Veterinary Clinical Medicine-I (General and Systemic)

OROGASTRIC AND NASOESOPHAGEAL FEEDING TUBE 

Orogastric feeding tube

• These tubes are often used to provide nutrition to orphaned puppies and kittens. They are not left in, but are inserted at each feeding.

Nasoesophageal feeding tube

• Nasoesophageal feeding tubes are technically easy to place, and can be used safely in many animals. Do not use if the patient is comatose or lacks a gag reflex because of risk of aspiration. Nasoesophageal feeding tubes should probably not be used in animals with esophageal motility disorders. These tubes may be placed without general anesthesia. Complications of nasoesophageal feeding tubes include rhinitis, dacryocystitis, esophageal reflux, vomiting, aspiration, pneumonia, inadvertent tube removal, and obstruction of the tube. Placement of a nasoesophageal feeding tube is accomplished as follows:
  • An 8 French tube may be used in most dogs and cats; however, in small dogs and small cats, a 5 Fr tube should be used.
  • To place the tube, instill 2-4 drops of topical anesthetic into the nasal cavity, and tilt the head back. Do this 2 times.
  • The distal end of the tube may terminate in the thoracic esophagus or stomach. To accomplish this, measure the tube to the last rib. I usually place a small piece of tape as a butterfly to mark the tube and to provide a means of securing the tube once it is passed. Lubricate the end of the tube.
  • Pass the tube into the nasal cavity. In cats, pass the tube ventromedially. In dogs, pass the tube in 0.5 to 1 cm and then push up on the planum nasale while passing the tube in a ventromedial direction. Once it has been inserted a little further, flex the head ventrally to promote passage of the tube into the esophagus and not the trachea. When the animal swallows, continue passing the tube into the esophagus to the level of the butterfly piece of tape.
  • If it cannot be passed beyond the level of the medial canthus, it is probably in the dorsal meatus. Withdraw and redirect.
  • Secure tube using 3-0 nylon and the butterfly tape. Dogs usually require Elizabethan collars to prevent dislodging.
• Nasoesophageal feeding tubes are easy to place and maintain. Many dogs and cats will leave them alone as long as there is no tension placed on the skin of the face. Prior to feeding, you should insure that the tube is still within the esophagus. This can be done by infusing 5-10 ml of warm tap water and observing for coughing, or by injecting 5-10 ml of air while ausculting over the abdomen for "gurgling" as air moves into the stomach. Complications of nasoesophageal feeding tubes include irritation at the nares, dacryocystitis, inhibition of voluntary food intake, and migration of the tube into the respiratory cavity. If an 8 French tube is placed, convalescent therapeutic diets may be blended and administered; however, if a 5 French tube is placed, then only liquid diets may be administered.