchup bottle. When you want the ketchup out, you slap the side and shake the bottle. When you want the food down, you can do the same thing to your dog. This can also be effective for knocking any loose particles down the esophagus. After about 5 minutes of burping, have your dog rest in an elevated position for at least 10 minutes. We just have our dog lay elevated against the arm of the couch while we watch TV or something.
  

In all the process of feeding your dog will take about 20 minutes. This process should be repeated 3 times daily. Ask your Vet how much food your dog needs, then give your dog 3 equal feedings.

Vomiting and Reguritation

Dogs with Megaesophagus have an involuntary reaction of regurgitation. This is NOT the same as vomiting. Regurgitation takes the dog by surprise and causes the dog to aspirate matter into his/her lungs. Dogs know they are going to vomit and often find a place of their choosing to vomit.

With Sammie she has 2 types of regurgitation. The first and most common is the voluntary type. Dr. Crumley has speculated that she has some use of her esophagus. Therefore when food gets trapped in the esophagus, she forces it out by regurgitation. This is accompanied by a weird sound that I have likened to a Seal barking. On average this happens once every 24 hours.

The second type is totally involuntary and seems to accompany almost any activity regardless of how docile that activity may be. I know it because she will just be walking along and the foamy stuff just comes out of her mouth, taking both of us by surprise. This is the risky type of regurgitation. Dr. Crumley has speculated that it startles the dog and they breath in similar to when a human is startled ... think about it, makes sense.

Vomiting is due to an upset stomach and most dogs do this regularly too. It has nothing to do with MG and is probably related to the dog eating junk ... hey they're dogs!

Weight Loss Concerns

If your dog has Megaesophagus, he/she will almost certainly lose weight. It will be difficult to put that weight back on as well. Our Scottie went from 22 to 18 pounds. That does not sound like much, but that is nearly 20% of her body weight. The temptation may be to feed her food higher in fat content. However that can be a risk as that food is more difficult to digest and stays in the stomach much longer. Remember that when your dog regurgitates, some food is coming from the stomach. That food will put your dog at risk for pneumonia if it is aspirated into the lungs.

Sammie, because she is so thin, has trouble staying warm. We bought her a couple of sweaters, which she now wears at all times. Because she has no fat on her body, it makes it very difficult for her to retain heat. She was constantly shivering, which is her body trying to produce heat. The sweaters have been a great help and have eliminated the shivering.

If your dog does not have Megaesophagus, then the opposite is true. Because dogs cannot exercise much with MG, your dog will probably be at risk for weight gain. Use a much lighter dog food to control that. Trust me, this is the better condition.