Quill’s Megaesophagus: From Healthy Dog to Veterinary ICU

Nothing can prepare you for learning that your dog cannot properly swallow anything, even his saliva. This is the story of Quill, my 15-month Labrador Retriever puppy, and what would become the scariest two months of my life as a dog owner as he was diagnosed with megaesophagus and Myasthenia Gravis.

I share this story for other dog owners who have been in the same situation, not to scare you, but to give you hope. As I write this, Quill is sitting next to me, living life like a normal young dog, and I hope his story can help other dogs also live normal lives.

Quill’s Health Problems Begin

On December 20, 2023, Quill was a typical 15-month Labrador retriever puppy. He was young, energetic, and always ready to play. He was at a fun age in which he was house-trained and knew all of the rules of the house, even if he didn’t always want to follow them. His favorite activity was rough-housing and running zoomies at top speed in the yard with our beloved 10-year Black lab Tinkerbell. He was a joy to train, and happy to work with me daily on various training exercises, obedience cues, and polite leash walking. And of course, he was starting to show signs of what he would be like as a calmer adult dog, loving and snuggly and a wonderful companion. Our only vet visits had been for vaccinations and for a possible UTI.

Like all of my dogs, I had fallen in love with him the moment I met him, and those feelings had just grown stronger with every passing day. I had lost my Jackson, or Jax, to canine melanoma just 6 months before bringing Quill home, and raising Quill was part of recovering from the loss of Jax. Not only was Jax Quill’s “great-uncle” in human terms but Quill was bred the same weekend that Jax passed. I felt strongly that Jax sent Quill to me to help me heal. In fact, we had almost said no to getting Quill after my husband had an emergency appendectomy the exact week that Quill was ready to come home, but both my friend/breeder and I felt strongly that this puppy was supposed to be mine.

December 21, 2023: From Healthy Puppy to Very Sick Dog 

When Quill began vomiting on December 21, I was not overly concerned. If you are an experienced dog owner, you know that vomiting is not an unusual occurrence. Dogs, especially young Labradors, are notorious for eating things they should not. And of course, those things either come out most unpleasantly through the front or the back of your canine best friend. So I did what most experienced dog owners would do. I gave him a day to see if it was just a fluke, and when he was still sick the next day, I made an appointment with my regular vet.

I adore and trust my vet, and I have been going to the same practice with all of our animals for the last 17+ years. On December 22, she did a typical exam for a puking adolescent dog: x-rays to check for obstruction (he is a Labrador, after all), a fecal sample to check for parasites and basic blood work.

Nothing looked out of the ordinary, except for a parasite in his stool. She sent us home with a few prescriptions and instructions to feed him the standard boiled chicken and white rice for a few days until his stomach settled.

His stomach never settled. I never successfully got any of those meds to stay in him. The vomiting grew worse instead of better, and he was not keeping any food or water in him. I made another appointment on the 23rd and asked for subcutaneous fluids and a shot of Cerenia for nausea. The Cerenia stopped the vomiting, but then the drooling and regurgitation began.

If you are like me and did not realize there is a difference between vomit and regurgitation, vomit means the contents are coming from the stomach, while regurgitation means that the contents never made it to the stomach and are coming from the esophagus. According to the Washington State University College of Veterinary MedicineVeterinary Teaching Hospital, “Vomiting is the ejection of contents of the stomach and upper intestine; regurgitation is the ejection of contents of the esophagus. Regurgitation often, but not always, happens right after eating and the pet will try to eat the regurgitated food. Vomiting occurs a variable time after eating or may occur in a pet who is off food.”

I have never seen any of my dogs drool the way Quill was drooling. The more the evening progressed, the more Quill drooled. It was not regular dog drool, it was a steady stream of thick, white mucus that seemed to have an almost rope-like quality. It seemed as if it was choking him, and I took a video and sent it to my vet via Facebook messenger. It seemed as if there was a never-ending fountain of it inside of him.

I try not to abuse the fact that I am friends on social media with my vet, but in this case, I am glad I sent her that video. Even though it was now 10 pm on a Friday, the night before Christmas Eve, my vet messaged me back within a few minutes and instructed me to take him immediately to a local emergency vet.

She suggested several options, one of which was the emergency vet where we had been headed when Jax passed away, and another was a new facility that had recently opened. My vet feared that he might have a blockage that was not on the original X-rays and wanted me to get him an ultrasound or new X-rays.

December 23, 2023: The First Emergency Vet 

Quill and I arrived at the emergency vet around 10:45 pm. I had opted for the newer clinic because I had mixed opinions about the other facility based on my own experiences and those of some friends.

Quill and I were greeted and taken to a little private nook. The building had once been a big box retail store, and the exam tables were open to the public in the center of the clinic. Several vet techs were working, and I saw that there were already a few other dogs and their humans waiting to be seen.

I explained to the intake person about Quill’s vomiting and drooling and how it had progressed over the last 36 hours. I told her everything my vet had done, and that my primary vet wanted us to get an ultrasound. She took our information, typed it into an iPad, and then we waited. There were chairs and a little table in our nook, but I opted to sit on the floor with Quill curled up between my outstretched legs, his head resting on my thigh.

When the vet finally got around to seeing us, Quill’s situation had worsened. In addition to the drool and the regurgitation, he now had dark tan mucus streaming from his nose. I told the doctor that my vet was very clear on wanting an ultrasound. She told me they did not have the staff on hand to do an ultrasound, but they could do an X-ray.

I think it was at that point I started crying. We had been there for several hours, and I was watching my dog get worse with every passing hour without receiving any assistance or attention. The idea of leaving and going somewhere else and then starting the waiting process all over again seemed like a worse choice than staying where we were. I agreed to the X-rays after the vet explained that they would have an actual radiologist look at them, which they claimed would give better information than if a regular vet reviewed them.

After the x-rays, Quill and I waited. And waited. I found out that they didn’t have the actual radiologist on staff, they were waiting on an off-site tech to view them remotely.

I had left my phone charger at home, and my battery was down to 5%, leaving me with no way to update anyone or entertain myself with mindless social media or games. And so I sat, petting Quill, with silent tears streaming down my face the entire time. I always try to hold myself together when my dogs are in a scary situation so as not to stress them, but I could not hold my emotions in anymore.

There was another dog and family in the line of sight, and I could tell they were trying not to stare at me. I didn’t care who stared. All I cared about was that my puppy, barely past his first birthday, was in extreme danger.

Quill’s Diagnosis: Mega-esophagus 

Eventually, around 4:00, five hours after we arrived, the results were in.

“You don’t have an obstruction,” she said, and my heart soared for a split second.

“You have a mega-esophagus dog,” she said, and my heart felt as if it was suspended in time.

“That’s impossible, he was fine literally 2 days ago,” I said.

“Well, he’s definitely a megaesophagus dog, he’s not throwing up, he’s regurgitating” she replied.

She continued to tell me that it could be caused by a variety of things, including an autoimmune disease, or a birth defect. It could be genetic, it could be idiopathic (aka totally random) and I should take him home feed him little meatballs, and try to keep him upright during and after eating.

She told me to follow up with my regular vet and to get him a special chair called a Bailey Chair, and he’d probably have to eat from it for the rest of his life. She showed me the x-rays of his “floppy” esophagus that was stretched out and misshapen. She talked about how the biggest risk was aspiration pneumonia, in which the fluid from the stomach could go into the lungs when they regurgitated.

I had seen the videos of dogs in their Bailey Chairs on social media, so well trained that they climbed into them on their own and even closed the door with their paws in preparation to eat. I knew they ate in these chairs because they could not swallow on their own, and the upright nature of the chairs allowed gravity to get the food to their stomach. But nothing can prepare you for the sudden diagnosis that your 15-month-old puppy was now one of those dogs.

I was in shock, as well as entirely angry at the way she delivered this diagnosis information. I have the utmost respect for the veterinary world. I know how difficult their job is. I know that the suicide rate of veterinarians is extremely high. I view them as true heroes to animals, and I am grateful daily that they chose this path instead of something easier and more lucrative.

But I was also accustomed to the calm, steady demeanor of my regular vet, and this doctor had a frenetic energy and mannerisms that grated on my nerves. She delivered this life-changing information like you might tell someone their dog had a simple ear infection. She seemed so happy to have figured out the answer to Quill’s situation that she had zero compassion for what it might be like to receive this diagnosis.

I kept saying her diagnosis was impossible, he had always eaten and acted like a normal dog. I told her he’d been chewing on the end of a Jolly Ball, that he might have swallowed some of it, that there had to be an obstruction they missed. Or perhaps it was the dog flu that we had seen in the news, to which she answered me that the only place there was a dog flu was in the media.

By 5:00 am we were headed home. Quill was still drooling nonstop, fluid still coming out of his nose, and he had barely enough energy to walk to my car. They sent me home with a towel in case he regurgitated in my car, a few cans of low-quality “prescription” food, and some vague instructions to form it into meatballs and feed him upright.

The emergency vet did not think he was sick enough to be admitted, although I don’t know if I would have left him there anyway. I was finished with the staff and the atmosphere of the clinic and ready to take him anywhere other than there.

December 24, 2023: The Second Emergency Vet 

We arrived home around 5:30 am and I managed to get Quill inside, half on his power, half with me holding him up. He collapsed on the kitchen floor, and I noticed that he had developed yet another new symptom. Now he could barely lift his head and would not look at me. He would try, and then his head would roll to one side or the other like he could not pick it straight up.

Because he had not had any food or water stay in him for almost 2 days, I thought he might be weak from lack of nutrients. I tried to give him some of the canned food first from a spoon and then rolled up as a tiny little meatball. I offered him droplets of water out of my hand. He wanted nothing to do with any of it.

I decided to put him in his crate so he could rest and I could get a little sleep. I had no idea if my primary vet clinic was open for their Saturday hours since it was now Christmas Eve. My husband would be getting home from work around 7:30 am, and I thought that we could figure out our next steps together, like trying to figure out the upright feeding situation and what to do for our boy. I set an alarm for 7 am.

But I didn’t sleep. I was too afraid to take my eyes off of Quill.

There is an old sofa in the room where we have the dog crates. Nobody but the dogs ever sit on it, but it had been Jax’s favorite napping spot, and I have not been ready to get rid of it. Jax’s favorite blanket was still spread out over the back of it. I laid down on the dog sofa, wrapped in Jax’s blanket, a few feet away from Quill. Tink came to see me, and I petted her and cried into the thick fur of her neck.

I opened my Facebook messages and saw that there was a message from my vet asking about Quill, as well as one from a neighbor who I had met a few months prior. She said she had seen my posts about Quill and had messaged me that she liked a different ER vet that was closer to home than the one I had visited. That clinic had helped her with multiple health problems in her pets over the years, and she highly recommended them.

I sat up for a few minutes, watching Quill and deciding if I should go right away or wait for my husband to get home to go with me. And then I jumped up, put my shoes back on, grabbed my purse, and put him back in the car to go to the second ER vet of the day. It was a decision that would save his life.

From Healthy Dog to Quill’s Megaesophagus & Aspiration Pneumonia in 72 Hours 

We arrived at the second emergency vet, and we were greeted by a kind and friendly group of receptionists. I must have looked like a wreck, with zero sleep, wild hair, covered in dog slobber, with my face bearing obvious signs that I’d been crying. We were promptly taken into an exam room. A tech immediately took Quill to the back with them, while once again I relayed the events of the last 3 days along with the shocking megaesophagus diagnosis. I explained that we had just been down the street at a different ER clinic, but I was not happy there.

At this point, I was crying and completely unable to stop. I had cried the entire drive there, flashbacks of Jax’s last drive to the vet, when he passed away before we could get there mixing with my fear of losing Quill the same way. I had cried when my map app took me to the old location of the clinic and cried when I called them to ask for directions.

I have stayed strong and kept myself together through so many losses of humans and my dogs, but I had passed my breaking point. As a firewife, I am accustomed to the fact that I have to handle things on my own 33% of the time because my husband is at work in a job where he can’t just leave to be with me. And while I am usually strong and at peace with that, I was tired and wishing I could have him there with me just once for an emergency.

Fortunately the staff was very kind and took all of our information. My husband called me when he arrived home from work, and I told him to just take care of Tink, and that I’d update him when I found out more.

I assumed I would be waiting another few hours, especially on Christmas Eve. Instead, a veterinarian came to talk to me in less than an hour. They had done more X-rays, and they confirmed that Quill had developed megaesophagus. He had also developed aspiration pneumonia, which happens when regurgitated food or salvia enters the lungs. Quill would need to be admitted to what was essentially the ICU for at least one if not several days.

We agreed to their plan for his care and to test for a variety of illnesses, including Myasthenia Gravis and Addison’s Disease, and opened up a Care Credit card over the phone to pay the $6,000 estimate. We had health insurance for him through Embrace, but we had never used it, as he had been a perfectly healthy dog until this. I had opted for good coverage, and he had no preexisting conditions, but it is still scary to face a vet bill that massive for just a few days.

Leaving Quill behind was one of the hardest things I have done, but I felt more confident about his care than I had since this had all started. They let me give him hugs and kisses before I left. I drove home in a daze. Once home, I took a hot shower and got into bed with my girl Tinkerbell, where I slept until early afternoon to try to celebrate Christmas Eve with my family.

Coming soon: Quill’s Myasthenia Gravis Diagnosis

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