Megaesophagus in Cats - Causes, Treatment and Associated Conditions

Key takeaways

Megaesophagus is a condition where the esophagus becomes widened along its length, either due to reduced motion of the muscle or an obstruction that prevents food from entering the stomach.

Common causes include dysautonomia, autoimmune conditions, tumors, and poisoning
Cats with megaesophagus frequently regurgitate, and may show other symptoms such as difficulty swallowing, increased appetite, or weight loss
Diagnosis involves a physical examination, blood work, diagnostic imaging, and specific testing for conditions known to cause megaesophagus
Treatment typically involves treating the underlying cause and dietary changes to ensure nutritional needs are met
Many cats with megaesophagus are euthanized due to developing severe complications, such as aspiration pneumonia

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A closer look: Megaesophagus in Cats

The esophagus is the first portion of the digestive tract after the mouth. A healthy esophagus transports food from the mouth to the stomach by muscular squeezing (a process called peristalsis) along the tract. If the esophagus decreases its ability to move food through to the stomach, chewed food can build up in the tract, causing it to expand. If this persists, it can lead to a chronic widening of the esophagus, called megaesophagus.

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Risk factors

Megaesophagus is rare in cats, but can lead to life-threatening complications such as aspiration pneumonia and malnutrition. Cats showing symptoms such as regurgitation, weight loss, and difficulty swallowing require prompt veterinary examination to identify the underlying cause.

Cats with megaesophagus are predisposed to developing aspiration pneumonia, a serious and potentially life-threatening condition.

Possible causes

Megaesophagus is caused either by a disruption to motility of the tract (the ability of the tract to push food through) or by an existing obstruction preventing food from passing to the stomach.

Megaesophagus has both congenital (present at birth) and acquired (develops during a cat’s lifetime) forms.

Congenital megaesophagus is very rare. Some cases are associated with congenital myasthenia gravis, and some cases have no apparent underlying cause (idiopathic). Abyssinian and Siamese cats are most at risk of congenital megaesophagus.

Acquired megaesophagus has many potential causes.

Main symptoms

The major symptom of megaesophagus is regurgitation. Regurgitation requires no abdominal effort and causes no distress to the animal, in contrast with vomiting. Cats that regurgitate seem to suddenly have food material in their mouth with no signs leading up to the event.

Testing and diagnosis

Diagnosis of megaesophagus starts with a physical examination. Other tests that may aid in diagnosis include:

Blood work
Diagnostic imaging
Esophagoscopy
Testing for specific underlying conditions such as myasthenia gravis

Steps to Recovery

Treatment of megaesophagus primarily focuses on preventing aspiration pneumonia while meeting a cat’s nutritional needs. If possible, treating the underlying condition can resolve megaesophagus. Many cats require placement of a gastrostomy tube for feeding while treatment for their underlying condition takes place. Long-term methods for managing megaesophagus include:

Altering the consistency of food to ensure passage into the stomach
Placing feed and water bowls in an elevated position
Use of a “Bailey chair”, which keeps a cat in an upright position during feeding. These chairs are commonly used for dogs, but may not be tolerated by cats.

Most causes of megaesophagus require life-long therapy, including intensive management to prevent aspiration pneumonia and malnutrition. Many cats with megaesophagus develop severe complications such as aspiration pneumonia despite appropriate treatment and management. These cats are often euthanized due to poor prognosis.