Quill threw up last night.
For most Labrador Retriever owners, this is any given Tuesday.
But for a dog with Myasthenia Gravis—who experienced a terrifying bout of megaesophagus exactly two years ago—it’s a nerve-wracking moment.
It’s been a while since I’ve written about Quill’s Acquired Myasthenia Gravis diagnosis or what day‑to‑day life with a dog with an autoimmune disease looks like now. If I’m honest, I’ve avoided writing about it because I don’t want to jinx whatever fragile magic is keeping his illness under control. But two years after the worst two months of our lives, it feels like the right time to look at where we are.
Quill’s Megaesophagus and Myasthenia Gravis Diagnosis
For those who haven’t followed his story, just a few days before Christmas 2023—only months after his first birthday—Quill suddenly began regurgitating and drooling uncontrollably. His symptoms escalated so quickly that within days we’d been to two emergency vets, and he was ultimately admitted to the canine ICU with aspiration pneumonia and unexplained limb weakness.
We ran two Myasthenia Gravis tests. Both were negative.
But he had every symptom, and the medication used to treat MG was helping. So I kept pushing for answers until we made our way to the University of Wisconsin, where they diagnosed him with seronegative Acquired Myasthenia Gravis.
That diagnosis saved his life.
Returning to Regular Dog Life
Our neurologist at the University of Wisconsin explained that we might need to tweak Quill’s medication over time to find the perfect balance. But we were incredibly fortunate — the standard low-end dose of pyridostigmine bromide for his weight worked immediately, and we saw immediate improvement.
As soon as we returned home from Madison, Quill’s life began to look normal again. We repeated barium X‑rays with my regular vet, and she could no longer see any evidence of a “floppy” or poorly functioning esophagus. She told me I could try feeding him as usual, without the Bailey Chair. Terrifying, yes — but he kept his food down, drank water from his regular bowl, and handled everything beautifully.
For the last two years, he has eaten from a slow‑down bowl on a slightly elevated platform. We do that out of an abundance of caution. He enjoys treats, his beloved ice cubes (“crunchy water”), and the occasional cheese bribe or human‑food tidbit.
And best of all, he’s back to full Labrador Retriever shenanigans: zoomies, fetch, wrestling with visiting dogs, and chasing every bunny and squirrel who dares enter the yard.
Why Vomiting Is a Big Deal
Several months ago, he vomited twice in a few days—both times on an empty stomach after getting bites of human food. The vomit looked like normal stomach upset (versus regurgitation, which comes from the esophagus not the stomach) but I still made an appointment.
We repeated barium swallow tests. His esophagus looked normal. We put him on sucralfate to soothe his stomach and repeated the tests again a few weeks later. Still normal.
A month later, he vomited once more. We chalked it up to him sensing my stress before an early‑morning flight. (Quill can smell a thought forming in my head. His nose is next‑level.)
And then last night, I woke from a deep sleep to find he’d vomited again—90 minutes after bedtime. So far it’s an isolated incident. He’s acting completely normal. But when you’ve lived through megaesophagus, even one vomit feels like a warning bell.
The reason vomiting is such a big deal is that excessive vomiting or regurgitation can cause aspiration pneumonia. This is why megaesophagus and/or Myasthenia Gravis can be fatal.
According to PetMD, aspiration pneumonia occurs when food, liquid, or stomach contents enter a dog’s lungs, causing inflammation and infection that can quickly become life‑threatening. Quill had a severe case of aspiration pneumonia when he first became ill, and the emergency vet was unsure if he would survive.
This is why there has not been a single night that I haven’t checked on him multiple times a night since his original diagnosis, even though he sleeps a foot away from me and I have supersonic hearing when it comes to a dog getting sick; I jump out of bed faster than my husband when the tones go off at the firehouse.
Living in the In‑Between: Constantly Monitoring for Symptoms of Myasthenia Gravis
I monitor Quill constantly. Some might call it neurotic; I call it paying attention to my dogs since they cannot tell me if they don’t feel good.
I watch for:
•regurgitation
•excessive drool
•weakness
•changes in his voice
•difficulty jumping
•urinary accidents
So far, we’ve had none of the symptoms he had during his MG onset. Just four isolated vomit incidents over two years.
My conscious brain knows I’m prepared. I know what to document. I know how to recognize megaesophagus. I know the signs of too much or too little medication. I know what to do.
My subconscious brain, however, loves to worry.
Myasthenia gravis can go into remission, which is tested using the same test that we used to try to get a diagnosis. Unfortunately, as a seronegative dog, we cannot use that test to determine if his disease is active or in remission. We can only use the constant monitoring of his condition.
Worried But Eternally Grateful for Every Normal Day
The irony is that I also have an autoimmune disease—lupus. You’d think that would make me more anxious about my own health, but I’m surprisingly relaxed about it. Maybe because I know worrying won’t change anything.
But when it comes to Quill?
Every vomit incident takes me back to that terrifying night in the first ER, when he laid across my legs, with drool streaming from his mouth, fluid oozing from his nose, and a strange vet with zero bedside manner telling me, “Oh, you’ve got a megaesophagus dog!”
I feel incredibly lucky every single day that he responded so well to treatment, that he can eat like a normal dog, that he doesn’t need a Bailey Chair, and that he’s had two full years of Labrador shenanigans.
I would do anything for him. I would do anything to make sure this good health continues until he is old and gray and ready to go to the Rainbow Bridge as a very senior boy.
And I’m grateful every day that “anything” currently looks like a regular slow‑down dog bowl, a normal routine, and a dog who is blissfully unaware of how fragile this all once felt.
