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Author: Admin | 2025-04-28
Has a more favorable prognosis if underlying disease can be promptly identified and successfully managed.4 Refractory cases result from chronic esophageal distention, myenteric nerve degeneration, and muscle atrophy.In GeneralRELATIVE COST OF TREATMENTDepends on severity of clinical signs and recurrences of aspiration pneumonia. Many pet owners spend $500 to $1000/year managing the dog with megaesophagus.FUTURE CONSIDERATIONSCurrent clinical research is focused on identifying genetic predispositions and or mutations (congenital form) and the underlying cause of the disease (acquired form). The mechanism of acquired idiopathic megaesophagus appears to be a disorder of the afferent innervation of the esophagus, but the exact cause has not yet been determined. New therapies are needed, as most prokinetic drugs are ineffective in the treatment of this disease.TX at a Glance• Treat any underlying causeMyasthenia gravis:pyridostigmine, 1.0-3.0 mg/kg PO Q 12 HORprednisone, 1.0-2.0 mg/kg PO or SC Q 12 HORazathioprine, 2 mg/kg PO Q 24 H initially; then 0.5-1.0 mg/kg PO Q 48 Hmycophenolate mofetil ?Hypothyroidism:levothyroxine, 22 µg/kg PO Q 12 HPolymyositis:prednisone, 1.0-2.0 mg/kg PO Q 12 H• SucralfatePO: 1 g Q 8 H for large dogs0.5 g Q 8 H for smaller dogs0.25-0.5 g Q 8 H-12 H for cats• Prokinetic therapy?bethanechol• Antiemetic/gastric antisecretory agents?• High-calorie diet in small, frequent feedings from elevated position.Test consistencies from liquid to solid for tolerance.• Temporary or permanent gastrostomy tube feeding in recalcitrant cases• Animal maintained in standing position for 15-30 min after feeding• Antibiotics (for aspiration pneumonia)CANINE MEGAESOPHAGUS • Robert J. WashabauReferences1. Risk factors associated with the development of canine acquired megaesophagus. Gaynor A, Shofer F, Washabau RJ. JAVMA 211:1406-1412, 1997. Acquired myasthenia gravis: Selective involvement of esophageal, pharyngeal, and facial muscles. Shelton GD, Willard MD, Cardinet GH, Lindstrom J. J Vet Intern Med 4:281-284, 1990.3. Risk factors for acquired myasthenia gravis in dogs. Shelton GD, Schule A, Kass PH. JAVMA 211:1428-1431, 1997. Diseases of the esophagus. Washabau RJ. In Ettinger SJ, Feldman EC (eds): Textbook of Veterinary Internal Medicine, 5th ed. Philadelphia: WB Saunders Co, 2000, pp 1142-1153.5. Megaesophagus in two cats. Hoenig M, Mahaffey MG, Parnell PG, Styles MF. JAVMA 196:763-765, 1990.6. Pyloric and oesophageal dysfunction in the
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