Vol. 19, No. 3March 1997SmallAnimalGastroenterologyContinuing Education Article
Refereed Peer Review
FOCAL POINTKEY FACTS
Disruption of the afferentpathway has been implicatedin the pathophysiology ofboth congenital and adult-onset idiopathic caninemegaesophagus.
Definitive diagnosis of eithergeneralized or focal myastheniagravis requires identification ofcirculating antibodies againstacetylcholine receptors.
The most common endocrinediseases associated withmegaesophagus arehypoadrenocorticism and,possibly, hypothyroidism.
Advanced techniques,including manometry andnuclear scintigraphy, areuseful in evaluating esophagealmotility.
Acquired megaesophaguscan result from numerousneuromuscular, endocrine,or inflammatory disorders aswell as from obstructive lesionsin the esophagus.
Canine and FelineMegaesophagus
University of Tennessee
Erick A. Mears, DVMChristine C. Jenkins, DVM
egaesophagus refers to a diffusely dilated esophagus with decreasedor absent motor function. Canine megaesophagus can occur as acongenital disorder (with signs first appearing before or soon after weaning), as an acquired disorder (secondary to an underlying primary condi-tion), or as an adult-onset idiopathic disease. Feline megaesophagus is rare andoccurs as a congenital or secondary acquired disorder.
Congenital megaesophagus is recognized at weaning and is believed to becaused by a lack of innervation of the esophagus.
The mode of transmissionin most breeds of cats and dogs has not been well defined.
However, congeni-tal megaesophagus is known to be inherited in wirehaired fox terriers andminiature schnauzers.
It is transmitted in wirehaired fox terriers as a simpleautosomal-recessive trait, whereas in miniature schnauzers, it is transmitted as asimple autosomal-dominant or a 60% penetrance autosomal-recessive trait.
A predisposition may exist in other canine breeds, including Great Danes, Ger-man shepherds, Irish setters, Labrador retrievers, Newfoundlands, and Chineseshar-peis.
Feline breeds that may have a hereditary predisposition include theSiamese and Siamese-related breeds.
Acquired megaesophagus can result from numerous neuromuscular, en-docrine, or inflammatory disorders as well as from obstructive lesions in theesophagus.
Early diagnosis and elimination of predisposing diseases are essen-tial for successful management because prolonged dysfunction can cause irre-versible distention. Adult-onset idiopathic megaesophagus is associated with a poor to graveprognosis. A high percentage of patients are euthanatized because of the pro-gression of clinical signs and recurrent aspiration pneumonia.
The esophagus consists of the upper esophageal sphincter proximally, theesophageal body, and the lower esophageal sphincter distally. The upperesophageal sphincter separates the pharynx from the body of the esophagusand indirectly prevents aspiration of ingesta into the respiratory tract. Thissphincter is composed of striated muscle and is innervated by the somaticbranches (glossopharyngeal, pharyngeal, and recurrent laryngeal) of the vagusnerve, which originates from the brain stem nucleus ambiguus.