16 January

Gus’s ME Journal, 1/16/18 Digging, Digging, Finding Surprising Things

by Jon Katz

Ever since Gus was diagnosed with megaesophagus a month ago, I’ve been research the illness, and also studying research on the many different kinds of intestinal disorders dogs can acquire and suffer from.

Some things about the megaesophagus diagnosis have always intrigued me. One is that Gus showed no signs of this disease until recently. In the first eight months of his life, he did what most Boston Terriers do once in a while, he spit up a bit every now and then.

On the medical sites, Boston Terriers are not listed as likely or common carriers of megaesophagus, in fact they don’t show up on any of of the lists of dogs who commonly suffer from the disease (most are also quite larger.) In addition, Gus only regurgitated his food in the mornings, almost never in the afternoon or evening.

Megaesophagus dogs can regurgitate their food any time, day or night.

Beyond that, none of the dogs in Gus’s breeding program have ever shown any signs of the disease, the mother, the father, the siblings. Gus’s bowel movements have always been normal, and he has never shown any sign of malnutrition, a consistent danger from megaesophagus.

I have the stirrings of an alternative idea about Gus, ever mindful that I am not a trained veterinary specialist. i was a reporter, and a good one. I am grateful for that time, i know how to look for and gather information, and I have leaned to trust my instincts.

I am grateful for my time as a reporter, i love gathering information, rotting it out and analyzing. I hope it helps Gus. I think I might be onto something here.  I’m eager to share my findings with our vet, Dr. Fariello. She encourages my research. We’re meeting on Thursday.

Here’s what I am finding.

We have seen the barium X-rays, and it is see that his esophagus is enlarged, but the studies caution that many dogs are believed to have megaesophagus but it sometimes  does not cause problems for the dog, the body works around it, and is never diagnosed.

As I have been  exploring the disease, I have come across numerous studies gastrointestinal (GI) and digestive disorders and I am finding a number of precise symptoms and characteristics that mesh with Gus’s problems.

There are many different types of digestive disorders, they range from eating something other than dog food, to food allergies, infections, or lack of digestive enzymes. German Shepherds and collies are especially prone to particular digestive problems.

I found several gastrointestinal disorders whose symptoms including morning regurgitation (not vomiting) of thick, foamy yellow liquid. That is precisely what was happening to Gus. Since we expanded the doses of his motility medication Metoclopramide, prescribed for gastrointestinal problems, Gus has not spit up or regurgitated anything, he regained his normal weight and is as active as ever.

Metoclopramide, according to various veterinary school and research websites,  is given to help with the quick passage of food through the upper digestive tract. It is used to treat disorders of the upper gasto-intestinal tract such as acid reflux disease.

Metoclopramide is also often used as an anti-vomiting drug.

In otherwise healthy pets that have a chronic vomiting problem due to delayed gastric emptying, Metoclopramide helps reduce the delay by speeding up the passage of food. Chronic vomiting of this type is typically characterized by a small amount of yellowish bile vomit, usually in the mornings.

This research caught my eye. Since we increased the dose of Metoclopramide we are giving Gus a few days, the regurgitation, chronic vomiting of a small amount of yellowish bile vomit – the bile smell is unmistakeable –  has stopped.

Two or three times, and to experiment, we didn’t hold Gus upright in our laps, and he had no gulping or regurgitation or vomiting at all. Gus is an otherwise healthy dog, which many megaesophagus dogs are not, the disease has a number of recognizable side effects.

VetMD lists the following symptoms of megaesophagus:  vomiting, cough, nasal discharge, increased respiratory noises, weight loss, extreme hunger or loss of appetite, excessive drooling, bad breath, stunted growth.

Gus has rarely vomited (mostly regurgitated), has had no nasal discharge, makes the typical flat- nosed small dog breathing noises, has had only one period of weight loss (after he was switched to low-calorie, gastroenteric food), the weight loss was quickly restored, is typically hungry, has had no loss of appetite, bad breath or stunted growth.

Gus has no other symptoms, and I keep going back to the fact that this condition erupted suddenly.

I also see in the research that many working dogs and farm dogs and pasture dogs are especially prone to gastrointestinal diseases because they eat the feces and droppings of farm animals – chickens, sheep and donkeys, even the larvae of flies.

In addition, the disease occurs much more frequently in large dogs than small ones. Dogs with the disease are usually divided into two groups: Those with congentital megaesophagus, which typically shows up in the first weeks and months of life. Congenital megaesophagus is usually the result of incomplete development of the nervous system or due to a physical obstruction of the esophagus caused by a remnant of the fetal vessel, also called persistent right aortic arch.

Acquired megaesophagus is most often the result of specific nervous system diseases, like Addison’s disease. Obstructions to the esophagus can also cause an enlarged, stretched esophagus. But most cases of megaesophagus have no known cause.

With megaesophagus, it isn’t only that food doesn’t end up serving its primary purpose – nutrition – but even more dangerous, the feed moving in the wrong direction can enter the trachea and the lungs as it does so. As a result, aspiration pneumonia is the most common cause of death from this disease. It is not always easy for people to spot, thus treat.

The greatest difficulty in diagnosing meaesophagus is not identifying the disease itself, but determining the underlying cause.

It took awhile to find it, but medical veterinary researchers have listed the dogs predisposed to this disease:

For the congenital form of the disease: Great Dane, Irish Setter, Newfoundland, German Shepherd Dog, Chinese Shar Pei, Labrador Retriever.

For acquired megaesophagus, the following breeds are predisposed to the disease: German Shepherds, Golden Retrievers, Irish Setters.

Almost all of these breeds are large dogs, and Boston Terriers are not on any of the predisposition lists.

Gus was constantly picking up small pasture waste – especially  sheep pellets –  and eating it. We wanted him to be a farm dog, but it might have been unwise, and caused  some digestive issues. I should say we know a bunch of farmers who have BT’s and have had no health problems. But none of them have sheep.

All of the small breeds have sensitive digestive systems, primarily because they are small systems.

Many of the farm animals, especially sheep,  carry parasites and infections that do not affect them but do affect more  animals like dogs and cats. Barn cats frequently die from gastrointestinal diseases.

I’m going to explore this new theory further and bring my findings to Dr. Fariello. I trust her completely and it is unlikely my diagnosis is as sharp or accurate as hers. But she encourages this kind of independent research and is very open to other ideas, especially from pet owners who have the opportunity to monitor their dogs closely.

I work at home all day, and can record Gus’s progress, mishaps, diet, behavior and appearance.

But I am increasingly drawn to consider the idea that other gastrointestinal factors may be at work here.

Right now, it’s a growing hunch: Gus certainly has an enlarged esophagus – I saw it  on the X –  but it wasn’t causing him any troubles before. And it was considerably smaller than the other X-rays I saw online, perhaps because the other dogs were much bigger.

It’s possible that it just recently became enlarged, but Gus is almost a year old, and it isn’t typical, I am told,  for a dog that age to acquire the disease. I need to be careful about drawing sweeping conclusions at this point – little is really known about this disease. Gus could be spitting up his food tomorrow, or any day thereafter.

If so, I will say so.

But I am also looking back at the calendar. And since we have kept Gus out of the pasture in the morning, the number of incidents have steadily decreased in frequently and stability.

With the additional doses of Metoclopramide, prescribed to stimulate the muscles in the digestive tract, the problem has stopped completely over the last few days.

We’ll have to see if it recurs, and in what way, and how often. Dr. Fariello told me right off the bat that Gus was the first megaesophagus dog she has ever seen, and so we are researching the disease together. It is a challenge for me, this is new terrain. But then again, I like challenges.

I normally don’t do my own investigating on the Internet, veterinarians are so much more qualified than I am to diagnose animals. But megaesophagus is different. Little is really known about how it begins and how it might end.

i feel a particular responsibility to make sure I know as much as I can, and this has already paid some dividends I think. I will continue this work and see what happens.


  1. You don’t mention the possibility of wormers and other drugs given to the farm animals, especially the sheep that are consumed when the dogs eat the manure. I would also explore homemade dog food. It’s actually quite easy to do with tremendous benefits. It is certainly in sync with your own dietary beliefs. Commercial dog foods are very suspect these days. Good luck on your journey to find a good solution for Gus.

    1. We worm the animals every year, Colleen, that does not make them free of parasites and infections. They can’t be made to live in a bubble on the farm. I won’t be doing homemade dog food.

  2. I wondered about the megaesophagus diagnosis, given that he’s not of a breed disposed to it, his family members don’t have it, he was fine until sudden onset, and he was going out in farm pastures. I know you aren’t second-guessing your good vet, but you know your dog and his daily life better than anyone, as your vet would agree. Keeping a diary of episodes, changes in medication, food is critical to his recovery. I’m encouraged, as I know you must be.

  3. I wonder if you’ve researched hiatus hernia in dogs Jon, I have one and have to take the UK equivalent of Motoclopramide, it’s called Losec, and it keeps me from having acid reflux when I lie down at night. I’ve just googled ‘can dogs have it’ and apparently they can. Gus’ symptoms seem very much like mine were – although I am not a dog!! – wouldn’t it be wonderful if Gus’ problem could be solved by just medication. I’m keeping my fingers crossed for him.

  4. I love researching in this way. Whenever I’ve faced a new disease or condition in one of the animals I have read, read, read as much as I could about the disorder. There are many good sites; some veterinarian sites as well. Usually I would distill what I learned into an article that was easy to read. The articles I wrote were published in our national breed club magazine. Every once in a great while I even found information that changed how certain disorders were viewed by the experts. The internet is a cornucopia of information, a tool like a library, but convenient and open to everyone.

  5. Every dog, like every person, is an individual and what is true for one may or may not be true for another. Your research and especially your careful observations of Gus may very well lead to a different diagnosis and treatment for Gus. Like Holly, I find the research that you are doing fascinating. Good luck with it. Gus is lucky to have an owner who is so inquisitive and wants to know all there is to know about what’s going on with him. It’s like a good detective story. I can’t wait for the next chapter! Maybe this will lead to another book.

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