{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:08:48Z","timestamp":1776132528884,"version":"3.50.1"},"reference-count":17,"publisher":"American Veterinary Medical Association (AVMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2021,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec id=\"s001\">\n<jats:title>CASE DESCRIPTION<\/jats:title>\n<jats:p>In Latvia in 2014, acquired idiopathic megaesophagus (AIME) was observed in increased numbers of dogs that consumed varieties of 1 brand of dog food. Within 2 years, 253 dogs were affected. In Australia in November 2017, 6 working dogs that consumed 1 diet of another brand of dog food developed AIME. In total, 145 Australian dogs were affected.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"s002\">\n<jats:title>CLINICAL FINDINGS<\/jats:title>\n<jats:p>AIME was diagnosed predominantly in large-breed male dogs (&gt; 25 kg [55 lb]). Regurgitation, weight loss, and occasionally signs consistent with aspiration pneumonia (coughing, dyspnea, or fever) were noted. Most Latvian dogs had mild to severe peripheral polyneuropathies as evidenced by laryngeal paralysis, dysphonia, weakness, and histopathologic findings consistent with distal axonopathy. In Australian dogs, peripheral polyneuropathies were not identified, and histopathologic findings suggested that the innervation of the esophagus and pharynx was disrupted locally, although limited samples were available.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"s003\">\n<jats:title>TREATMENT AND OUTCOME<\/jats:title>\n<jats:p>Investigations in both countries included clinical, epidemiological, neuropathologic, and case-control studies. Strong associations between the dog foods and the presence of AIME were confirmed; however, toxicological analyses did not identify a root cause. In Latvia, the implicated dietary ingredients and formulations were unknown, whereas in Australia, extensive investigations were conducted into the food, its ingredients, the supply chain, and the manufacturing facilities, but a cause was not identified.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"s004\">\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>A panel of international multidisciplinary experts concluded that the cause of AIME in both outbreaks was likely multifactorial, with the possibility of individualized sensitivities. Without a sentinel group, the outbreak in Australia may not have been recognized for months to years, as happened in Latvia. A better surveillance system for early identification of pet illnesses, including those associated with pet foods, is needed. (<jats:italic>J Am Vet Med Assoc<\/jats:italic> 2021;259:172\u2013183)<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/javma.259.2.172","type":"journal-article","created":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T14:46:05Z","timestamp":1625582765000},"page":"172-183","source":"Crossref","is-referenced-by-count":5,"title":["A comparative analysis of two unrelated outbreaks in Latvia and Australia of acquired idiopathic megaesophagus in dogs fed two brands of commercial dry dog foods: 398 cases (2014\u20132018)"],"prefix":"10.2460","volume":"259","author":[{"given":"Karyl J.","family":"Hurley","sequence":"first","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Werribee, VIC 3030, Australia (Mansfield, Lacorcia); Riga, Latvia (Mat\u012bse VanHoutan); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011 (Allenspach); Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Melbourne, VIC 3050..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Mansfield","sequence":"additional","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Werribee, VIC 3030, Australia (Mansfield, Lacorcia); Riga, Latvia (Mat\u012bse VanHoutan); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011 (Allenspach); Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Melbourne, VIC 3050..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilze Mat\u012bse","family":"VanHoutan","sequence":"additional","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Werribee, VIC 3030, Australia (Mansfield, Lacorcia); Riga, Latvia (Mat\u012bse VanHoutan); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011 (Allenspach); Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Melbourne, VIC 3050..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Lacorcia","sequence":"additional","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Werribee, VIC 3030, Australia (Mansfield, Lacorcia); Riga, Latvia (Mat\u012bse VanHoutan); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011 (Allenspach); Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Melbourne, VIC 3050..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Allenspach","sequence":"additional","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Werribee, VIC 3030, Australia (Mansfield, Lacorcia); Riga, Latvia (Mat\u012bse VanHoutan); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011 (Allenspach); Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Melbourne, VIC 3050..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey","family":"Hebbard","sequence":"additional","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Werribee, VIC 3030, Australia (Mansfield, Lacorcia); Riga, Latvia (Mat\u012bse VanHoutan); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011 (Allenspach); Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Melbourne, VIC 3050..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley L.","family":"Marks","sequence":"additional","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Werribee, VIC 3030, Australia (Mansfield, Lacorcia); Riga, Latvia (Mat\u012bse VanHoutan); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011 (Allenspach); Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Melbourne, VIC 3050..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Poppenga","sequence":"additional","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Werribee, VIC 3030, Australia (Mansfield, Lacorcia); Riga, Latvia (Mat\u012bse VanHoutan); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011 (Allenspach); Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Melbourne, VIC 3050..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James H.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Werribee, VIC 3030, Australia (Mansfield, Lacorcia); Riga, Latvia (Mat\u012bse VanHoutan); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011 (Allenspach); Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Melbourne, VIC 3050..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart C.","family":"Weimer","sequence":"additional","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, The University of Melbourne, Werribee, VIC 3030, Australia (Mansfield, Lacorcia); Riga, Latvia (Mat\u012bse VanHoutan); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011 (Allenspach); Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Melbourne, VIC 3050..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin D.","family":"Woolard","sequence":"additional","affiliation":[{"name":"From Scientific and Regulatory Affairs, Mars Inc, McLean, VA 22101 (Hurley); 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