Feeding a dog with a narrowed oesophagus

[LouHarrison]

Hello, I have been a member on here for some time but haven't posted for ages.
My 8 yr old westie, Tilly had to have emergency surgery in March to remove a bone lodged in her oesophagus and the result is a permanent narrowing which means she can't eat normally. What seems to work best is blending food up with liquid to a moussey consistency and feeding it in smallish portions.
I am a raw feeder (Nutriment and other completes) but am struggling to find a workable solution using what I normally feed - most minces don't blend down enough due to the bone content and stringy bits. Basically her oesophagus is like a funnel - it is working as it should, i.e. pushing food down towards her stomach, but there is a point near the end of it where there is a narrowing and if anything gets stuck there even for a moment, then she regurgitates everything, which can be distressing for both of us, especially when it lasts for 7 or 8 minutes.
I wondered if anyone on here has any experience of feeding a dog with a similar problem. I know that there are varying degrees of damage that can occur - some dogs can still eat normal foods and some dogs can only have liquid and Tillly is somewhere between the two (her oesophagus is probably about 1-1.25cm diameter at the narrow point. I am muddling along but am not finding a solution that is practical for me and works all the time for her. I am thinking quite seriously about home cooking.
I have another westie who I will keep on raw. Thanks in advance for any advice :-)

[Tinyplanets]

Sorry to hear this, it sounds like a distressing experience for you and Tilly.

I haven't had experience of this but I have noticed that when the nutriment isn't quite thawed and I put some boiled water on, I have sometime put too much on and it goes a bit like soup. It really seems to slow my dog down as she can just wolf it in two gulps at times. I have started adding a little water just to slow her down. Perhaps that might be worth a try. I wouldn't leave it down if she doesn't eat it in one sitting as it will have been at good temperature for bacteria growth but if like my dog, she eats it all then perhaps worth a try. I don't normally notice any large bits in nutriment.

[LouHarrison]

Thanks Tinyplanets - and yes it has been a very distressing time, 3 weeks in a specialist hospital followed by several visits to try to enlarge the narrowing via endoscopy. But Tilly made it through and has taken it all in her stride and has recovered very well from the whole ordeal... now I just need to get her food right.
I do actually use Nutriment quite a bit and it is one of the finer minces (in grind terms, although I am v happy with it's quality too!). But I still need to blend it down more and pick out the bigger bits of bone as even they can cause a blockage, even when fed in small quantities let down with water. It's time consuming and when I get it wrong we have a regurgitation. It's all that sensitive I'm afraid :-(
Thanks for taking the time to reply :-)

[Dottie]

I am so sorry for poor little Tilly and for you. This must be very distressing.       As a matter of interest, what kind of bone was it that splintered? At least the vet was able to get it out and save Tilly's life.  I haven't anything more to add re the consistency of your current food but something has just come to mind and I have absolutely no idea if it will help.   Bailey Chairs are used for dogs with megaeosophagus which is the opposite of Tilly's problem.  However, when the dog is sitting in the chair, it seems to have the effect of straightening the oesophagus, thus helping the food to slip down into the stomach more easily.  It also slows the dog's eating down because the owner feeds it.  I think you would probably have to use a spoon or similar in view of the runny consistency of the food that you are giving.  As I say, it may be a stupid idea but it just came to mind so I thought it was worth mentioning. Best to discuss with the vet though.

The only other thing I can think of involves changing food so I don't know if you would be interested.  Cold pressed food dissolves in water beautifully and you can make it into the consistency you desire.  It can be like a crumble, porridge, potted meat/pate or like so - it all depends on how much water is added.  If you are interested, have a look at the video here.  Kibble can be soaked too but it tends to take a bit longer. 

[LouHarrison]

Thanks Dottie, I will have a look at cold-pressed food. I did start off feeding her tinned food when she first came home - we were away from home so it was the easiest option and the vet recommended we start  there . At that point we were blling the food into small balls but that has become less successful and is very time consuming, feeding a ball every 30-60 seconds so it can take 30 mins plus to feed her.
I had looked at the Bailey chairs and it's not  stupid suggestion at all, I'm just not sure if it is necessary as her oesophagus is working (so no need for gravity to do the work) it is just there is a point where a blockage can occur and I think this could happen even if she is sat up. To start with the referral centre where she was (Dick White's in Newmarket) fed her holding her like a baby, but they said that wasn't necessary and she should be able to eat normally. I have got her a rised bowl but am a little worried about that as have read conflicting things about it increasing the risk of bloat, which i am concerned about because she is taking in a lot of liquid with her food.
In terms of what happened - all my fault. She is raw fed and usually very good with bones, leaving anything too big. A I say we were away from home and had to stay longer than I'd taken food for so I ordered some more from a different place than usual and the only bones I could get were turkey carcasses. I thought twice about giving them as they were bigger than what I would usually give (duck necks etc) and I gave the slightly larger one to Tilly rather than my other dog, Dylan. He is a gulper so I didn't want him to have it and sure enough he munched his down in 5 minutes flat . Tilly spend about 25 minutes on hers quietly munching away but then swallowed down the last bit without chewing it properly.
We are very lucky to have her with us still as the first vet we went to missed the blockage on the Xray and by the time they realised the problem and attempted an endoscopy (2 days later) it was too firmly lodged. A 60 mile drive at night to the referral centre resulted in a more sophisticated endoscopy but that damaged the oesophagus and we were told she had little chance of surviving. They said they could call in a surgeon but thought the damage was too severe and infected but by some miracle we got a call at 2.30am from the surgeon to say that he had actually managed to repair the damage. We had to wait several days to find out if the repair would hold and then 2 weeks more to see if she would be able to eat anything (rather than by stomach tube) and then some more weeks of endocsopies to try to stretch the narrow point using a balloon. It was incredibly stressful (away from home the whole time) but she very luckily ended up in the right place (her surgeon was the most amazing chap)  and her tenacious terrier character got her through it.
I saw the piece of bone the morning after the surgery - it was about 2cm long, jagged at the end. I later learned that turkey bones tend to be denser than say chicken as the birds are slaughtered later in life. It was a very costly mistake in more ways than one.

[Dottie]

Thank you very much for explaining about the cause of this problem. Sharing information such as this is sometimes hard but could prevent suffering.  As someone who has been through something very similar (not a bone) I can fully appreciate how stressful this has been and how you must be feeling. My dog made a full recovery thanks to a superb vet but he did warn me that strictures can occur.   As with Tilly, the obstruction was not seen on x-Ray.

If you decide to give cold pressed food a trial ask for samples from Gentle or Guru and explain your problem. Both of those are UK companies with helpful ladies at the helm. Please would you keep us informed of Tilly's progress? I am so glad that she pulled through - what a brave little girl.

[LouHarrison]

Thanks Dottie :-) She is a brave girl and she deserves me to find the best way forwards for us.
I have fed them gentle in the past (when we went on a campervan trip to Italy last year) - the biscuits you mean? I just fed them dry but had not thought about mixing them with water.

I have spoken to another few people in similar situations (with varying degrees of damage) and it is amazing how often oesophagal blockages are overlooked, even though they are not that uncomon especially with terriers. I have heard of 2 cases that took 2weeks to diagnose. I even asked the vet I went to first to check the oesophagus as I knew of a case of this happening (not a bone) and she led me down a route of possible fibrosis in the lungs - that turned out to be trauma in the lungs caused by the blockage which to my untrained eye looked very obvious on the xray. You can't see the bone but the bulge in the oesophagus is very clear. I later asked the vet to use Tilly's case as a training case in the practice to raise awareness. I've also posted at length about it on FB groups I'm in.

Thanks again for your suggestions and interest xx

[Dottie]

The pieces are referred to as nuggets and are not really biscuits. You would have to experiment with it to get a suitable consistency.  I hope that it will help. 
On the subject of bones, I once read that the British Veterinary  Associations do not recommend use of them and perhaps it is these sort of problems that are the reason why they take this stance.  I did raw feed for a little while but used complete so didn't have to give bones.  I am too scared to give them although I have given duck neck once or twice. Due to that bad experience they don't get anything except Nylabone and I keep a very close eye on them with that.  They usually only have a few minutes chomp and that's it. They used to have Natures Menu frozen paddywack and that seemed OK as it is sinew.

[LouHarrison]

I was always slightly nervous with bones and always supervised very closely. I wouldn't ever give them again, though I will still give my other dog large marrow bones as they are good for the teeth and can't be swallowed. I may try Tily on those but need to make sure she couldn't get anything off them. I only gave them as an occassional treat as also feed complete raw foods.

The surgeon at DWR said he sees a lot of cases like this (being a specialist) and that it is just bad luck but can happen with all manner of things including toys, chews, pizzles, sticks etc. In fact the other very severe case I know of was caused by a toy bone which was stuck for over 2 weeks.

I've read a few negative things about nylabones so am reluctant to give Tilly them although she does need something to chew on. They both have antlers but are not always that interested in them and even they have bits that come off so it is a problem.

[Dottie]

Yes, it is just bad luck and dogs ingest all kinds of items, not just pieces of bone.  Perhaps the specific problem with bone fragments is that they are sharp and can easily pierce the lining of the oesophagus and gut.  We blame ourselves but it is  difficult to keep an eye on them at all times.  I don't know of anything that 100% safe so we just have to do the best we can. 

Mine have had Nylabones for many years but I understand that they too are not entirely without risk. I read the website to ensure I was buying the right product and luckily the type that I purchase is recommended.  My lot don't persist with Nylabone - they just have a gnaw for a few minutes then pack it in.  So far they have never broken any off - they just raise bristles on it and these are reputed to help to clean their teeth.  However, I still brush their teeth using a doggy enzymatic toothpaste. 

You mention antlers and it reminded me that I bought one at Christmas time a few years ago and not one of them showed a flicker of interest. Ended up giving it away! 

[LouHarrison]

LOL, sounds familier -  I bought some of those root things this Christmas for my two, to keep them out of mischief while we were all eating Christmas lunch.... no a flicker of interest then or since. Cost me £20!!