Megaesophagus (mega = large; esophagus = food pipe) describes a pathological enlargement of the esophagus. In the case of megaesophagus, the esophagus is not contracted by the muscles as usual, but is abnormally dilated and filled with air as a result of muscle paralysis.
In terms of causes, a distinction is made between congenital and acquired forms. Genetically determined megaesophagus is caused by mechanical constriction or a muscular disorder that affects the patency of the esophagus. The lack of muscle tone or the pressure of food stuck in the esophagus wall then leads to abnormal dilation after a certain period of time.
A special case is congenital mechanical narrowing of the esophagus due to a malformed aorta (persistent right aortic arch), which is particularly common in Boston Terriers, German Shepherds, and Irish Setters. As soon as the young puppies start eating solid food, it cannot pass through the narrowing and mechanical dilation occurs due to food blockage.
Diseases that can lead to dilation of the esophagus include:
Depending on the severity of the paralysis, swallowing disorders of varying degrees occur. These range from mild swallowing problems to a complete inability to eat. The paralysis often develops gradually and initial symptoms such as mild coughing or gagging are often mistakenly interpreted by the owner as respiratory problems. As the paralysis progresses, food can no longer be swallowed properly, returns to the mouth, and is spat out. This passive process is called regurgitation, as it does not involve the typical abdominal muscle movements associated with vomiting. This can occur during feeding, but also at a later stage.
In cases of chronic megaesophagus, emaciation, weight loss, and inflammation of the esophagus may occur. Further complications of the disease often include pneumonia, which develops when regurgitated food enters the windpipe and is inhaled. This is referred to as aspiration pneumonia. The animals show signs of fever and are lethargic.
If underlying diseases are present, their symptoms are often more prominent and megaesophagus may remain undetected at first.
The attending veterinarian will usually be able to make an initial diagnosis based on your detailed preliminary report and a thorough clinical examination. This diagnosis can be confirmed with the help of chest X-rays, which may require the administration of a contrast agent beforehand, depending on the case.
Due to similar symptoms, esophageal diverticulum must be distinguished from megaesophagus. This is only a localized and not a complete bulging of the esophagus. Both conditions can be clearly distinguished from each other on the X-ray. Esophageal diverticulum is rarely congenital (terrier breeds). They are often caused by food impaction or a foreign body that has been trapped for a long time.
In cases of malformed aorta, the mechanical constriction of the esophagus can be completely eliminated with the help of timely surgical intervention. However, if the operation is performed too late, the dilation may remain despite the narrowing being resolved.
If there is an underlying disease that triggers megaesophagus, the prognosis is good if the underlying disease can be successfully treated.
Congenital forms occasionally heal on their own in puppies if food is prevented from remaining in the esophagus and complications are avoided. Surgical or drug treatments are not possible in this case. With the help of certain feeding techniques (raised feeding, changed food consistency, several small portions), you can make it easier for your dog to eat and pass food. However, this only prolongs the life of most dogs with congenital megaesophagus that does not regress spontaneously to a limited extent, and acute pneumonia due to aspiration or pulmonary fibrosis (scarring due to the formation of connective tissue between the alveoli) often leads to the death of the animal.
Endoscopy is an imaging, minimally invasive procedure in which body cavities and hollow organs can be viewed and examined using an endoscope. Endoscopes are either rigid or flexible and have a light source and a camera at the front that transmits the image directly to a screen.
Imaging diagnostics refers to all diagnostic procedures that use diagnostic devices to generate two- or even three-dimensional images of the inside of the body. These images can be used to detect disease-related changes, among other things.
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