Esophageal Achalasia as a Cause of Refractory Canine Megaesophagus

This presentation will provide a comprehensive overview of the different therapeutic strategies that are available to optimize the management of dogs with megaesophagus, with subsequent improvement in quality of life and a reduction in frequency of aspiration pneumonia in affected animals. The development of esophageal achalasia in 70% of dogs with megaesophagus causes profound retention of food and liquid boluses in the esophagus, despite the utility of gravity-assisted feeding, and contributes to the high prevalence of regurgitation and aspiration pneumonia. This seminar will review how veterinarians can diagnose esophageal achalasia and manage this motility disorder via the advent of botulinum toxin injection into the lower esophageal sphincter, pneumatic dilation of the lower esophageal sphincter, oral administration of sildenafil administration, or via Heller myotomy and fundoplication. The benefits and limitations of these therapeutic strategies will be highlighted using a case-based template.