Long-term management of a dog with idiopathic megaesophagus and recurrent aspiration pneumonia by use of an indwelling esophagostomy tube for suction of esophageal content and esophagogastric tube feeding

Abstract

A 10-year-old neutered male Labrador Retriever dog was diagnosed with idiopathic megaesophagus. Despite receiving conventional treatments including elevated feeding, the dog showed repeated regurgitation and aspiration pneumonia, consequently developing weight loss and severe malnutrition. For the purpose of controlling regurgitation, an esophagostomy tube was placed for draining the esophageal fluid. Additionally, an esophagogastric tube was placed for nutritional support. After tube placement, the average frequency of regurgitation was reduced from 2.4 times a day to 0.1 times a day. The nutritional state of the dog improved gradually, and the body weight increased from 18.5 to 27.9 kg. The dog died on day 951, and necropsy revealed a gastric ulcer (2.5 cm in diameter), presumably esophagostomy tube-induced injury. This case report suggests that patients with idiopathic megaesophagus and persistent regurgitation might benefit from esophageal drainage through an esophagostomy tube.

Fig. 1.

A: Endoscopic view of the E-tube (white-filled triangle) and EG-tube (white-unfilled triangle). An aspect of the E-tube and several side holes (black arrow) were made. B: Radiographic view of the E-tube and EG-tube.

Fig. 2.

Line graph (gray scale) shows the dog’s body weight transition. Vertical bar graph (black scale) shows regurgitation frequency per day. Black arrow indicates the day of E-tube and EG-tube placement. After tube placement, regurgitation decreased remarkably, and body weight increased steadily. Asterisks indicate the days of E-tube clogging and replacements performed.