Feeding tubes practical

Question 1

What kind of diets can be used with nasoesophogeal tubes?

Answer 1

Liquid diets such as EnteralCare (dog or cat)

Question 2

What kind of diets can be used with oesophogeal tubes?

Answer 2

Tubes 14Fr can use Instant Convalescence Diets (LCD)

Question 3

What kind of diets can be used with gastrotomy tubes?

Answer 3

Can use more concentrated diets: Instant Convalescence Diets, Eukanuba High Calorie, Hill’s a/d diet, blenderised maintenance diets

Question 4

What kind of diets can be used with jejunostomy tubes?

Answer 4

Liquid diets only: enteral care

Question 5

Why should be careful using a Fortofol C diet?

Answer 5

Very high Na content - unsuitable for patients with heart failure!

Question 6

Advantages - oesophagostomy tube - 9

Answer 6

simpler to place (vs gastrostomy), large bore can be used, generally well tolerated, for longer-term nutritional supporty and/or bypass of oral cavity or oropharynx, animals able to eat via oral route anyway, generally for short to mid-term, used immediately after placement, most owners can manage feeding their pet this way

Question 7

Disadvantages - oesophagostomy tube - 5

Answer 7

requires GA for placement, surgical procedure, stoma site infection, removed by patient, complications - local inflammation

Question 8

Naso-oesophageal tube - advantages - 5

Answer 8

non-invasive, well-tolerated, doesn’t prevent animal eating/drinking, suitable if too unstable for sedation/GA, easy to place

Question 9

Disadvantages - naso-oesophageal tube - 6

Answer 9

Unsuitable if vomiting excessively/unconscious/lack gag-reflex/mega-oesophagus, easily dislodged, limited by the small bore of the tube, only suitable short-term, complications (rhinitis, epistaxis, tracheal intubation), interferes with sense of smell

Question 10

Jejunostomy tube - advantages -5

Answer 10

bypasses stomach, long-term, useful for non-functional lower GIT or malabsorptive conditions, feeding can be started immediately, well-tolerated

Question 11

Jejunostomy tube - disadvantages - 7

Answer 11

requires GA and ex lap to place, feeding should be at a constant rate infusion, diarrhoea common, prolonged hospitalisation, expensive, high maintenance, complications are serious and include peritonitis

Question 12

Define PEG

Answer 12

Percutaneous gastrostomy tube

Question 13

Advantages - gastrostomy tube - 5

Answer 13

useful for short/medium/long term feeding, wide diameter tube allows many feeding options, PEG tubes can be bought as a complete kit or modified, if prolonged use PEG tubes can be modified to a low-profile feeding tubes, can be used by owner

Question 14

Disadvantages - gastrostomy tube - 7

Answer 14

require flexible video endoscopy, unsuitable if vomiting/unconscious or have GI obstruction, placement requires GA and laparotomy or specialised endoscopic equipment, wait for 24 hours prior to feeding, risk of severe complications such as peritonitis if dislodged, should remain in place for 7-10d to allow adequate adhesions (longer if hypoproteinaemic or immune-compromised), medium to small sized dogs the tube removal requires endoscopy to retrieve the ‘stopper’ whereas is larger dogs this can be left to pass in the faeces