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My Dog’s Experience With Myasthenia Gravis and Megaesophagus

People ask me why I devoted so much of my life to caring for my ailing German Shepherd. All I can say is that I got so much more in return than what I gave.

Dog With Myasthenia Gravis and Megaesophagus
Gypsy, a GSD, suffered from myasthenia gravis and megaesophagus. Photos: Melissa Smith/Petful

Having a German Shepherd Dog as your companion is a special experience, one that remains with you for a lifetime.

As I have experienced, the breed tends to be smart, energetic, courageous, protective and fiercely loyal. Your GSD will love you and protect you until your pet’s last breath.

That being said, as with any breed, GSDs are often predisposed to certain physical conditions that you should be aware of.

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What Is Myasthenia Gravis?

One common condition in the breed is myasthenia gravis.

It’s a rare autoimmune disease that happens when certain nerve receptors aren’t able to function properly. In plain English, it affects the nerves in your pet’s body.

In some animals, this can cause mild muscle weakness. In others it is much more severe, and your GSD can rapidly become almost immobile.

An accompanying condition is megaesophagus.

What Is Megaesophagus?

The esophagus is a muscular tube that connects the back of the throat to the stomach for the passage of food. The esophagus is designed to milk food down toward the direction of the stomach.

In megaesophagus, though, the tube develops a pouch in which food can sit and be delayed on the downward journey. If the dog puts their head down, then the food is likely to be regurgitated under the influence of gravity.

  • Dogs may be born with megaesophagus, in which case they show signs at a very young age.
  • Or the problem may be acquired later in life as a result of a physical blockage or because of certain diseases.

The condition is more common in breeds such as GSDs, Wire Fox Terriers, Miniature Schnauzers and Irish Setters.

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Symptoms of Megaesophagus

Signs directly related to megaesophagus include difficulty swallowing and food regurgitation.

The regurgitated food often comes back up in a sausage shape (matching the esophageal pouch), and because it has not been in contact with stomach acids, it is undigested. This also means that affected dogs may not benefit from any calorie intake and are often skinny or in poor body condition.

Another set of symptoms of megaesophagus in dogs relates to the knock-on effect of regurgitation: an increased risk of aspiration pneumonia.

Because food “falls” back into the mouth under gravity, if the dog breathes in at the wrong moment, they may inhale food into their windpipe and down into the lungs. This material irritates the lung tissue and is likely to set up pneumonia with symptoms of coughing, fever, lethargy and loss of appetite.

Dog With Myasthenia Gravis and Megaesophagus
Gypsy, left, and Gretchen were best friends.

When my GSD, Gypsy, was about 12.5 years old, she started throwing up occasionally. I didn’t think much of it. After all, what dog doesn’t yack up their meal now and then — and usually after you’ve just cleaned the carpets?

However, little did I know this was a sign of a serious condition.

At the time, my sister also had a GSD, Gretchen. Gretchen and Gypsy, although not littermates, were sisters at heart as my sister and I are sisters by blood.

They spent a lot of time together when I or my sister would dog-sit. They played and poked about and had great fun together.

Gretchen contracted a rare heart tumor that unfortunately remained hidden until it was too late.

Gypsy Collapses

Then, one August night, Gypsy collapsed and could barely breathe. When I rushed her to the emergency veterinarian’s office, her X-rays indicated severe pneumonia and potentially something more.

There was a long period of testing. We tried everything we could because the test for myasthenia gravis was quoted at $200. When all else failed, we tested Gypsy. It came back positive.

This is where I had to decide what the best course of action would be. I looked at Gypsy, and her spirit spoke to me. She wasn’t ready to give up.

So I resolved that it would be her decision when and if it was time to give up.

Adapting to the Condition

Unless there is a physical factor that can be surgically corrected, it is not possible to correct the physical abnormality of a dilated esophagus. If, however, the problem is caused by a medical condition, such as Addison’s disease, treating that problem usually helps.

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For Gypsy, this came down to a lifestyle change.

Because a dog with megaesophagus cannot properly swallow, you need to be more vigilant than ever before. Any small item that your dog can eat off the ground or from the trash becomes a potential killer because they can aspirate it into their lungs.

Your dog can’t ever be allowed to eat anything or even drink when you are not there to position them properly — which is in as upright a position as possible so that gravity can do the work that the esophagus can no longer do.

Gypsy got older, and the myasthenia crept on. She had more accidents and spent less time moving around. One day I saw a look in her eyes that broke my heart into a million pieces.

With Gypsy, this was compounded by the fact that as she grew older her hindquarters grew weaker, and she had severe arthritis in her hips. This made putting her all the way upright (think of a “beg” position) nearly impossible.

So our routine became putting her in a “sit” position while I would hold her bowl and let her eat from as elevated a place as possible.

Gypsy also needed several medications a day, and these also required the “sit” position. Your dog has to maintain this position as long as possible after eating or drinking. Twenty minutes is ideal. This allows the food and water to make it safely to the stomach.

Vigilant at All Times

As the summer turned to fall, and then winter set in as the next year began, our days became a routine.

I would get up with Gypsy between midnight and 2 a.m., then feed her, give her medication and take her outside.

Outside she had to be monitored, because dogs just love eating anything they come across. Especially poop — and let me tell you, you haven’t lived until you’ve seen regurgitated poop! That aside, feces can be especially dangerous because of the aspiration danger.

Before I left for work for the day, I would bring Gypsy outside again. She would usually be all right until about 2 p.m. when my son got home from school, and he would let her out and watch her.

Keep in mind that before you leave every day, your house has to be dog-proofed:

  • No trash available.
  • Toilet seat down.
  • Kitty litter out of range, (I keep the litter box in the bathroom, so I bought a 5-foot metal gate and installed it in the bathroom doorway.)
  • No other animal’s food or water left anywhere.
  • All food items off the floor.

You have to be vigilant at all times. One episode of kitty litter consumption or a stray cracker can mean a dangerous bout of aspiration pneumonia.

You need to set aside blocks of time to devote to your GSD. During feeding time and outside time you cannot be distracted, on the phone, making dinner, etc.

So our days went on, and Gypsy fought with all she had. She got weaker and had a hard time walking for more than a few minutes, but still her eyes were bright, and boy did she want the rabbits that played on the front lawn!

She was mischievous and stubborn. She hated the medication part of the day so much that she actually figured out how to hold a pill under her tongue and then spit it out when I wasn’t looking.

She got older, and the myasthenia crept on affecting all functions, especially in the latter part of her body. She had more accidents and spent less time moving around. One day when I looked at her, I saw her look back at me with a very peaceful look in her eyes.

My heart broke into a million pieces. I knew she was telling me it was time, and she was ready. I honored her request.

Gypsy left this earth on October 1.

During her care, people would ask me if I was crazy. I used to get up so early every day, spend my life around Gypsy and what she needed. Her medication, her accidents, her penchant for kitty litter (and subsequent regurgitation, ick!) and her medical bills, which mounted into the thousands despite the help given by our vet.

All I can say is that I got so much more in return than what I gave in taking care of her.

Gypsy was my best friend. She was there to love me for years of my life, she protected me, she listened to me rant on and on about my days (even if she had no clue what I was talking about). She made me laugh and taught me the value of caring.

Here she is:

The Seriousness of the Disorder

Should your German Shepherd be diagnosed with myasthenia gravis, you need to understand the true magnitude of what you’re facing.

Your GSD needs you now more than ever in order to live a full and happy life. Discuss with your vet all of the options and plan a realistic portrait of what your life will become.

It means a special diet:

  • Your dog will no longer be able to eat solid dog food, and feeding time will not consist of dumping a scoop of your typical brand into the dog dish.
  • Feeding time will require your full attention and 45 minutes to 1 hour.
  • Usually there is a specific dog food your vet will tell you to use, and this dog food should be blended to a certain consistency. It varies depending on the severity of your GSD’s megaesophagus, but you will need a blender for certain. This dog food can be very expensive.
Should your dog be diagnosed with myasthenia gravis, you need to understand the true magnitude of what you’re facing.

Outdoor time must be monitored closely:

  • No more attaching the lead and letting the dog just bop around in the back yard while you make dinner.
  • You need to be outside and observing at all times.
  • Even when walking your GSD, you must be vigilant to ensure nothing is eaten or licked off the ground.

Before you leave for the day or even take a shower, you need to keep all trash out of bounds. Please don’t say, “Well, he’s never gone in the trash, so I don’t have to worry.” You do have to worry, because all it takes is once.

Make sure there is nothing on the floor your dog will happily consume, and make sure all other pet food and water supplies are out reach. Your dog will depend on you to ensure they get enough fluid in their diet. Again, you need to place the dog in an upright position for feeding or drinking water.

Dog With Myasthenia Gravis and Megaesophagus
Gypsy loved the snow.

Your GSD will require medication. Ensure that the medication actually makes it into the stomach. A good trick is blending it in with food. No, you shouldn’t use those handy treat-like items to disguise a pill — your GSD won’t be able to swallow it.

If your dog is anything like Gypsy, check the mouth! As I mentioned earlier, she learned how to hide a pill under her tongue and spit it out when I wasn’t looking.

Realize that treats are a thing of the past. Talk with your vet about what you might add to the food instead. You have to pulverize it in the blender anyway, so you can pretty much throw anything in there that the vet says is OK.

Additional Concerns

Your GSD may suffer from other conditions that aggravate the myasthenia gravis and megaesophagus.

In Gypsy’s case, it was severe arthritis — which contributed to a lack of bowel control. She had accidents more toward the end. Please remember, this is not your GSD’s fault. They cannot help it, and they are not doing it to spite you.

No one feels more upset about having an accident than your dog. They know it’s shameful. Treat them with compassion, and make an effort to be home more to give them more opportunities to make it outside.

Above all, know your dog. Be open to what they need and want. Gypsy wasn’t ready to go until it was her time, and I will always be grateful that I respected that. The hard part wasn’t keeping her with me — it was letting her go when she said it was time.

It’s a challenge, but when you give your heart, everything that you give you will get back a thousand-fold in love.

References


vet-cross60pThis article on caring for a dog with myasthenia gravis and megaesophagus features some health-related contributions from a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. This article was last reviewed May 30, 2020.

If you have questions or concerns, call your vet, who is best equipped to ensure the health and well-being of your pet. This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. See additional information.
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