Kapitel 98 - feeding tubes

Question 1

When if nasoesophageal feeding contraindicated?

Answer 1

for animals with an abnormal gag reflex, esophageal dysfunction, coma, or other condition that increases the risk for aspiration as well as persistent vomiting.

Question 2

Where should the tip of the nasoesophageal be located and how is this measures?

Answer 2

a. Mid to distal esophagus
b. By measuring from the animal’s nose to the seventh or eighth rib

Question 3

What does this image illustrated?

Answer 3

Placement of a pharyngostomy tube

Question 4

What are the complications associated with an improperly placed pharyngostomy tube?

Answer 4

a. If the tube is kinked, placed too cranially or too large it will interfere with epiglottis leading to coughing, dyspnea and risk for aspiration pneumonia.
b. It could also cause complete or partial airway obstruction.

Question 5

What are the indications for gastrotomy tubes?

Answer 5

For animals in which the oral cavity, pharynx, and esophagus must be bypassed because of injury, disease, or obstruction or after pharyngeal or esophageal surgery when the presence of a feeding tube could interfere with healing.

Question 6

What does PEG stand for?

Answer 6

Percutaneous endoscopic gastrotomy

Question 7

When is placement of a PEG contraindicated?

Answer 7

a. In animals with severe ascites, obesity or other conditions hinder close apposition of the stomach to the body wall.

b. In animals with esophageal strictures where the scope cannot be passed atraumatic.

Question 8

When is low-profile gastrostomy tubes placed?

Answer 8

a. For long term feeding
b. Usually used through a permanent gastrocutaneous fistula.

Question 9

What is the recommended minimum time to leave the gastrostomy tube in?

Answer 9

a. 7-10 days
b. (if placed percutaneously and with gastropexy you want to make sure adhesion have formed between in stomach and the body wall before removing the tube)

Question 10

How long does it take for the gastrocutaneous fistula to seal?

Answer 10

Seals within 24 h

Question 11

What is the most serious complication of enterostomy tubes?

Answer 11

Peritonitis

Question 12

How do you calculate RER as kacl/d?

Answer 12

70 x BW^0,75

Question 13

What biochemical changes are characteristic for re-feeding syndrome and when is it most observed?

Answer 13

a. Hypokalemia, hypophosphatemia and hypomagnesemia

b. With 4 days after feeding is started again

Question 14

How do you treat re-feeding syndrome?

Answer 14

Correct the electrolyte deficiencies and reduce the feeding volume to 50% of the RER until the animal is stable again.