There are a number of canine health topics posted on this page. Click on the following links to go directly there.Please be aware the EPILEPSY is now creeping into our breed.Article will be put on as soon as possible

Veterinary Acupuncture         Allergic Skin Diseases     Adult Respiratory Distress Syndrome (ARDS)

Hearing (BAER )test   Hip Dysplasia             Hydro Therapy             Megaesophagus

They are only for information and I would strongly advise that you get in touch with your Veterinarian and ask for his / her opinion.

It is however important that you also discuss issues like alternative medicine, as more and more Vets today are prepared to go that way. The pet insurance companies are also more willing to accept that pets can be treated with alternative treatments and medications. You might find it surprising but treatments such as acupuncture, physiotherapy, hydrotherapy and chiropractors are now widely used on pets as well as humans.

Having had dogs treated with acupuncture for acute arthritis and a dog with back and neck injury healed with the help of a chiropractor, I am more that willing to take my very loved pets to these experts instead of having them pumped full of steroids, anti-inflammatories and pain killers.

The following article has been written by Tim Ingram, the vet who treated Duke, and is reproduced here with his kind permission. Tim is specialising in acupuncture for animals, and Duke was one of his earliest patients with the technique.

Veterinary Acupuncture

Introduction

Acupuncture originates from Traditional Chinese Medicine (TCM) and has been used to treat disease in humans and animals for over 2000 years. One of the fundamental concepts in TCM is Qi (pronounced “chi”). Qi is the energy that maintains all of the processes of life and is categorised according to its location within the body and the function it performs. According to TCM, Qi flows and circulates around the body in pathways called meridians. When this flow is disrupted in any way there is disease. Acupuncture alters the flow of Qi through the meridians and therefore can correct imbalances, restoring health.Over the last few decades Western science and medicine has sought to ascertain the possible mechanisms of acupuncture. Changes in blood flow, hormone levels and nerve impulses have all been documented. There has been particular interest in the knowledge that acupuncture can produce a rise in the level of endorphins (the body’s own morphine-like analgesics). This effect is proven and undoubtedly at least partly explains the pain-relieving effect of acupuncture. Another area of research has been the centred on the theory that acupuncture may stimulate nerve pathways that inhibit the sensation of pain.

The acupuncture session explained

Basically acupuncture involves the stimulation of points known as acupoints with a very fine metal needle. These points vary in size from around 1-25mm and are located at various depths under the skin.

Before placing the needles the acupuncturist will obtain a detailed history of the animals symptoms. A thorough clinical examination will then be performed to obtain a diagnosis (if this is not already known) and to identify special acupoints called trigger or Ahshi points. These are tender or painful areas and tend to be needled first. Then, a collection of points will be used depending on the problem. The needles are usually left in for between 10-20 minutes. In some cases the acupoints may be stimulated; by mild electrical current, by gently heating the needles with smouldering herbs or by injecting certain liquids into the area.

What types of problems can be treated?

Acupuncture can be used to alleviate many problems including arthritis, spondylitis, incontinence, inappetance, lethargy etc. The most common use tends to be the alleviation of chronic pain such as arthritis in the hip joint. It may be used as a sole treatment and in conjunction with conventional therapies such as anti-inflammatory drugs.

How many treatments are needed?

This varies from case to case but generally acupuncturists would begin with at least 1 session per week for around 4 weeks. At this point the patient would be reassessed and according changes made to the frequency of therapy. For alleviation of chronic conditions such as arthritis, treatment may be ongoing but may be reduced to one session every few weeks or even months.

How successful is it?

This can vary greatly according to practitioner and patient. Each case is different, but broadly speaking the proportion of patients showing a good improvement in symptoms is often quoted at around 60%+. For around 10% of patients there appears to be no improvement.

How can I find a practitioner?

If your local vet does not know of the nearest practitioner, the link below contains a list of recognised acupuncturists in the UK

www.komvet.at/ivadkom/_ukni.htm#pract

T J Ingham BSc(Hons) BVSc MRCVS                          For more information try this link:

         "ALLERGIC SKIN DISEASES"         by Lowell Ackerman, DVM

  AKC Gazette: Sept. 1990, pp. 94-101

Carol Weiss has kindly given permission to reproduce this article on our web site. Comments in italics are the Carol Weiss’ and not Dr. Ackerman's.

(All Dalmatian breeders and owners should memorize this article! It is perhaps the most thorough and definitive one on the subject I've read in recent years, and is written in terms understandable to non-vet readers. It supports what I've personally suspected for some time, namely that many if not most of Dalmatians' skin problems start out with an allergic reaction.  If you can "break" the chain reaction early enough, I believe a lot of resulting complications of the allergic reaction can be aborted before they take hold, such as infections, loss of hair, and scar tissue.)

• Dr. Ackerman cites the two most common types of dog skin allergy excluding that due to fleas: 90 percent of them are called "allergic inhalant dermatitis" or AID (in humans, called "hay fever" or "atopy") and the remaining 10 percent due to food allergy.
• Airborne pollens are breathed in ("inhalant") by humans allergic to them and induce reactions within their breathing system such as the sneezing of hay fever.
• Dogs, he explains, breathe in the airborne allergens which do not cause sneezing as in humans but instead CREATE ITCHING.  The allergic symptoms include the dog scratching, chewing or biting generally at their feet but also at sites all over the body especially armpits, groin and flanks. Recurrent ear infections also are a very frequent result of AID, he says.
• (The "chain" reaction: if the allergy-induced itching is left untreated or not noticed, the uninterrupted scratching and biting ultimately breaks the protective surface of the skin.  Bacteria then invade those openings creating a "secondary" skin infection superimposed on top of the allergic reaction. The skin infection, in turn, aggravates the itching sensation so that an itch-scratch-infection-itch cycle occurs.)
• (Dals with AID will show symptoms at various times and for various durations.  If they are allergic only to one or two species of "hay fever plants" (certain trees, grasses, weeds), they will itch seasonally only when those plant species are blooming and pollinating.  If they are allergic to many species of trees and of grasses and of weeds whose pollinating cycles overlap, the itching can extend for months or even most of the year.)

Molds and house dust are other airborne allergens creating itching in dogs, Dr. Acker-man notes. High humidity seems to be an aggravating factor (allergic Dals do better in dehumidified air-conditioning...). In terms of heredity, he suggests AID will be passed on if both dam and sire have them, food allergy not.

AID can be accurately diagnosed, he states, by skin testing. The hair is shaved in an area, marked with a checkerboard stamp and then individual squares of the checkerboard injected with known allergenic substances.  Hives will appear almost immediately in reaction to those specific substances which confirms them as the offending allergens. The test is expensive but gives an accurate inventory of substances to remove from the dog's environment, if possible.Food allergy is more difficult to detect those individual foods being allergenic but he details the lengthy procedures. Skin symptoms of food allergy mimic those of AID but, additionally, food allergy can be manifested in the gastrointestinal, neurological and respiratory systems (symptoms such as vomiting, diarrhea, anal itch, passing of gas, sneezing, asthma-like symptoms, behavior changes and seizures).

• Dr. Ackerman details various treatments of both types of allergy and cautions against the longterm (and indiscriminate) use of steroids such as prednisone.
• (I have had success with antihistamines such as Chlor-Trimeton® or Benadryl® available now without a prescription, which I give the minute I notice my Dals starting to scratch or bite frequently and certainly more than is usual and normal. If they do not significantly stop scratching or biting within 48 to 72 hours of receiving the antihistamine, I assume it is not AID and stop the medication. If they visibly do stop significantly, I continue the pills for 10 days to 2 weeks, stop them and watch if the itching and biting recur. If they do, I then see my vet before continuing the medication indiscriminately. But this technique has definitely aborted the "chain" reaction by stopping the scratching and biting before the skin is broken and infection sets in. On the other hand, this must not be considered a guaranteed panacea nor a simple "quick-'n-dirty" solution to all itching and biting. When in doubt, check with your vet !)
• Incidentally, Dr. Ackerman notes that antihistamines are successful only in about one-third of dogs with AID.
• Reviewed by:              Carroll H. Weiss             Carroll.weiss@att.net

Adult  Respiratory Distress Syndrome (ARDS)

Dogs with ARDS are not reccomended to to be bred from according to ECDC untill after 5th generation
The author, Dr. Tyge Greibrokk,has kindly given me permission to reproduce this article for inclusion on my web site. Dr Tyge Greibrokk has been  a professor of analytical chemistry at the University of Oslo in Norway since 1986. He is the head of a major research group, international editor of a scientific journal, he has supervised more than 100 masters and Ph.D. students and he is the author/coauthor of about 200 scientific publications, including papers on methods for DNA-analysis and one paper on inherited deafness among Dalmatians.
Introduction
Adult Respiratory Distress Syndrom (ARDS) appeared as a symptom of a genetic defect (ref.1) among Dalmatians in Finland (and once in Denmark) in the years 1987-1997. In Finland 6 litters were affected, the last in 1997, with a total of 17 dogs thought to be suffering from the disease. All the 17 dogs died or were euthanized. Early on, indications for an inherited disease were found by dr. A.-K. Järvinen and coworkers in Finland and studies of the pedigrees of the affected litters soon pointed towards the bitch O´Soul Escada as the probable source of a genetic defect. The damage to her genes is thought to have been caused by a point mutation. Several of the descendants from Escada were extensively used in breeding and the results (concerning ARDS) appeared to be in accordance with an autosomal recessive mechanism of inheritance. Although there has been no test matings to ultimately prove this mechanism, the national breed clubs in Finland, Norway and Denmark and the health committee of the Danish Kennel Club have accepted the recessive inheritance hypothesis based on strong circumstantial evidence.

A study utilizing simple statistical metods for estimating the number of affected dogs that would be expected in Finland, starting with the first litter after Escada in 1977 (the O´Soul K-litter), ending with all the litters registered in 1997, including all the litters in between (in Finland) supported the hypothesis of a recessive inheritance (ref. 2).

Probability of inheriting the defect gene
A dog which has inherited the recessive defect gene is called a carrier. A carrier cannot become ill, unless both parents carried the bad gene. If a carrier is mated to a non-carrier, the probability for a puppy of inheriting the bad gene is 50% (1/2). Since we in most cases do not know who the actual carriers are, we can only talk about statistical probabilities for inheriting the defect gene. This means that in the next generation (the 2. generation after a known carrier) the statistical probability for being a carrier is 1/4, in the 3. generation 1/8, in the 4. generation 1/16, in the 5. generation 1/32, in the 6. generation 1/64, in the 7. generation 1/128 and so on. All this assumes that the other parent is outside the ARDS lines. Thus, from the 7. generation on, the probability of being a carrier is less than 1%.

A recessive gene in the population will by constant "dilution" (mating each new generation with non-carriers) soon become no health problem, as long as new carriers are not produced. As a matter of fact point mutations are quite common and a national population may contain many defective recessive genes, which are not known, appearing only by extensive in-breading. This is the reason why small populations are bound to give genetic problems and why it is important not to reduce the genetic variation more than absolutely necessary.

Probability of provoking the disease
Recessive inheritance means that the illness can only be caused by parents both carrying the disposition for the defect. In average, 25% of the puppies (1/4) after two carriers will become ill, 25% will be free of the gene, while 50% will inherit the gene without becoming ill. It is important to be aware of that this is the statistical average of large numbers. Thus, in a small litter it is very likely that no defects will be found. The way of calculating the statistical probabilities of provoking the disease, in mating two dogs which both have an ARDS background, is to multiply the two probabilities. If a 7th generation dog is mated with a 6th generation dog, the probability of provoking ARDS is 1/128 multiplied with 1/64, which is close to 0.01%. For all practical purposes this is outside the danger zone.

Recommendations to the breeders
In 1993 the discussion of means to stop the ARDS threat, spread from Finland to Norway and Denmark. The breed clubs made some preliminary recommendations, until further knowledge could be obtained. The author of this article, who by the way had no breeding on the ARDS lines, argued for taking rapid measures, in accordance with the expectations of recessive inheritance. The discussion soon centered on the potential losses by eliminating too many good dogs from breeding, versus the risk of spreading the bad genes. After extensive discussions with veterinarians that were familiar with inherited diseases, it became clear that the specialists would not give direct advice on exactly where to stop breeding, because they had little knowledge of other potential problems that could be provoked by limiting the population too much. Everybody agreed on, however, that parents, littermates and direct offspring of afflicted dogs should not be used in breeding. Further measures were left to the breed clubs to decide. The recommendations which finally were made, met no opposition when this author discussed the situation with geneticists at a conference of inherited canine diseases in UK in 1994. Later, when the situation had become less urgent concerning immediate measures, the recommendations (in Denmark and Norway) were strengthened in order to prevent new carriers from being imported.

Current rules/recommendations in breed clubs
So far the breed clubs in Finland, Norway and Denmark have rules/recommendations for their breeders on ARDS. The recommendations vary according to how difficult the situation was considered in each country. In Finland, carriers, littermates of carriers and the first generation of offspring are not allowed in breeding. In Denmark the same plus the second generation are not allowed. In Norway the same plus 3th and 4th generation are not allowed. In Finland the sum of ARDS-generations must not be below 10 when two dogs are mated. In Norway the sum is at least 13 and in Denmark it is at least 14. Thus, in Denmark it is allowed to cross two 7th generation dogs or i.e. one 3th generation dog with one 11th generation dog. In Denmark, imported dogs must not be closer than 7 generations after a carrier. According to the opinion of this author, more breed clubs could assist their breeders by making recommendations for breeding. Such recommendations should probably vary in different countries, according to the size of the potential problem. It is important that the information is balanced, not resulting in hysteria and war between breeders. Furthermore it should be made clear that it is up to the breeders how long the ARDS will continue to be with us as a potential problem. By continued breeding on dogs close to carriers, the ARDS threat will stay with us. By breeding away from the carriers, the problem can be solved in a few years, as demonstrated by the development in Norway. A country (breed club) without dogs on ARDS-lines, wishing to avoid the extra bureaucracy of keeping track of every generation, could follow the import restrictions of the Danish club.

Possibility of identifying a carrier
In theory it is possible to develop methods to identify the carriers by analyzing their DNA. However, the site of the bad gene on the DNA is not known, and blood samples from only a few afflicted dogs are available. Current methods cannot resolve the problem with this material, unless new research is directed towards developing more information. Unfortunately, such research is very expensive, probably too expensive for the limited resources of the breed clubs in Europe. The possibility of developing a DNA-test for checking the absence/presence of a carrier in the near future, is therefore not high. Consequently it would be wise to base new measures on the information which already is available today.

Getting information
That information is available from the European Cooperation of Dalmatian Clubs (ECDC). Dalmatian owners/breeders seeking the "ARDS-status" of their dog(s) may contact the author, with a copy of the pedigree(s). Some of the European Dalmatian clubs already have received the background knowledge and can also provide the same information on request.

References A.-K. Järvinen, E. Saario, E. Andresen, I. Happonen, S. Saari and M. Rajamäki, Lung injury leading to respiratory distress syndrome in young Dalmatian dogs, J. Vet. Int. Med. 9 (1995) 162-168. T. Greibrokk, Inheritance of the disposition for ARDS among Dalmatians, ECDC meeting, Kolding, Denmark, August 1999.

                                               HIP DYSPLASIA

Many Dalmatian breeders and owners disagree that this is a condition that appears in the Dalmatian.The truth is that it can and does appear.After this article there is some more basic information and also an explanation of the score system used here in UK

Hip Dysplasia is a common condition of large breed dogs and many dog owners have heard of it but the fact is that anyone owning a large breed dog or considering a large breed dog as a pet should be become very familiar with this condition. The larger the dog, the more likely the development of this problem becomes, particularly as the dog ages.

                                                                         What is “Hip Dysplasia”?

The term “dysplasia” means “abnormal growth” thus “hip dysplasia” means abnormal growth or development of the hips. Hip dysplasia occurs during the growing phase of a puppy, usually a large breed puppy, and essentially refers to a poor fit of “ball and socket” nature of the hip. The normal hip consists of femoral head (which is round like a ball and connects the femur to the pelvis) as well as the acetabulum (the socket of the pelvis), plus the fibrous joint capsule and lubricating fluid that make up the joint. The bones (femoral head and acetabulum) are coated with smooth cartilage so that motion is nearly frictionless and the bones glide smoothly across each other’s surface.

The femoral head (the ball in the ball and socket joint) The acetabulum (the socket in the ball and socket joint) The femoral head “ball” is designed to fit inside the acetabulum “socket.”

When a dog has hip dysplasia, the ball and socket do not fit smoothly. The socket is flattened and the ball is not held tightly in place thus allowing for some slipping. This makes for an unstable joint and the body’s attempts to stabilize the joint only end up yielding arthritis.

                                       A) Early stage hip dysplasia -   note space between femoral head and acetabulum

                                         B)  Normal hip - femoral head fits snugly inside acetabulum

                               If this condition  starts when the dog is still a puppy, why  don’t we see it till the dog is old ?

   There are two sets of patients typically affected by hip dysplasia. The first group is the adolescent dog, typically 6-18 months of age. This radiograph  shows the hips of such a patient. This dog has Hip Dysplasia but has not yet developed arthritis. Note the shallow hip sockets. This dog was brought to the vet’s office for signs of discomfort. Radiographs were taken and hip dysplasia was discovered . Many dogs with similar radiographs will not be in pain and thus will not end up at the vet for an evaluation. These dogs show up as elderly dogs, after they have been walking on their poorly formed hips for many years. After many years, bony build up along the margins of the socket, mineralization of the joint capsule, cartilage wear, and inflammatory change in the joint (i.e. degenerative arthritis) has become painful and now the dog comes to the vet for an evaluation

Obviously different individuals may have different degrees of dysplasia. A dog’s weight makes a difference (a lighter dog can tolerate a more abnormal hip joint). The muscle mass supporting the joint is greater in a younger dog and helps reduce the stress directly on the bones. Still, some dogs have truly shocking radiographs and virtually no symptoms while others show relative subtle changes and are very uncomfortable. It is not known why there is not a better correlation between radiographs and actual pain.

Do not expect a dog with dysplasia (or any other chronically painful condition for that matter) to cry or whine in pain. Instead discomfort is shown with reduced activity, difficulty rising or lying down or going up stairs. A characteristic swivel of the hips is seen from behind and classically stairs are taken in a “bunny hop” fashion

The primary cause of hip dysplasia is genetic but inheritance of this trait is not as simple as we might make out.Here in UK we tend not to Hip Score Dalmatians as it is not a “problem” in the breed.Though in Europe they hip score all breeding stock to make sure that there are “hopefully” no defects.

There are two reasons to pursue testing: to explain a dog’s discomfort/rear weakness or to screen a dog for breeding purposes. If a dog is not going to be bred and is not in any apparent discomfort, there may be no benefit to looking at the conformation of the bones in a radiograph except possibly to look back at a future time to get a sense for progression of bony changes.

The first step in diagnosis is an examination. Your veterinarian will likely extend the dog’s hind leg backward to check for pain. (Hip dysplasia causes pain on hip extension.) The dog may be asked to walk around to possibly demonstrate the hip swivel. Another test involves having the dog lie on its back with a hind leg perpendicular to the body. As the leg is moved away from perpendicular to the body, a dysplastic hip will generate a “pop” as the femoral head slips to the center of the acetabulum. This “pop,” which can be felt if one’s hand is resting on the hip during the exercise is called an “Ortolani sign.” You may hear this term used as hip dysplasia is discussed.

                                 DO NOT ATTEMPT TO TRY THIS OUT ON YOUR DOG.!!!

 If you wonder what can be done for your dog should this occure in your dog the answer is clear.Your dog can have a hip replacement just as in humans and they do work.Your Pet insurance will most likely cover the expences but ask first.

Getting hips scored to assess for hip dysplasia is now starting to be part of many breeders  breeding program. Here at CHANDHALLY we will now start to Hip Score the dogs we use. Many breeders do not Hip Score simply because there has never been an issue in Dalmatians. I have desided to go one step forward and atleast have my own stock scored.Though my older girls are now too old for this procedure and retired from breeding the younger generation that I may breed from will be tested. Some people will only test for HD- Hip Dysplacia - if it has been noticed in their breedline. In any case, have a look at the chart drawn up below which gives an approximation (ONLY!) of the rating charts used here in UK--As you can see by the chart, the hip score scheme  gives a detailed chart  on what the hips rate are on both hips.

Excellent Good Fair Borderline Mild Dysplasia Moderate Severe 0-4 (no>3hip) 5-10 (no>6/hip) 11-18 19-25 26-35 36-50 51-106

The current BVA/KC scoring scheme for hip dysplasia (HD) has been in operation since 1984 and since then over 100,000 X-rays have been assessed. Dysplasia means abnormal development, and the degree of hip dysplasia present is indicated by a score assigned to each hip. The hip score is the sum of the points awarded for each of nine aspects of the X-rays of both hip joints. The minimum hip score is 0 and the maximum is 106 (53 for each hip). The lower the score the less the degree of hip dysplasia present. An average (or mean) score is calculated for all breeds scored under the scheme and advice for breeders is to use only breeding stock with scores well below the breed mean score.it is well worth noting that for example a bitch with a high hip score should breed with a dog of very low score to  help improve the result of the offspring

         HYDRO THERAPHY

Sky’s story from her visit to the HYDRO TRERAPHY treatment after a serious IMPACT with a tree - that DID NOT move. Resulting in an emergency night visit to the VET as we thought she had broken her Hip or thigh bone.Many X-Rays later it showed a very bruised hip and stifle  “knee” .No excersise or playing in the garden for well over 3 months now- except for this.Fully covered by PET PLAN insurance..Thank goodness

    Canine hydrotherapy involves the therapy and treatment of dogs in a supportive warm water tank. Hydrotherapy enables vets to treat conditions such as displacia and arthritis without the need for a swimming pool, and is a proven and effective alternative to conventional animal physiotherapy. Hydrotherapy is the modern, safe, and friendly way to treat many animals including canines.

Canine HYDROPHYSIO / Hydrotherapy has been defined as the use of movement,with the dog or animal in a supportive water medium, to retrain muscles.

Canine Hydrotherapy usually involves a course of sessions tailored to suit the individual dog, and is often beneficial pre-surgery and post-surgery. HYDROPHYSIO is also used to provide a cardiovascular workout, and in the treatment of conditions such as obesity, stroke and arthritis.

Many dogs enjoy the relaxing warm water environment of a HYDROPHYSIO tank, and the hydrotherapy techniques are increasingly being used to improve fitness levels of healthy animals, and to improve muscle development.

There are many benefits of aquatic therapy including:
Improved muscle strength and endurance
Improved range of joint motion
Reduction of odema and swelling
Improved Cardiovascular function

Due to the effect of buoyancy, a dog will place relatively much less weight on it's joints when in water, thus allowing older animals and those recovering from surgery to exercise more comfortably, safely and efficiently in water.

It has long been established that hydrotherapy is beneficial in the recovery programme for certain injuries in the veterinary field. Until recently its use in animals was restricted to performance horses and racing greyhounds.

First round of 10 minute of swimming finished -Sky had to be helped out due to her injury

Then we walk around for a bit to help with the movements and  change of activity --Note harness and lead on Sky

Then back to the pool for another 10 minutes of swimming in the warm water..

Sky is now jolly fit and in super condition.She now runs up the “plank” and dives in and is swimming against the current for a solid 20 minutes. Just attatched to a wall mounted  lead and the harness. Some improvement, but it has taken 4 1/2 months to get here

The treatment of Sky will continue for as long as it takes , Perhaps a few more months ,but we already see an improvement.Amazingly this “so called”  very fit dog is totally tired out after our 20 minute work out.She is using different muscles and is therefore having to work harder but without having to put any weight on her injured Hip and Stifle.She absolutely loves coming here.Now she runs up the steps to get to the pool..and best of all..We can go for walks abain with the other two and have a short run in the forest.Wonderful...

                                                   MEGAESOPHAGUS

                                                     Vomiting or Regurgitation ?

Most people do not realize that there is a difference between these two actions. Vomiting is an active process. There is gagging, heaving, and retching as the body actively expels stomach contents. Regurgitation is passive. For whatever reason, food is swallowed from the mouth but never  goes anywhere beyond that point. Food sits in the esophagus until it simply falls back out of the mouth at some point. In the dog, megaesophagus is the most common cause of regurgitation.

                                                                             What is Megaesophagus?

The esophagus is the tube connecting the throat to the stomach. When food is perceived in the esophagus, neurologic reflex causing muscle contraction and relaxation lead to rapid transport of the food into the stomach, like an elevator going down. Other reflexes prevent breathing during this swallowing process to protect the lungs from aspiration.

When these reflexes are interrupted such as by disease in the esophageal tissue or nerve disease, the esophagus loses its ability to transport food. Instead the esophagus loses all tone and dilates. Also, the reflex protecting the lung is disrupted and aspiration pneumonia commonly follows.

                                               What Conditions Cause Megaesophagus?

Most cases involve young puppies (Great Danes, Irish setters, German Shepherds are genetically predisposed). In these cases the condition is believed congenital though it often does not show up until the pup begins to try solid food. Congenital megaesophagus is believed to occur due to incomplete nerve development in the esophagus. The good news is that nerve development may improve as the pet matures. Prognosis is thus better for congenital megaesophagus than it is for megaesophagus acquired during adulthood.

Another congenital problem is the “Vascular Ring Anomaly.” This is a band of tissue constricting the esophagus. Such tissue bands are remnants of fetal blood vessels which are supposed to disappear before birth. They do not always do so. Improvement is obtained when the band is surgically cut but in 60% of cases some residual regurgitation persists.

In adult dogs, diseases that cause nerve damage can lead to Megaesophagus. Myasthenia gravis would be a common cause and very important to rule in or out. Myasthenia gravis is a condition whereby the nerve/muscle junction is destroyed. Signals from the nervous system sent to coordinate esophageal muscle contractions simply cannot be received by the muscle. Megaesophagus is one of its classical signs though general skeletal muscle weakness is frequently associated. This condition is treatable but special testing is needed to confirm

Scarring in the esophagus (as would occur after a foreign body episode or with damage to the esophagus from protracted vomiting) may be sufficient to interrupt neurologic transmissions or even narrow the esophagus so that food cannot pass through it. (Such a narrowing is called a “stricture.”) Technically, this is not a true megaesophagus as the muscles are working normally; there is simply an obstruction present. Special balloons can be inserted in the esophagus to dilate the narrowed area but some residual regurgitation is likely to persist. Tumors of the esophagus may have similar effects in that they, too, can cause obstruction.

Hypothyroidism may be associated with megaesophagus. It is easy to rule thyroid disease in or out with blood testing and it is important to treat a thyroid hormone deficiency; however, megaesophagus usually does not correct with thyroid replacement therapy. Whether or not hypothyroidism can truly cause megaesophagus is still being debated.

Addison's disease (hypoadrenocorticism) has also been associated with megaesophagus though this would be a rare cause. This condition represents a deficiency of cortisone production by the adrenal gland. This deficiency alters the metabolism of esophageal muscle. Diagnosis and treatment are not difficult

                                             The Diagnoses

First, the megaesophagus must be diagnosed. This is done radiographically. If megaesophagus is not obvious on plain films, it is better not to use contrast (Barium) studies if possible. This is because megaesophagus patients have the tendency to inhale or "aspirate" food contents that back up in their throats. This is dangerous enough when the material is simply food but if barium is present and becomes inhaled, the body has great difficulty removing it from the lungs. Still, sometimes this is the only way to see the megaesophagus.

The next step is to determine whether or not the animal has "aspiration pneumonia" from inhaling regurgitated food material. Chest radiographs in combination with a history of cough, nasal discharge, and the presence of fever indicate pneumonia. Usually the chest radiographs will show disease in the areas of the chest which are lowest in the standing animal as this is where gravity draws inhaled material. The presence of aspiration pneumonia makes the case much more serious as pneumonia can be a life-threatening condition.

Endoscopy is an important diagnostic test for the megaesophagus patient and, if possible, should be done in all cases. In endoscopy a long skinny tube with a special camera on the end is passed down the esophagus to the stomach. Ulcers on the esophageal walls will be seen and any narrowings will be obvious. Biopsies can be taken if any suspicious lesions are present.

Blood testing to rule in or out treatable causes of megaesophagus should be performed.

                                                             Treatment

The first step is to determine if the dog does better with a liquid or solid diet. Every individual is different. One must train the dog to eat in an elevated position. Ideally, the pet should be kept in this position for 10-15 minutes after the meal. Feeding tubes can be placed directly in the stomach for more convenient feeding. If the “cardiac sphincter” which separates the stomach from the esophagus is weak, though, regurgitation may still occur. A medication called Metoclopramide (trade name: Reglan) may help increase the tone of this sphincter.

Medication for nausea may be helpful for patient comfort and strong antacids will help minimize acid related damage to the esophagus when food is regurgitated from the stomach.

There is a motility modifier called "Cisapride" which is helpful to many cases. Theoretically this should not be so as the type of muscle in the dog's esophagus is not of a type that should be affected by this medication. Nonetheless, many individuals experience fewer episodes of regurgitation while on cisapride. Given the difficulty in managing this condition, we recommend at least a one week trial for any megaesophagus patient. Cisapride also is able to increase cardiac sphincter tone. Cisapride is no longer commercially available in the U.S., but it can be made up by most “compounding pharmacies.” For a list of many compounding pharmacies,

Aspiration pneumonia is treated with fluids and antibiotics as is any other bacterial pneumonia, though these individuals may re-aspirate at any time and require treatment all over again. Hospitalization may be required.