Your cat starts regurgitating food and water. Or a kitten is born with the problem. What is meant to be swallowed just pools at the back of the mouth and then comes back out when the cat leans forward. What’s going on?
There’s a reasonable chance the cat has megaesophagus. It’s a condition in which the esophagus, the muscular tube connecting the mouth to the stomach, is unable to send food from the oral cavity down the chute, so to speak. The reason is that the esophagus has become flaccid and bigger from dilation (which explains the prefix “mega”). Its muscles cannot contract properly to propel solids and liquids along. The condition is very dangerous for the obvious reason: a cat has to be able to eat to stay alive.
Complicating the situation is that what’s regurgitated into the front of the mouth might accidentally get inhaled into the lungs and cause aspiration pneumonia; it’s a common side effect of the illness. Fever, labored breathing, and coughing may also develop.
Fortunately, megaesophagus is a rare condition, but Siamese and Abyssinian cats are predisposed to it, and a cat of any breed can be born with or develop the disease. Other than genetic defects that can make it a congenital condition present from birth, causes include neuromuscular disorders such as dysautonomia (degeneration of the automatic nervous system) and myasthenia gravis (a glitch in the signaling between the nerves and the muscles). Autoimmune disorders and obstructive tumors can lead to it, too. But most often, the disease is idiopathic, meaning the reason for its onset remains unknown.
Diagnosis
A definitive diagnosis of megaesophagus can often be made with imaging such as x-rays. Blood work may also be ordered to look for the presence of a toxin that could potentially be causing the problem.
Of course, if an underlying cause can be found and treated, the megaesophagus should resolve and the cat can resume (or begin) eating normally. Sometimes, when a kitten is born with the disease, it even resolves on its own, at least to some degree. But if no cause can be found, and if a kitten does not outgrow the disease, the prognosis is guarded at best.
With incredibly supportive care, Dusty was able to survive with megaesophagus — and eventually outgrew the condition.
Supportive care
With megaesophagus, nutritional management is everything. Specifically, the cat must be in an upright position to eat. Consider that in people, the esophagus naturally goes downward, so the force of gravity helps the food along.But because of the way our four-legged friends are positioned, the esophagus goes not down but across. Placing food and water bowls up high so that a cat kind of has to stand to eat forces the esophagus into more of a vertical rather than a horizontal position. Some people use what is known as a Bailey chair, designed by a family with a dog named Bailey who had the condition. It looks something like a high chair and makes a cat sit upright to take in food. Not all cats take to it; many would just rather have to stand on their own to eat from an elevated bowl.
The consistency of the food is critical, too. It has to have just the right amount of liquid in the “gruel” to make it go down without resistance. It can be a trial-and-error effort that gets worked out with the vet to ensure that the pet gets enough nutrients. Making things more complicated still is that a cat with megaesophagus often has to be fed several small meals a day. He won’t be able to take in too much at any one time, even with all the other measures put into place.
It takes an inordinate amount of dedication, but there are definitely situations in which it works out. We heard from one reader, Dyanna Wunsch of Wantagh, New York, who fell in love with a cat named Dusty that appears to have been born with megaesophagus. He ate standing up, and the disease resolved after his first year. But he still had multiple esophageal issues, which necessitated that she try different foods until she found one that worked. With her dedication, Dusty finally made it over the 3-pound mark and is doing much better.
“You have no idea what we have gone through with him,” Ms. Wunsch says. “I put all my blood, sweat, and tears into keeping him alive, working my own personal schedule around him with his multiple feedings a day. The end results are just the beginning of a better life for him. It may not be perfect like a normal cat, but it’s perfect for him.”
