Caring for a Dog 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.

Gypsy suffered from myasthenia gravis and megaesophagus.
Gypsy suffered from myasthenia gravis and megaesophagus.

Having a German Shepherd 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 German Shepherd Dog (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 pet caretakers should be aware of.

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. This one is just what it sounds like — your GSD’s esophagus can become enlarged and the muscles do not function properly. This causes food to get trapped and possibly aspirated into the lungs, which in turn brings on a potentially life-threatening case of aspiration pneumonia.

When my GSD, Gypsy, was about 12 ½ 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.

Gypsy, left, and Gretchen were best buds.
Gypsy, left, and Gretchen were best buds.

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. She died on August 29, 2011. That 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

This was a lifestyle change.

Because a dog with megaesophagus cannot properly swallow, the pet parent must 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 your pet can aspirate it into the lungs.

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

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 GSD must maintain this position as long as possible after eating or drinking; 20 minutes is ideal. This allows the food and water to make it safely to the stomach.

Vigilant at All Times

Our days became a routine. I would get up with Gypsy between midnight and 2am, 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 2pm 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 must 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, 2012.

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 veterinarian.

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

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 GSD 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 one 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.

Outdoor time must be monitored closely. There is no more attaching the lead and letting the dog bop around in the back yard while you make dinner. You must 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 must 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.

You must make sure there is nothing on the floor your GSD will happily consume. You must make sure all other pet food and water supplies are out reach. Your GSD will depend on you to ensure he gets enough fluid in his diet. Again, you must place the dog in an upright position for feeding or drinking water.

Gypsy loved the snow.
Gypsy loved the snow.

Your GSD will require medication. You must ensure that the medication actually makes it into the stomach. A good trick is blending it in with food. No, you may not use those handy treat-like items to disguise a pill; your GSD will not be able to swallow it.

If your GSD is anything like Gypsy, check the mouth! As I mentioned earlier, she learned, to my chagrin, 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 okay.

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 GSD. He knows it is shameful. Treat him with compassion, and make an effort to be home more to give him more opportunities to make it outside.

Above all, know your GSD. Be open to what he needs and wants. 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.

Melissa Smith

View posts by Melissa Smith
Melissa Smith, discussions manager for Petful, has been researching and writing about pet behaviors for several years. A longtime pet lover, she lives in Massachusetts with her teenage son, their cat Harrison and the spirit of their German shepherd named Gypsy. Melissa is pursuing a bachelor’s degree in multimedia design and hopes to adopt as many needy animals as she can.

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