Plus-Hex CLINICAL

DOI : https :// doi . org / 10.56496 / AQCE7599

Ruby Scholefield , RVN

Swift Referrals

ENVELOPE ruby . scholefield @ yahoo . co . uk

Ruby qualified from the College of Animal Welfare in 2021 . She began her career in first opinion practice before moving to referral nursing in June 2021 . Ruby has a keen interest in medical nursing and emergency and critical care nursing . She has participated in numerous practice audits and is actively involved in practice surveillance .

ABSTRACT Enteral feeding allows adequate nutritional support to be delivered to a patient via a feeding tube . There are a multitude of reasons why enteral feeding may be the most suitable method of feeding a hospitalised animal .

This article provides a general overview of the three main feeding tubes used in veterinary practice : the naso-oesophageal tube , the oesophagostomy tube and the percutaneous endoscopic gastrostomy tube . It also discusses how to appropriately choose , use and care for these tubes .

Keywords enteral , feeding , tube , patient , nutrition , naso-oesophageal , oesophagostomy , percutaneous endoscopic gastrostomy

Introduction

Patients can be reluctant to eat in a veterinary setting , which can result in insufficient nutritional intake with potentially significant and negative consequences . Malnutrition can hinder recovery and weaken the immune system , leading to an increased susceptibility to other illnesses [ 1 ] .

Often , in such cases , syringe feeding is used in an attempt to meet the patient ' s daily resting energy requirement ( RER ). However , it can be stressful for the patient , and ensuring the required calorie intake can be challenging , so this is not the recommended technique . The stress related to syringe feeding can result in further food aversions in the patient , and can increase the risk of aspiration in a non-compliant animal . Therefore , the use of a feeding tube is considered best practice .

Feeding tubes can be used postoperatively if the patient is unable to eat or if food needs to be withheld from the patient for an extended period of time , for example , cats with jaw fractures or animals that have experienced oesophageal trauma .

The placement of a feeding tube should be considered if the patient has been anorexic for 3 days or longer , as this will assist in maintaining the patient ' s nutritional status and aid recovery [ 2 ] . The placement of a feeding tube should be seen as a preventative measure rather than a last resort .

Types of feeding tube

Naso-oesophageal tube

The naso-oesophageal ( N-O ) tube ( Figure 1 , page 54 ) is a non-invasive method of enteral feeding . It is placed by carefully passing the tube through one of the patient ' s nares and the pharynx into the oesophagus . This type of feeding tube can be used for only 5 – 10 days , so it is a short-term solution [ 3 ] . Placement should be attempted while the patient is conscious , with the use of local anaesthetic , as this allows the animal to swallow the tube , thereby easing its passage . However , N-O tubes are not always tolerated , which can result in the tube being sneezed out if it is not secured appropriately , so mild sedation may be required .

Volume 39 ( 6 ) • December 2024

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