2 Year Vet Check-Up

Sidney had his 2 year Vet appointment last Friday. They tested his blood work, fecal samples and several other things. The tests all came back great. No problems. He is healthy and in good shape and weighed in at 53 pounds.

So even though Sidney is on 5mg of Bethanechol twice a day and gets one Prilosec OTC tablet in the evenings - that hasn't adversely affected his health. I was worried that maybe since he is a dog and these aren't typical meds for a dog to be on regularly, that maybe it would affect other parts of him negatively. Luckily, this is not the case and Sidney has a clean bill of health. So our routine is working. His diet is keeping him in shape. He is well-hydrated, has a great coat and the meds seem to help minimize the regurgitation from what we can tell. Although he regurgitated when I got home from work yesterday. Wouldn't be life with Sidney's Megaesophagus without at least one hiccup.

Sidney is Feeling Better

Sidney seems much better. Not sure what was wrong - but it is always better to be safe than sorry. When we suspect anything, we address it immediately. If the main threat to Sidney's life is Aspiration Pneumonia, then we are taking that very serious.
I believe that as long as we diligently keep a watch for any of these symptoms that Sidney will live a very long, healthy and happy life.
ALSO - the photo is what Sidney does when he is feeling uncomfortable or sick. He raises himself fairly vertical on the couch and sits like that until he feels better. Pretty impressive.

Sick in the Middle of the Night

Sidney woke me up at around 4am the other day. It wasn't the normal swallowing sounds or regurgitation. It was more like he was struggling to regurgitate. He did it several times and then kept trying. I felt so bad for him, but I really couldn't do anything at 4 in the morning aside from sit with him and try and make him feel better. Maybe he ate a stick or something. It's tough to tell. He unfortunately loves to eat sticks for some reason, which is super frustrating. YES, we try and correct the behavior every day - easier said than done.

I was worried because he sneezed several times and it seemed like he was having trouble breathing. What sucks is it's hard to distinguish between a Megaesophagus issue and a random he has something stuck in his throat issue. Of course I err on the side of caution. Aspiration Pneumonia is the enemy. It is the one thing that will kill him with this stupid condition. After a while he seemed to get out whatever the problem was, but we still need to be careful.

We have watched him closely, got him on his Aspiration Pneumonia meds to be safe and have the Vet on speed dial. So far he hasn't shown any more symptoms or issues. However last night around 4am again, he woke me up with his "more normal" gulping/swallowing sounds. He sits up as straight as he can because I think it makes him feel better in a vertical position. My smart little guy.

He hasn't lost his appetite and hasn't lost any energy or had any difficulty breathing, etc. So I think we will be OK - hopefully anyways. We will get him checked out next week to be sure unless I see something that we need to rush him to the Vet sooner.

Our Canine Megaesophagus Diet Routine and Bailey Chair - TV News Story

Here is a WKYC/NBC News Story about us and Sidney. I'm always a fan of giving people hope and spreading the word that Megaesophagus IS NOT A DEATH SENTENCE!!

Click on the video below to view.

11pm Newscast - WKYC Channel 3
Click to view story on the WKYC News Channel web site.




6am Newscast - WKYC Channel 3 
Click to view video on WKYC News web site

Regurgitation in his Bailey Chair

Photo above shows what he regurgitated - down by his feet.

Most days are good, some days are bad. The other day Sidney regurgitated while he was in his Bailey Chair. I have no explanation why. I didn't see it happen. Maybe he could have been standing up with his chest on his paw bar, or his esophagus could just have been irritated. Not sure. Poor guy.

This has happened before - not a lot, but it has happened before in his Bailey Chair. I cleaned it up and left him in the chair for the remainder of his 30 minute sit time. He seemed alright after that. It didn't look like the entire meal, but some Knox Blox were in there. He has been drooling a lot more than normal lately - which happens sometimes. When he is more drooly than normal I keep a closer eye on him. I'm not sure if that indicates anything is wrong outside of being a drooly Lab, but better safe than sorry.

I guess it's just important for us to keep an eye on him, which we obviously do. He seems fine and hasn't had any problems after that. Regurgitation happens, even in his Bailey Chair.

Happy 2nd Birthday Sidney!

Above is Sidney's first time in his Bailey Chair as a newly diagnosed Mega-E puppy and what he looks like today as a full grown, healthy, happy Labrador Retriever.

Well I guess that month or so of life expectancy wasn't so accurate. I remember the overwhelming feeling or dread when we received the "Diagnosis of Doom." I also remember how worried we were that we couldn't maintain a routine with both of us working full-time jobs. I also remember how overly concerned we were in the beginning with getting his weight up - in fact I weighed him every single day. I also remember worrying that he could die any day.

All of those concerns were a long time ago and a distant memory. Everything we do is just, well, normal. We enjoy our time with Sidney the Healthy Lab, not Sidney the Mega-E Puppy Doomed to Die. Sure we're always worried about Aspiration Pneumonia and concerned when Sidney has his "bad periods". Trust me - we aren't getting lazy or complacent, we just don't spend our time worrying about what can go wrong and are instead enjoying life with our fur kid. I know a lot of people with dogs. They have the same worries about their dog's health, just about different things. My dog ate a rope (yes a friend's Lab ate an entire rope) or my dog got sprayed by a skunk, etc.

The fact is that all dogs need special attention. The 2 years we have spent with Sidney and managing his Megaesophagus condition has really been a blessing. I think the problem, if any, was more emotional than anything else, especially in the beginning. But through Sidney we have been able to help so many other people that faced the same diagnosis in the beginning with their dogs. We've heard from people about our blog and how it helped them. We've built several Bailey Chairs for people who were in need. Local TV News and Newspapers have covered his story and educated so many people.

I know we got Sidney for a reason. Happy 2nd Birthday little buddy!

Our Routine for Megaesophagus When Traveling

During the months of September, October and November I am required to be working and out of the house for almost 15 hours a day. So I take Sidney with me. But this basically takes us out of our comfort zone for THE ROUTINE. We do bring his Portable Bailey Chair and his travel bag with everything we need, but he is not in his crate with his head elevated, etc. We also make sure to have Knox Blox on hand in the refrigerator for him as well. I found that they will melt into liquid if you leave them in the car. DUH.
While we are working - mainly outside - Sidney is tied up near us so we can keep an eye on him. But the problem for us is that it's OUTSIDE. Take a look at the photo. There are acorns, sticks, leaves and all kinds of stuff on the ground that he can chew on or eat. End result is that most likely his esophagus gets irritated and regurgitation follows. This is my main worry. He has regurgitated a few times this weekend from grazing, but for the most part he has done great. Maybe he is getting a little older and becoming less of a chewer. He will be 2 years old September 26th.
So our routine has changed a bit - basically the TIME OF DAY he gets his Bethanechol pills and also the TIMES OF DAY he gets his meals. I was worried that this change in timing would have a bad result, but so far it isn't affecting him in any way that I can tell. I think as long as we keep the meds and meals on a decent schedule - it won't matter as much. At least that's what we hope.

Sidney's Megaesophagus Medicine Routine

We've had a few nights where Sidney regurgitated - but WAY more where he hasn't. I like to think it's because of the routine we have worked out based on our trial and error over the past year and a half. Many dogs don't need any medicine for this from what I hear. We worked with our DVM to figure out what worked for Sidney. Sidney may not need any - but what we are giving him seems to work, or at least it isn't making matters worse. We have tried different routines with his meds.

SUCRALFATE
At first we gave Sidney his Sucralfate 2x per day (EVERY DAY) to soothe his esophagus. That really was a lot of work from a timing standpoint on our end. Now, we just give it to him when he's having bad periods of regurgitation episodes.

METACHLOPROMIDE AND BETHANECHOL
For his digestion meds, we started with Metachlopromide 3x per day - 30 minutes prior to meals. That worked OK. But not as good as we liked, so we decided to try 5mg of Bethanechol 2x per day - 30 minutes prior to meals (we hide the pill in Knox Blox). At first we made the mistake of giving him Metachlopromide AND the Bethanechol - that just made him much worse. It's either one or the other. So we discontinued the Metachlopromide and changed entirely to Bethanechol. We also started Bethanechol in 10mg doses (that seemed too much for him). So we have since went down to 5mg doses, which has worked well for us. We have always had Sidney sit in the Bailey Chair for 7-10 minutes after he got his meds. Maybe it's because we started Bethanechol when he was a puppy that it seems to help. I'm honestly not sure if it does, but since everything is working well - we are going to continue it. Better safe than sorry.

PRILOSEC OTC
The final med that we give Sidney EVERY DAY is Prilosec OTC (or a generic). He gets the pill in his evening meal. I feel like it has helped eliminate night-time regurgitation, or at least has helped decrease it significantly.

While it hasn't always been easy, it seems what we are doing is working for Sidney. If and when the routine stops working successfully, we will just figure out the next routine that works best. Maybe it will be a different med - or no meds at all. Who knows? But for now, I am happy with how great Sidney is doing despite this cruel condition.

Sucralfate for Megaesophagus

Last night Sidney woke me up around 1:30am. I could tell he wasn't feeling well. Recently when he is gonna regurgitate he makes these weird swallowing sounds. Kind of like gulps. Then he sits up as straight as he can and looks kind of sad. I have no idea why this happens sometimes, it just does and it breaks my heart. So he regurgitated his dinner meal on the carpet and I cleaned it all up. I decided to try using Sucralfate to try and soothe his esophagus. In the beginning, we used to administer this every day. Now we just turn to it when it seems he is sick and his esophagus may be irritated. Plus, he absolutely HATES it. Even though he hasn't had it in a while, he remembers the little medicine squirter and runs at the sight of it.
Anyways, the Sucralfate essentially is used to act as a coating or "Band-Aid" for his esophagus to help soothe it when it is irritated. I know it must be administered an hour before or two hours after any other medication or food as it can bind with other medications preventing them from working properly or bind with food potentially causing a blockage. What we do is dilute 1/2 a pill in 6ml of water. We have a medicine squirter (not sure the technical term) and once it is dissolved we shake it vigorously. We then give it to Sidney in small squirts until it is all gone. Most people say that they need to be horizontal for this, which seems to defy most of the advice to avoid Aspiration Pneumonia. So after I give it to Sid, I hold him vertical for about a minute to be safe.
It seemed to work for him last night. I laid on the couch with him the rest of the night and he seemed good. But at lunch after he ate he made those sounds again while in his Bailey Chair, so I am going to give him some more Sucralfate when I get home from work and see if that helps the little guy.

Quality of Life with Megaesophagus

I know some people are concerned about dogs with Megaesophagus having the opportunity for a good quality of life (as it is commonly referred to). I think the issue is that your dog has to sit in the Bailey Chair for 30 minutes, 3 times a day or more. Plus, they really can't be eating grass, snow, sticks (which they shouldn't anyways) and normal treats etc. Honestly, I don't think any of these things really matter. Above is a photo of Sidney from this weekend taking a trip on the boat. Notice he's smiling. He's happy as heck. And it's not because those coolers are full of beer! The rest of us are smiling about that.
Sidney doesn't need to eat any treats and other junk to be happy. We treat him like family and in return he does the same to us. We make each other happy. His life isn't about treats and eating dog food from a bowl on the ground. It's about the other 22.5 hours in the day that he isn't in his Bailey Chair. We take walks, play with toys and spend quality time together every day. If you asked me, Sidney's quality of life is pretty great, despite his Megaesophagus condition. It's rare that his tail isn't wagging. The hour and a half in the Bailey Chair isn't any more time than dogs spend sleeping during the day - which is WAY more than that.
So don't be discouraged by this condition. Outside of eating funny, Sidney is your normal, crazy and HAPPY Chocolate Lab! You just need to watch him a bit more closely, which I would do even if his esophagus wasn't broken.

Signs of Aspiration Pneumonia

Sidney has had AP once when he was first diagnosed with MegaE. Luckily, we haven't had it again yet.

There is no one, or single combination of Aspiration Pneumonia (AP).

Below are some things to watch for.

Signs of aspiration pneumonia include:
LETHARGY
ELEVATED TEMP
COUGH
HEAVY BREATHING (SOMETIMES NO COUGHING)
LOSS OF APPETITE
TREMBLING
YAWNING EXCESSIVELY

Many dogs only show one of the signs - for instance, Sidney didn't cough or have a temp, but he was refusing to eat his food. Often, when we suspect something is not quite right with Sidney, we are correct... you have to trust your gut instincts. I've read that many of these dogs have NORMAL temperatures, and, in fact, normal blood counts (not all, obviously). And, most "sound" okay when the Vet listens with a stethoscope.

The ONLY way to definitely tell is with x-rays (3 views ideal) - not just listening to the lungs which may sound clear - and you need to see a vet immediately if you suspect AP since this is ultimately the most dangerous element of Canine Megaesophagus. Additionally, to make the Vet's job a little harder, the x-ray changes may not show up for 1-3 days after the dog gets sick. So, it takes a pretty astute owner and Vet to pick up early AP.

With MegaE dogs, they are usually on antibiotics for 3-4 weeks and usually 2 different types of antibiotics (such as Baytril and Clavamox). However for us, we just had Sidney on Clavamox.

With MegaE dogs you want to hit the AP hard and fast! Not only DON'T wait until the next day; don't wait at all. Take them to an ER, if necessary.

Late Night Regurgitation

A few nights back Sidney woke me up at about 3am making swallowing sounds. Kind of like 'gulp' sounds. He jumped out of the bed and went, I assumed, in the bathroom to lay down. I kept hearing the sounds so I went in the bathroom and turned on the light and he wasn't there. He was still in the bedroom, but sitting in a tall (close to vertical) position with his back against the wall. Definitely an odd behavior.
Anyways - I carried him into the bathroom and let him stand horizontally on all fours and he finally regurgitated. It was a ton of RG. I stayed up with him the rest of the night and everything seemed fine after that.
His odd behavior made me wonder if he kind of has learned that being vertical when his esophagus is irritated or full makes him feel better. I know when he is on the couch he sits like a person with his head on the back of the couch when we think he's feeling bad. Maybe Sid is smarter than we think.
Sometimes we go weeks or a month without RG, but sometimes it happens a lot. That's the deal you sign on for with caring for a dog with Canine Megaesophagus. Which is cool with me.

Rest in Peace Bailey

I'm sorry to say that Bailey, in which the "Bailey Chair" was invented for and named after has passed away after almost 13 years living with MegaE. He was born with Congenital Megaesophagus as a puppy in 1998 and lived a long and happy life. Thank you so much Bailey and his mom Donna for the inspiration, help, and support to fight this condition. Bailey and Donna have helped save and extend the lives of thousands of ME dogs all over the world.

His legacy will live on and Sidney and I are forever grateful. Without the help of Bailey and Donna, we would not have Sidney with us today.

Summer Hydration with Knox Blox

Since it's getting hotter out - I feel like I need to keep Sidney more hydrated than in the winter. Especially after walks or trips to the dog park. Again, Sidney does not do well with water - even in his Bailey Chair. So we feed him extra Knox Blox. Of course that means he has additional sittings in his Bailey Chair than normal - but he's in there 7-10 minutes for these. It seems to work for us. Here's our recipe:

QTY 1 - Box of 4 Packets of Unflavored Knox Gelatin
QTY 3 - Cups of Boiling Water
QTY 1 - Cup of Regular Tap Water (Cold or Room Temp) - Some people use Low Sodium Chicken Broth here.
QTY 2 - Tablespoons of Honey (if you do not use Chicken Broth)

I mix the 4 packets that come in the box into the 1 Cup of Cold water and also then mix in the Honey. Then I add the boiling water and stir. I have a container like a Pyrex dish that I keep it in. I put it in the fridge and when it hardens we cut the Gelatin into ice cube size blocks with a spatula. I generally feed him about 10 or so when he was exercising. Kind of just feel it out based on how much he seems to be panting.

If I just give him the Knox Blox and no food, he is in his chair for about 7-10 minutes. That seems to work fine for him. I assume more time for other dogs is needed depending on the routine.

We decided recently that since this is the way we will get Sidney his hydration from now on, we decided to buy the gelatin in bulk which was WAY cheaper. Amazon sells it in bulk if you were curious about an easy place to get it.

Poor Sidney

Sidney had a rough few days, which happens from time to time with dogs that have Megaesophagus. He regurgitated quite a bit. In his crate, at night, throughout the day and also in his Bailey Chair after eating on Saturday. When that happens I usually just clean it up and instead of trying to repeat the feeding, I skip it. But I do keep him in the Bailey Chair and feed him additional Knox Blox so at least he stays hydrated. We start the sit time over again at 30 minutes.

Normally I will try to use the Sucralfate when he is having a bad period, but this time I didn't use it. I just made sure to keep a close eye on him for a few days in case he looked like he may have aspirated. It doesn't seem like he did.

Sidney was much better yesterday, we didn't have any episodes and he never lost his appetite. So hopefully that was our hiccup for now and he gets back on track.

Updated Routine Managing Sidney's Megaesophagus and Building a Bailey Chair

ABOVE: Marley in his Portable Bailey Chair I built.

Things have been going pretty well with Sidney. He have had limited RG periods, but nothing out of the ordinary. He's doing really well and is really happy. Our routine, meds and procedures seem to have Sidney on track to live a long and healthy life.

Since the last post I have built several Bailey Chairs for people in need that couldn't make them on their own. It has now become my weekend charity job. But I'm happy to help out. The above photo is Marley in the chair I built him. Happy little guy.

The only major change with Sidney is that we changed his diet slightly because we were told he was getting a little overweight.

Our new diet is:
1 Cup Eukanuba Large Breed Puppy Food (Kibble) soaked in 2 cups of hot water (it cools while soaking for 30 minutes)
1 Squirt of Salmon Oil for his coat

Blended together and fed 3 times a day in his Bailey Chair.
He sits in the Bailey Chair for 30 minutes.
We also feed him Knox Blox after his food - usually a handful (about 1 Cup)

This seems to work well for us - the main change is eliminating the Instant Oatmeal and Eukanuba Puppy Weaning Formula calories from the meal that were necessary in the puppy growth stage.

Current meds are:
5mg Bethanechol - 2x per day (30 minutes prior to the morning and evening meal)
1 tablet - Prilosec OTC - with the evening meal

All in all, hopefully it stays in the "no news is good news" category for a long time. But we always make sure we are careful looking for signs of Aspiration Pneumonia. That can just come out of nowhere, no matter how careful we are.

Canine Megaesophagus Diet and Routine - TV News Story about Sidney

One of the Cleveland News Channels did a feature story on Sidney and Congenital Megaesophagus and our diet and routine. We really appreciate them helping get out the word that Canine Megaesophagus IS NOT A DEATH SENTENCE.

Click on the video below to view them.

11pm Newscast - WKYC Channel 3
Click to Visit Story on WKYC Web Site

Sidney's Megaesophagus story was in the newspaper

Click on the above article photo TWICE to enlarge it for reading

OR

Paste the below link into your browser to view it:
http://www.akron.com/pages.asp?aID=11442

Sidney had an article in the local newspaper about his Canine Megaesophagus and his routine and diet. It's always good to get this information about ME being manageable. It's sad when I see people say that they put their dog to sleep and wish they would have found the information on how it can be managed sooner.

Great Web sites if your dog has Megaesophagus

Aside from the Yahoo MegaE Group Forum, there is a site on something called Squidoo that a woman in Seattle put together which I thought was perfect. Especially for people whose dog just got diagnosed with ME. It has Bailey Chair instructions, info on the condition, food and Knox Blox recipes and lots of links, etc.  The Facebook group has lots of people and pretty fast response to questions.  The MegaE.org site has good info and has success stories.

Facebook Group:
https://www.facebook.com/groups/4329632343/

Squidoo MegaE Site:
http://www.squidoo.com/Megaesphagus-Dog

Yahoo MegaE Site:
http://pets.groups.yahoo.com/group/megaesophagus

Canine MegaE.org
http://www.caninemegaesophagus.org/ 

Merry Christmas

It was great to have Sidney celebrate his second Christmas. Considering we didn't think he would even make his first because of his Congenital Megaesophagus doom and gloom diagnosis. But I now know we have many more together for sure, as long as I keep our routine and continue to watch for ANY sign of Aspiration Pneumonia. We did have some problems with his regurgitation over the holidays. Being so busy - we missed a few Bethanechol doses in a row. He then regurgitated the next day a few times. I do not believe in coincidences, so no matter how busy I am, I will never miss one again. It's really easy if he hasn't regurgitated in a week or so to feel the false sense of security that everything is fine. That's the scary part because you always need to keep the routine and be on watch. It's my job to keep Sidney healthy.

To be honest, I'm not sure if the Bethanechol really helps anything as far as motility, etc. But since we started using it, his bad periods are much, much less frequent. So it will continue.

Plus, we have a real Xmas tree and he did eat some of the pine needles that cover the floor. I think this is the last real tree Xmas in order to avoid any issues with Sidney.

1 Year Post-MegaE Diagnosis Today

It was one year ago today that we were informed that Sidney had Congenital Megaesophagus and probably didn't have much longer to live. He was 14 pounds and 10 weeks old. We struggled to find our way to give Sidney a quality of life while we still had him around.

However, what we did instead was give him a way to survive and live a long and very normal life. We found the Yahoo MegaE Discussion Group Site and the people there helped us get through the stressful beginning of managing the condition. That was 1 year ago and a lot has changed since then - all for the better.

He is now 53 pounds and almost 14 months old! He has RG episodes, but they are not very common and he isn't suffering through them, only my carpet is. For those reading this and are wondering if it is difficult to manage, it is at first because you are basically freaking out and convinced your dog is doomed. But when the routine sets in and the fear subsides, it's just the way it is. Sidney is a happy, energetic, normal Chocolate Lab, he just gets to eat in a chair and gets honey licks for treats instead of regular treats. I'm sure he doesn't care one bit (or realize that it isn't normal).

Just a message of hope for everyone dealing with this same condition.

1 Year Vet Check-Up Yesterday

Sidney had his yearly check-up at the vet yesterday. He was 55.5 pounds and is now almost 14 months old. Everything checked out great. His regurgitation period from a few posts back has subsided. YAY. So Sidney is a considered a normal, healthy Lab Puppy, despite the ME!!

We received his Report Card on health that listed everything as an "A". He did get a bad grade for his left ear, a "D" - he has an ear infection, but we got the medicine and are administering it twice a day - so it will be fine.

The best grade Sidney got was a "C". That was for his weight. I know it's tough to get weight on MegaE dogs so the "C" grade was fine with us. However - after looking at why we received a "C" grade, I felt that it should have been an "A++++". We received the "C" because Sidney is actually considered 5.5 pounds OVERWEIGHT!!!!

Sidney keeps on proving everyone wrong. Way to go my porky little friend!!

Success Story - Spreading the word that Megaesophagus IS NOT A DEATH SENTENCE!

Click on the article a few times and it will get large enough to read!!

Sidney had an article about his condition come out in The Cleveland Canine magazine. It goes out to DVM offices, pet stores, etc. If it helps one dog not be put to sleep because of MegaE, mission is accomplished!!

Regurgitation has returned, AGAIN.

For some reason Sidney has started regurgitating again - usually it has been in the middle of the night for the past week. Yesterday he did in the morning in his Bailey Chair as well. We're keeping an eye on him closely. He has not lost his puppy energy (BIG TIME), but feeding him has been slightly more difficult. I actually spoon fed him yesterday morning, but the evening meal he ate pretty fast. The thing with Sidney is that we will have a long stretch where it seems like everything is OK with no RG periods. Then all of the sudden it shows up again. While it's normal with his condition, it still kind of sucks because I feel bad for him and want him to be better.

Hopefully this is over soon and we don't have to risk Aspiration Pneumonia. We are gonna give him some Sucralfate in between meals to see if this helps.

New Diet for Megaesophagus is Working Great

Sidney's new diet without canned dog food as half of the mixture is staying down great. We now have bumped up his dry/soaked Eukanuba Large Breed Puppy Food to 1.5 cups and are eliminating the addition of the tablespoon of Eukanuba Puppy Weaning Formula. We are going to use the Weaning Formula addition during times when he is having bad RG periods to try and get additional calories in his meals. While this new mixture takes up more water to blend, Sidney seems to be able to hold it and not have any accidents like a big boy. Plus there is no harm in making sure he is hydrated extra well. We decided to change this because he's up to 57 pounds at 13 months. He'll always be a smaller guy, but his weight seems right on for his size. He started out at only 14 pounds when he was diagnosed in December of 2009 and gained weight really slow, but stayed healthy. I guess that's how it works with ME puppies.


Here is his new yummy meal that he gets 3 times a day:

1.5 cups of Eukanuba Large Breed Puppy Food
1 Tablespoon of Olive Oil
2 Tablespoons of Instant Oatmeal
2 cups of water - possibly more

This is all soaked in water and blended to a milkshake consistency.

We still feed him 5 or 6 Knox Blox for additional hydration after he eats his meal.

HAPPY 1st BIRTHDAY SIDNEY!!

Sidney turned one year old yesterday. After being diagnosed with ME at 10 weeks, we're really happy to see this day and all of the others that will follow.

Happy Birthday little buddy!!

Sidney's First Concert

I own a haunted house company named The Carnival of Horrors, which I am building during the month of September. Sidney hangs out there with me because I need to get him his food and meds, but need to be there all day and night. It's at an outdoor amphitheater named Blossom Music Center. Usually each year we build the event while concerts are going on. KISS played last Sunday, so Sidney got to see them live. Kind of funny how people kept asking how I snuck him in.

On another note he seems to have his appetite back. Still RG'ing periodically like normal. But I think he is loving the buffet of sticks on the ground at Blossom, which is irritating his esophagus. He did RG inside one of the haunted houses, but I cleaned it up!

Seemed a bit odd - Aspiration Pneumonia?

Last week Sidney started to not show too much interest in eating his food. He did eat, but wasn't as excited as usual, which made me nervous. This went on all week. I know we changed his food to all soaked blended kibble, but he still was excited to eat it. He also started regurgitating again (more than normal), so we rushed him on Friday into the vet to check for Aspiration Pneumonia. They always have him as a #1 priority.

We didn't do the X-Rays (costs a ton and it doesn't show up in a really early stage), but she listened to his lungs, took his temp, etc. Just to be safe we have him on his Clavamox meds and are keeping a close eye on him. If he still seems odd we'll get the X-Rays done.

He did wake me up last night regurgitating, but I saw that he ate an acorn while examining what he regurgitated, so I know the culprit. Yes, it's smart to examine the nasty mess to see if anything outside of his normal food is in there. I usually get more alarmed if it is only food and no outside element is to blame for the RG. We try to always check his mouth after he was outside because he loves to sneak in contraband. There are a ton of sticks in front of our door that he tried to bring with him on the way back in the house.

He seems to be doing better now. Still isn't super excited for the food all the time, but he still licks the bowl clean. Sorry buddy if it doesn't taste as good as the canned stuff. When you get a job you can eat your canned food!!

Helping those in need - Building a Bailey Chair

I don't post much on the Yahoo ME Support Group site but always check it out to see if someone needs help or if there is any new info that could be beneficial to Sidney. There was a person in Florida with a cute little German Shepard puppy that wasn't able to build a Bailey Chair. I know how helpless you feel in the beginning after you get this horrible diagnosis, so I offered to help them out and build one like Sid's Portable Chair.

A nice friend Linda, that has her own ME dog named Baron, that I met through the Yahoo site that lives nearby offered to pay for the shipping. So I used the materials I had left from Sid's Portable Chair and other random projects and built little Barry (puppy's name) a chair.

They send us pictures and updates on how Barry is doing and he's doing great.

New experiment with his Megaesophagus diet

So one of the more expensive things about ME dogs, aside from initial vet bills, is the food. At least in our case. We have been soaking 1/2 cup of Dry Eukanuba Large Breed Puppy Food with 1/2 cup of Canned Eukanuba Puppy Chicken and Gravy Food. As you can imagine, canned food for a Lab can get expensive. Plus, the cans seem to run out fast (we can't buy 100 at a time) and we are running to the pet store on a more than regular basis to buy the cans. Then while I'm there we spend more money because we want to buy him toys. So, I go in the store for 12 cans of food and get out with double the cost.

Regardless, now that Sidney is about 11 months old and is 100% house-trained and has better bladder control, we are going to try 1 cup of the Dry Dog Food soaked and eliminate the Canned (we are still adding the Fish Oil, the Instant Oatmeal and the Eukanuba Puppy Weaning Formula). The reason we did the 50/50 mixture at first was because we were having to add so much water to the dry food to get it soft enough to be blended into a milkshake that he was wetting himself in his cage every day after the new ME diet. I think we just were giving our puppy more water than his little bladder could handle.

Now that he's older, I hope that not only will the additional water not affect his bladder, but also help him get more hydration. We do feed him about 4 or 5 Knox Blox with each meal, but I think more is better than less.

My main concern is that his stomach and esophagus will allow this change, but it's worth a shot. He'll get the same nutrition. I know a lot of ME dogs can't do soaked dry kibble, but Sidney has done well with it mixed with canned. Wish us luck!

Having a few bad days

Sidney started regurgitating this week out of the blue. I'm pretty sure it wasn't something he ate off of the ground (I didn't see anything when I was cleaning up after him). I know that it happens from time to time, but I made sure to keep a really close eye on him to make sure he didn't show signs of aspiration pneumonia. He hasn't RG'd for a day or so now - so we might be through it. Poor little guy.

Traveling with Sidney and his Portable Bailey Chair

 I have loaded the plans at the below link - via the Facebook Canine Megaesophagus Support Group Files Section:
Sidney's Portable Bailey Chair Instructions
This weekend was Sidney's first official trip to Middle Bass Island in Lake Erie. The official name is Put-in-Bay. He did great on the boat and only didn't appear to agree with the large waves we encountered on the way up. But overall, I didn't agree with those waves either. He had his life vest on and didn't seem to mind, which was pretty cool. Plus he got to witness the removal of some drunk idiot's driving of a golf cart into the lake!
Luckily we beat the major storm by 10 minutes. That would not have been fun. Anyways, Sid seemed to do great and had ZERO RG. There was a boat ramp with lake access right next to the boat, so Sid had fun playing in the water and we had even more fun trying to keep him from eating seaweed and for some odd reason, he liked to attack water bubbles.
We brought his travel case with us and we built his Bailey Chair downstairs by an air conditioner vent, which he loved!! His travel bag worked out perfect again. We had his Magic Bullet, Canned and Dry Food, Oatmeal and Eukanuba Puppy Weaning Formula for meals. We used the microwave to heat water for his dry food to help it soften faster. We also brought a bunch of Knox Blox from home and kept them in the fridge. We must love Sidney because that took up a lot of space for beer!! We also had his meds and toys, so it's REALLY nice to know we can travel with Sidney fairly easily. We brought his Pro-Collar to sleep in if it seemed he woke up gurgly or if he regurgitated. But he didn't. He had a few bad days a week or so ago in the middle of the night, but we think he just ate something outside that irritated the esophagus.
So all-in-all, Sidney is officially a boat dog!!

Canine Megaesophagus Toys

Poor Sidney only has a limited amount of toys he can really play with. We have to make sure he doesn't get toys where he can eat the stuffing or eat pieces off like Labs like to do. Sidney is a Lab puppy and LOVES to chew (luckily not the furniture). Problem is, we can't let him. He isn't allowed to eat anything without being vertical in his chair.

We found some that are tough nylon types of toys that he likes. Kind of like the Kong Wubba toys (SEE PHOTO). He likes to chase the tennis ball too (if it squeaks). It was/is difficult because he has so much puppy energy that we need to tend to him more than if we could give him a bone to chew on to occupy him. He can't have any bones, treats, rawhides, treats, treats or TREATS (you get the picture, all the stuff dogs LOVE). On all the Lab sites I looked at - everyone gives their dogs Kongs with treats inside, toys with treats inside, etc. I wish Sid liked the Nylabones that are mostly indestructible, but he could care less about them, they're just a tasteless piece of hard plastic. Before his diagnosis, he loved chewing on bones (not real bones but dog bones). That would give us a little down time from our crazy little guy. But he's getting used to playing fetch with the toys he can have.

Hydration for Canine Megaesophagus - Knox Blox

Since it's sometimes difficult for Sidney to keep down water, he gets additional hydration from Knox Blox. This is like Jell-O without the branding name. We feed him the Knox Blox in his Bailey Chair after he eats. He also gets water from the food mixture, but when it's hot that just isn't enough. Here's the recipe we use, I've seen that other people also use low sodium chicken broth to replace the 1 Cup of Cold Water, but Sid likes 'em this way and they kind of are treats to him since he LOVES honey.

QTY 1 - Box of 4 Packets of Unflavored Knox Gelatin
QTY 3 - Cups of Boiling Water
QTY 1 - Cup of Regular Tap Water (Cold or Room Temp)
QTY 2 - Tablespoons of Honey

I mix the 4 packets that come in the box into the 1 Cup of Cold water and also then mix in the Honey. Then I add the boiling water and stir. I have a container like a Pyrex dish that I keep it in. I put it in the fridge and when it hardens we cut the Gelatin into ice cube size blocks with a spatula. I generally feed him 2 or 3 of them per meal depending on what he needs. I also give him some after the dog park or when I need to give him his medicine (I hide the pill in the Knox Blox and he eats it that way).

If I just give him the Knox Blox, he is in his chair for about 7 minutes. That seems to work fine for him. I assume more time for other dogs is needed depending on the routine.

Some helpful Megaesophagus Web sites

Here are some Web sites that helped us when we were in panic-mode when we received Sidney's diagnosis.

Yahoo ME Support Group (by far the most helpful site with info and support):
http://pets.groups.yahoo.com/group/megaesophagus/

Squidoo - Great blog written about a MegaE dog named Tyson with TONS of great info:
http://www.squidoo.com/Megaesphagus-Dog

Marisvet (a good simple "Lamens terms" explanation of the condition):
http://www.marvistavet.com/html/body_megaesophagus.html

Good Site for Success Stories (which means a lot when you think your pup is doomed):
http://www.caninemegaesophagus.org/

ME NING Community (another support group):
http://megaesophagusdogs.ning.com/

Facebook Group:
http://www.facebook.com/group.php?gid=4329632343

YouTube videos of the Bailey Chair and other ME stuff:
http://www.youtube.com/watch?v=sidA3-7XezU
http://www.youtube.com/watch?v=BQF19LR1rRk&feature=related
http://www.youtube.com/watch?v=y5sgQTCI2LA&feature=related
http://www.youtube.com/watch?v=D7zd4LbIEjY&feature=related
http://www.youtube.com/watch?v=7mSZQcN2yVY&feature=related

New Daily Schedule - Megaesophagus Diet and Meds

Since I changed his meds from Metachlopromide to Bethanechol and have been a bit more relaxed on the Sucralfate, I figured I would update his Daily Routine on this post.

Basically, I try and give him the Sucralfate when he is having his regurgitation episodes as opposed to once or twice a day, EVERY DAY.

However, the past few days have been rough for him, he's regurgitated at least once or twice a day, so he's back on the Sucralfate as of now. It's been a pretty substantial amount and my carpet isn't looking too pretty right now. But he didn't RG last night or this morning, so we may be in the clear, although he did somehow grab a fly out of mid-air and ate it yesterday afternoon. He'll eat ANYTHING, which is frustrating, but we do what we can to stop it. Lots of hands in his mouth puling out random stuff.

Here is his current diet and medication/feeding schedule:

AS NEEDED IF HE IS REGURGITATING: Gets a half tab of Sucralfate diluted in 6cc of water (ONLY WATER – NO HONEY) – shake vigorously and give him small bursts so he swallows slowly
• NEEDS it 2 hours after eating or 1 hour before anything else to ensure it coats the esophagus – only needs held up for 30 sec to 1 minute after

MEAL PREPARATION: Blended to Milkshake Consistency
• ½ Cup of Dried Eukanuba Kibble Soaked in ½ cup of HOT water and 1 TBSP of Salmon Fish Oil (Soak it in HOT WATER and the Olive Oil right after he gets his medicine and sometimes you need to add more water – HOT WATER so it softens food)
• ½ Cup of Eukanuba Canned Food – Chicken and Gravy Puppy Food
• 1 TBSP of Oatmeal and 1 TBSP of Eukanuba Puppy Weaning Formula
• ½ - 1 cup of additional water

MORNING MEDICINE (BETHANECHOL – 5mg): Get’s ½ a tablet of Bethanechol – He needs to be in his Bailey Chair for 5 minutes after he gets it – I hide it in a Knox Blox and feed it to him in his chair

MORNING MEAL: Bailey Chair for 30 minutes
• Also give a few Knox Blox for hydration

AFTERNOON MEAL: Bailey Chair for 30 minutes
• Also give a few Knox Blox for hydration

EVENING MEDICINE (BETHANECHOL – 5mg): Get’s ½ a tablet of Bethanechol – He needs to be in his Bailey Chair for 5 minutes after he gets it – I hide it in a Knox Blox and feed it to him in his chair

EVENING MEAL: Bailey Chair for 30 minutes
• 1 tablet of Prilosec with food – I hide it in a Knox Blox like Bethanechol

A day at the dog park

One of Sidney's favorite places is a place called Bow-Wow Beach. It's a great dog park with a lake that he makes sure he plays in all the time. One of the tough things about having an ME dog is the ability to let him be a puppy. You can find yourself getting caught up in everything he puts his mouth on and wondering "will this cause him to get sick, again get Aspiration Pneumonia and die?" The fact that you can actually see him smiling the whole time at the park makes everything worth it. He always finds some other puppies to play with and just has a great time playing, running and getting dirty!

We try and play fetch in the water, which has some success. He still is unsure of the full swimming thing, but is always running in the water. I do worry that sometimes he may get a gulp of water when he's in there, but I just try and hold him up after he gets out for a while. We've been there about 30 times and he hasn't had any problems, so far so good. He does RG there sometimes with all the running around and whatever else he gets in to, but better there than on my carpet and couch!! He seems fine when he's there overall and is just having the time of his life, so we'll keep going.

Trying Bethanechol - AGAIN.

Last time we tried Bethanechol, we had some bad RG weeks. But what I didn't realize was that we shouldn't give Sidney the Metachlopromide AND the Bethanechol. It's one or the other. We did both and it obviously didn't work well.

So we decided last week to try and change from the Metachlopromide to the Bethanacol to see how it works. Instead of getting the 2.5 ml of Metachlopromide 3x per day (1/2 hour prior to each meal), we now just give him .5mg of Bethanechol 2x per day.

So far he has done great and has had ZERO regurgitation. Another big reason I hope this can be a permanent change is time we can save. With both of us working, the 2nd (after-work) meal limits what we can do that evening when you have to administer the Metachlopromide 30 minutes before he eats. With the Bethanechol only twice a day in the morning and evening, that middle medicine session is eliminated!! Why is that important?

Let's say I get home after work at 5:30pm. I have to get him out of his cage and walk him. Maybe I can get him the Metachlopromide by 5:45, which means that he cannot get his meal until about 6:15pm. Then, 30 minutes in the chair and it's almost 7pm. Plus we like to take him to the dog park, but given that we do not want to risk food sliding out of his stomach and back into his esophagus, we really need a minimum of an hour after that for digestion. So, to get Sidney to the dog park at 8pm? Heck it's almost bed time. Plus, a Pittsburgh Penguins hockey game may be on. I need a life too!

So what I am getting at is that I can skip the Sucralfate I give him at lunch (and switch it to after work) and feed him his 2nd meal instead, since there is no 30 minutes to wait prior to his meal and we can go straight to the dog park after work at 5:30pm instead of at 8pm. HUGE difference. As for the Sucralfate? I just give him it before we head out to the park. This will free up my time and his time to exercise.

Goal here is a happy and exercised puppy, as well as a parent with some sort of life. So far, so good.

Portable Bailey Chair

If you want my plans for the Portable Bailey Chair I made for Sidney - email me at ryanpluta@yahoo.com

I uploaded the instructions on the Facebook Canine Megaesophagus Support Group's Files Section:

Sidney's Portable Bailey Chair Instructions 

So one of the big problems with Sidney is moving his Bailey Chair when we travel or if someone looks after him. The main one he uses is in our kitchen and is built heavy-duty because it never dawned on us that we would be needing to move it around. If anyone reading this needs to know how to build a Bailey Chair (regular version), Donna Koch from the Yahoo Support Group will send you a DVD on how to build it for just what she spent in postage. Her dog Bailey is who the chair is named after.

Anyways, our main Bailey Chair is large, bulky, heavy and cumbersome for us to transport on any regular basis. So what I did Friday was build one that is portable and can be built and disassembled in about 20 seconds. It has 2 sides, a back and the bottom base. I also have the Paw bar and a bottom spacer that holds the sides in place and dowel rods that holds the sides and back together. I made it to slide into supports so that it holds together without actually screwing it it place. Now that I am trying to explain it, I realize I'm not too good at explaining it. Anyways, trust me - it works great and is light and easily broken down for transportation.

Sidney had a great time on the boat this weekend and was well behaved and 'gasp' didn't have one regurgitation problem at all, even though he didn't sleep in his elevated cage. We did put a pro-collar on him when he slept which keeps his head elevated to avoid any esophagus irritation. All in all it's great to know that Sid can travel and spend the day somewhere fun without worrying about his feeding routine!!

Made it through the rough patch

Poor Sidney was throwing up for about a week and sometimes it was multiple times a day. By far the most since we got a handle on the Megaesophagus condition last December.

We decided to stop using the Bethanechol and use up all of the remaining Metachlopromide instead of using them both together. We will then try the Bethanechol by itself and see which seems to work best for him and go with that med. Sidney had horrible retching and regurgitation for a week or so that hopefully ended yesterday. He seemed better, but you never know. We're keeping an eye on him. Hopefully the rough patch is over.

He seemed kind of sluggish, but now has his energy back. I was concerned about him getting pneumonia from all of the RG, but he seems to be doing better. I feel so bad for the little guy when he has his rough days. It may have been some esophagitis from eating stuff off of the ground. He never lost his appetite though, which is good.

Bad Day - Changing Bethanechol Dosage

We started the Bethanechol in 10mg doses, 2x per day, which seemed like it was doing some good. However, yesterday morning Sidney was retching, making some horrible vomit sounds. He then vomited all over his cage. This also happened the previous morning. This is a bit abnormal for an ME dog. Normally the RG just kind of falls out. Especially in mornings where stomach acid found is way into the esophagus and irritated it overnight. This was different, this was a vomiting episode (still looked like stomach acid). Again in the late afternoon he looked like he did it again while I was watching him on his Internet Camera, so I know we have a problem that needs immediate attention.

We are going to try and decrease the dosage to 5mg, 2x per day and see if that was the cause. We did give him an extra dose of Sucralfate last night before bedtime to see if that helps soothe his esophagus. It didn't seem like he regurgitated this morning, so some good news. With ME dogs, you need to keep a log of all changes you make to get the proper routine down. If this doesn't help, I will eliminate the Bethanechol and track his progress then. Problem is that you never know what causes the episodes, just have to do your best to figure it out so he doesn't contract secondary aspiration pneumonia, which is the scariest part of this whole thing.

Introducing a New Med - Bethanchol

This is a photo of Sidney chewing on Michael Vick








After seeing several people speak highly of Bethanechol on the Yahoo group site and doing my own research online, we started the Bethanechol on Friday by giving 10 mg before the morning and evening meals, when he gets his Metachlopromide. Costs were prohibiting it because I was told by my vet that it was about $66 for a month supply. But I found out that Costco has the prescription for $25 for a 12 week supply. Worth the 2 hour round trip for that since Sid has been having episodes every morning.

It was difficult to try and find a way to get it into his tummy, since water usually doesn't stay down too well. First I tried to crush it and mix it with some fish oil, but that didn't stay down too long and I was cleaning it up off of the floor in no time. It needs to be taken on an empty stomach, so I finally ended up hiding it in a Knox Blox (the Jell-O cube that we give him to eat in his chair to keep him hydrated) and that seemed to work. Kind of like a make-shift Pill Pocket. We may need to put him in his Bailey Chair for his pre-meal meds now to get this done correctly.

Bethanechol is used in people to treat urinary retention after surgery. The thought in ME dogs is that it can help with the nerve function in the esophagus, hopefully giving it some of its life back. Here's some medical info I found online. It is a cholinergic agonist, so it binds to cholinergic receptors and causes smooth muscle contraction. For it to work the nerves that connect to the smooth muscle do not have to be functioning. We were really concerned that there would be urinary or intestinal side effects of the Bethanechol, since these tissues are also smooth muscle with the same receptors. Basically we're worried he's going to start peeing all over the place and lose control of his bladder. So, the first morning Sid received 10 mg. He had no bladder accidents, so he received another 10 mg that night. He usually RGs right when he wakes up in the morning, but he didn't this time. Good news. We continued with 10 mg twice a day. He didn't RG again until this morning, all over the bed and carpet. I think it's because I let him sleep in my bed as opposed to his cage we rigged up to keep his head elevated, or he ate something at the dog park or on our hike this weekend. Sorry Sid. We didn't notice a dramatic effect and not sure if this will take more time to do what it is supposed to do, but he did RG much less than normal. Not going to get too excited just yet.

It is still early in this test, but I will continue to try and evaluate if it is making a difference, but you never know if he ate something he shouldn't have behind my back.

There are several believers that the Bethanechol can reduce the symptoms of Congenital Megaesophagus in dogs. But, there is NO cure, so if this helps him RG less then it will be worth it. STAY TUNED.

Keeping an Eye on Sid

Problem with Megaesophagus is that when he regurgitates, he has a chance to contract secondary aspiration pneumonia. The worry is that when he does RG, he eats it back up, then does it again, again and again. Recipe for disaster. I only live about 15 minutes from where I work and usually go home at lunch to check on him and give him his sucralfate. But there were some really bad patches where you could just see all of his blankets stained with RG. Kind of scary knowing the consequences.

So in order to try and see if he is regurgitating while we are at work and to give us a chance to stop him from eating it back up and getting it in his lungs, I bought a wireless camera. So basically what I do is access it from work and keep an eye on him. I can now see if he RG's in his cage and cruise home to try and get it stopped and get him in his chair.

Also - I get to see how much fun he has in his cage with his toys - so it isn't all bad. I also get to see if he is full of energy and will know that he will bother me all night long to play. Puppies!!! Luckily he sleeps with his head at the front of the cage where we have it elevated to stop stomach acid from irritating his esophagus so it is easy to see what he is doing.

Our Routine and Treatment for Megaesophagus

So - what is life like with Sidney the Megaesophagus Puppy?


First, his treatment for Megaesophagus. He gets 3 meals a day. That's the most we could handle with our schedule. My family helped me build a feeding chair named a "Bailey" Chair. This is an invention by a family of a ME dog named, you guessed it, Bailey. They are kind enough to send you an instruction DVD on how to build the chair and what they do to manage their dog's condition. What this does is keep Sidney in the vertical begging position for feeding and his 30 minutes of wait time after his feeding to allow gravity to get the food down into his tummy.

Thirty minutes is a long time, I agree. It took quite a while having to sit with him while he was in the chair and keep him calm. We would smear some honey on the side of the chair for him to lick to get him to always associate good things with his chair. He is pretty good at just chilling out in the chair now without constant supervision, which is a huge burden lifted.

We created a meal that crams as many calories into it as possible. So we add instant oatmeal, fish oil and puppy weaning formula to his food and blend it in our Magic Bullet to milkshake consistency. Looks like barf, but he loves it.

To keep him hydrated, we make Knox Blox - which are basically Jell-O cubes we feed him in his chair after he eats. For treats, we made the Frosty Paws recipe we also let him lick in his chair. Plus there is about a cup or so of water in his food to blend it, which also keeps him hydrated. He cannot drink water like a non-ME dog.

We decided to use a few meds to help him out. First is Metachlopromide, which is to help him digest his food much faster than normal to avoid it sliding back up into his esophagus and eventually onto our carpet or couch. He gets this in liquid form - 2.5ml 30 minutes before every meal. We let him sit next to us on the couch for 5 minutes after he gets it so it finds it's way into his tummy. He's used to sitting upright like a person I guess.

Second is something called Sucralfate, which we use to "coat" his esophagus and kind of act as a coated Band-Aid to help when it is irritated to possibly avoid more RG episodes. We use 1/2 a pill diluted in 6ml of water and feed it to him in a little squeeze syringe. He HATES this one - and I find myself chasing him around the house for 10 minutes before I catch him to deliver the meds.

Then at night with his evening meal he gets a tablet of Prilosec OTC to try and help avoid his stomach acid irritating his esophagus and more RG while he's sleeping at night.

Don't get me wrong - there is no perfect way to avoid RG episodes - in fact it happens more often than not. We have good days and bad days, but most of what he RG's is crap he ate off the ground or stomach acid - most of his food, if not all gets digested!!!

Buy stock in Carpet Cleaner and Scotch Guard!!

Here is his daily schedule:

7am - MORNING MEDICINE: Gets 2.5ml of liquid Metachlopromide 30 minutes before his meal – He needs to be held vertical for 5 minutes after he gets it

7:30am - MORNING MEAL: Bailey Chair for 30 minutes
• ½ Cup of Dried Eukanuba Kibble Soaked in ½ cup of HOT water and 1 TBSP of Olive Oil (I soak it in HOT WATER right after he gets his medicine and sometimes you need to add more water – HOT WATER so is softens food)
• ½ Cup of Eukanuba Canned Food – Chicken and Gravy Puppy Food
• 1 TBSP of Oatmeal and 1 TBSP of Eukanuba Puppy Weaning Formula
• ½ - 1 cup of additional water

12pm - AFTERNOON MEDICINE: Gets a half tab of Sucralfate diluted in 6cc of water – shake vigorously and give him small bursts so he swallows without choking
• NEEDS it 2 hours after eating or 1 hour before anything else to ensure it coats the esophagus – only needs held up for 1 – 2 minutes after

5pm - AFTERNOON MEDICINE: Gets 2.5ml of liquid Metachlopromide 30 minutes before his meal – He needs to be held vertical for 5 minutes after he gets it

5:30pm - AFTERNOON MEAL: Bailey Chair for 30 minutes
• ½ Cup of Dried Eukanuba Kibble Soaked in ½ cup of HOT water and 1 TBSP of Olive Oil (I soak it in HOT WATER right after he gets his medicine and sometimes you need to add more water – HOT WATER so is softens food)
• ½ Cup of Eukanuba Canned Food – Chicken and Gravy Puppy Food
• 1 TBSP of Oatmeal and 1 TBSP of Eukanuba Puppy Weaning Formula
• ½ - 1 cup of additional water

7:30pm - EVENING MEDICINE (as needed): Gets a half tab of Sucralfate diluted in 6cc of water – shake vigorously and give him small bursts so he swallows without choking
• NEEDS it 2 hours after eating or 1 hour before anything else to ensure it coats the esophagus – only needs held up for 1 – 2 minutes after

9pm - EVENING MEDICINE: Gets 2.5ml of liquid Metachlopromide 30 minutes before his meal – He needs to be held vertical for 5 minutes after he gets it

9:30pm - EVENING MEAL: Bailey Chair for 30 minutes
• ½ Cup of Dried Eukanuba Kibble Soaked in ½ cup of HOT water and 1 TBSP of Olive Oil (I soak it in HOT WATER right after he gets his medicine and sometimes you need to add more water – HOT WATER so is softens food)
• ½ Cup of Eukanuba Canned Food – Chicken and Gravy Puppy Food
• 1 TBSP of Oatmeal and 1 TBSP of Eukanuba Puppy Weaning Formula
• ½ - 1 cup of additional water
• 1 tablet of Prilosec with food