NUTRITION
NUTRITION
Figure 7. Secure the tube using nylon suture with a
finger trap pattern. Additional support can be provided
using butterflies sutured or glued to the skin.
the tube can be placed on the right side of the neck
if necessary. Clip and prepare the region in standard
fashion (Figure 1).
1. Premeasure the tube from the midcervical region to
approximately the sixth to 10th rib space. Marking
the tube with a permanent marker can help you
insert the tube to the appropriate level.
2. Cut the end of the tube to remove a blind end, if
present.
3. Insert haemostatic forceps into the oral cavity,
down to the cervical oesophagus (Figure 2).
4. Palpate the haemostatic forceps dorsal to the
jugular vein and use the blade to incise through skin
and oesophagus over the tips of forceps.
5. Open the hemostatic forceps tips to grasp the distal
portion of the tube (Figure 3). Pull the tube through
the oesophagus and out through the oral cavity
(Figure 4), leaving the proximal portion of the tube
exiting from the cervical incision.
6. Redirect the tip of the tube back into the oral cavity
and distally into the oesophagus as far as possible,
using your fingers or tips of the haemostat.
(Figure 5). Gently pull on the distal end of the tube;
you’ll feel a “flip” of the tube in
7. Adjust tube placement to the predetermined length
(Figure 6).
8. Secure the tube using nylon suture with a finger trap
pattern (Figure 7) and cap the tube. Combine with
a purse-string suture if that’s your preference (or
butterfly).
9. Perform a lateral radiograph to ensure placement
to the appropriate rib space and place a cervical
bandage to cover the tube insertion site.
Postoperative Care
Blenderised canned (soaked or pelleted diets)
commercial diets can be administered through the
tube once the patient is fully awake. Start feedings at
25% of caloric requirement per day (divided into four
to six feedings per day) for the first day, increasing in
vet360
Issue 01 | MARCH 2018 | 34
EDITOR COMMENTS:
• To avoid volume overload in cats, I usually just
flush after feeding. Use warm water.
• To avoid painful oesophageal spasm, food must
be fed at body temperature and slowly over 5 -
10 minutes.
• Support the patient in a sitting position, when
feeding.
25% increments each day until the daily requirements
are met. Many medications can also be administered
if the tube is large enough in diameter. Administer a
small volume of warm water (5 to 10 ml) before and
after each feeding.
Complications
Complications are uncommon but include vomiting,
stoma irritation and inflammation, clogging of the
tube and infection.
Conclusion
Oesophagostomy tubes are relatively simple to place
and are essential for those patients where prolonged
inappetence is anticipated. If necessary, they can be
left in place for several months. In my own experience,
most owners find tube feedings and management
uncomplicated to a caudal direction within the
oesophagus.