PULLMAN, WA – For much of the past decade and a half, the career of Washington State University veterinarian Dr. Jillian Haines has been consumed by a rare and often fatal condition in dogs and cats known as megaesophagus.

Inspired by a beagle mix named Cake she adopted, Haines has become internationally recognized for her efforts to better understand, manage, and treat the condition, spearheading numerous studies that have transformed how the disease is viewed and treated. At WSU, Haines has also established and heads the Megaesophagus Care and Research Center, where she recently completed a study into how changes in the microbiome of the esophagus may influence disease severity and outcomes. She is currently leading projects to develop standardized quality-of-life scales to improve patient care and to investigate the role of achalasia in megaesophagus.

“This disease was once considered a death sentence, and many veterinarians would just recommend euthanasia,” Haines said. “Compared to 15 years ago, there is so much more hope now for pets with this condition.”

Megaesophagus occurs when the esophagus loses its ability to contract, causing food and water to remain trapped, often leading to regurgitation. Because animals may regurgitate unexpectedly or while sleeping, they risk aspirating food into their lungs, resulting in aspiration pneumonia — the leading cause of death for animals with the condition. The disease can be congenital in puppies, but adult cases often have no known cause.

Haines first began exploring the condition while completing a residency at Mississippi State University where she fostered Cake after the then puppy was relinquished after a car accident. While Cake recovered from her injuries, soon after she developed megaesophagus.

“At that time, the expectation was dogs with megaesophagus would only live a few months, so I thought I’ll just keep her as comfortable as I can for the time she has left,” Haines said. “But she thrived, and I had her another eight years before she passed away from cancer. Cake was a very special and sweet dog, and I learned so many things from her.”

After Cake’s diagnosis, Haines scoured veterinary literature about the condition but found little useful information. What she did painted a grim picture.

“All I could find was a study that said they tended to die, usually of aspiration pneumonia, which I already knew,” she said.

Although the veterinary literature was sparse, Haines found great sources of information online, primarily through dedicated pet owner groups that were sharing success stories and management techniques, including the now widely used Bailey chair, an upright feeding chair that helps dogs safely swallow food using gravity.

To help fill in some of the knowledge gaps, she soon launched several studies, including one in which analyzed the demographics, medical and family history, diagnosis, concurrent diseases, and potential predisposing factors of dogs with the condition and another evaluating how food moves through the esophagus in dogs with megaesophagus during upright feeding.

“That study was eye-opening,” Haines said. “It helped us understand why these dogs didn’t always respond to treatments as expected and changed many of our management practices.”

In 2014, Haines accepted a position at WSU. Since then, she and a small group of researchers have identified new treatment options, including sildenafil (Viagra), and their work has helped to improve management strategies, leading to better outcomes for pets and reduced burdens for owners.

While Haines has devoted years to studying megaesophagus, she credits her experiences with Cake, along with the support of clients and online communities, for helping her to better understand the condition and for spurring improvements in management and care. She continues to learn from pet owners and groups like the Upright Canine Brigade, which acts as a support group for owners of pets diagnosed with megaesophagus and has helped to fund several research projects led by Haines.

There is still no cure for the condition – and one may not ever be possible – but Haines is hopeful that ongoing and future research will continue to improve care and outcomes.

“It used to be that you’d take your dog to the vet, and they’d tell you there wasn’t anything you could do,” Haines said. “We’ve come a long way and dramatically improved the lives of these dogs and their owners.”