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Case Notes: Indaba: Dachshund with Megaoesophagus
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Indaba is a 15 year old Dachshund who is usually very sprightly for her age. Her name means "trouble", in a South African tribal dialect, and she has certainly lived up to it recently.

She first became ill on Christmas Day. She was given her traditional Turkey Christmas dinner and shortly afterwards she became very off-colour. Over the next 24 hours she retched repeatedly, sometimes followed by vomiting, and she became increasingly weak, shaky and depressed. By the middle of the night on Boxing Day she had started to have small seizures and was admitted as an emergency at the Henley surgery.

On admission she was severely dehydrated and very weak. She was put on a drip and started on antibiotics and anti-nausea drugs overnight. This improved her hydration and controlled the vomiting but by the morning she was starting to have severe breathing difficulties. Chest X-rays revealed a severe pneumonia and, underlying this, a hugely dilated and flabby oesophagus, a condition known as "megaoesophagus".

The oesophagus is the tube that runs through the chest cavity connecting the throat to the stomach; in a normal animal it has a strong muscular wall so that, when food is swallowed, it is propelled down into the stomach within a matter of seconds. In "megaoesophagus" the tube has lost its muscle tone and become stretched and "baggy" and so food & fluid tend to pool within it. Thus they are easily refluxed and accidentally inhaled causing an "inhalation pneumonia". The megaoesophagus would have developed over weeks or months but, we assumed, the added complication of the upset stomach caused by the Christmas dinner was the final straw, causing her to inhale particles of food and inducing a life-threatening pneumonia.

It was touch and go as to whether she was strong enough to pull through this. She remained in intensive care on an intravenous drip, antibiotics and anti-sickness drugs and at times she needed supplementary oxygen to assist her breathing.

Blood samples were sent off to look for a cause of the megaoesophagus. It was six days before she took her first lap of water and the following day her first mouthful of food. This was a long time for such a little, sick dog, and we were not out of the woods yet.

All food and water was fed from a height and then Indaba was held vertically and carried around over the shoulder like a baby for 20 minutes. This helps gravity assist the transit of food and fluid down to the stomach and reduces the chance of reflux. Slowly but surely her lungs have recovered from the pneumonia and she has regained condition and strength and spirit!

When the blood results came back from the lab, they showed that Indaba had a neurological condition called myasthenia gravis. This is a disease where the nerves fail to stimulate the muscles they are attached to and in many animals (and people) it can cause a generalised muscle weakness and periodic collapse as well as more specific dysfunction of internal muscles. The drug used to treat this disease can cause unpleasant and even dangerous side-effects.

In Indaba's case the myasthenia is affecting only the oesophageal muscles and so the owners have opted not to start on this drug but to continue to manage the megaoesophagus by postural feeding. To this end they have tested every baby carrying sling offered by "Mothercare" and found the ideal one to fit a miniature Dachshund!

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Henley Vets and Twyford Vets
The Veterinary Centre: 271 Reading Road, Henley-on-Thames, RG9 1EL - Phone 01491 574490
Also at Twycombe Lodge, Loddon Hall Road, Twyford, RG10 9JA - Phone 0118 934 0259