Megaesophagus (ME) has a high mortality rate associated with the difficulty of managing patients' feeding. Currently there are no evidence-based guidelines available for determining the best diet consistency in dogs with ME.
The aim of this study was to compare esophageal clearance times (ECT) of food with different consistencies in dogs with congenital idiopathic ME, and to assess if esophageal contrast videofluoroscopy can be used to guide management of dogs to improve clinical signs and quality of life.
Twenty-one dogs with congenital idiopathic ME were included. For evaluation, each dog was placed in a Bailey chair and administered barium sulfate orally in three forms: liquid, slurry and within canned food meatballs. The amount of barium and food was determined by bodyweight and resting energy requirement. Contrast videofluoroscopy of the esophagus was obtained at baseline and every 5 minutes for up to 30 minutes or stopped sooner if esophageal content had cleared. Each patient received specific recommendations for management based on ECT of the different diet consistencies, frequency of regurgitation, presence of esophageal reflux, decreased gastric motility, and body condition score. The follow up communication was performed to assess compliance and response to management changes.
No clearance was observed in 29% of dogs fed liquid, in 43% of dogs fed slurry and 67% of dogs fed meatballs. There was a significant difference (p < 0.001) between groups with the ECT of liquid being faster compared to both meatballs and slurry. There was no significant difference in ECT between slurry and meatballs, but the median percentage of esophageal clearance was 50% (interquartile range 0-79%) for slurry and 0% (interquartile range 0-60%) for meatballs.
The median number of regurgitations per week (RPW) decreased significantly from 5.5 (interquartile range 1.5-13) at the time of the first assessment to 2.5 (interquartile range 0.75-4) at the time of follow up (P = 0.0004) In addition, 16/21 (76%) of clients perceived their dogs quality of life to be much better, 4/21 (19%) to be somewhat better and 1/21 (5%) saw no change in quality of life at the time of recheck
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