N-O tubes do not affect a patient ' s ability to eat , so the patient can still be tempted to eat food orally [ 4 ] . As these tubes often have a very narrow diameter , administration of medication in crushed tablet form increases the risk of a tube blockage , so the liquid form of a drug is preferable . The consistency of food should also be carefully considered along with the animal ' s nutritional requirements . Some brands , such as Royal Canin , offer specific diets that are compatible with feeding tubes [ 5 ] .
A post-placement radiograph can confirm the tube ' s placement , ensuring it has not been placed into the tracheobronchial tree [ 6 ] . Incorrect placement could put the animal at risk of aspiration pneumonia [ 7 ] . Once positioned correctly , the N-O tube can be secured to the face with a suture ( Figure 1 ).
Brachycephalic breeds may have narrowed nares , so an N-O tube may not be suitable for use in these patients , and alternative methods may have to be used . N-O tubes can be easily dislodged by patient interference , so preventative measures such as the use of an Elizabethan collar is recommended .
formulation used . Liquids that are thick in consistency pose a risk of blockage , so should be avoided [ 8 , 9 ] .
A post-placement radiograph is required to check the positioning of an O tube ( Figure 3 ) [ 6 ] . Once the O tube is positioned correctly , a finger-trap suture is placed to reduce the risk of the tube being accidentally pulled out ; this suture works by tightening on the tube if it gets tugged and starts to slip .
O tubes can be left in situ for several months , as long as they are functioning correctly and the incision site is healthy and clean . The stoma site should be checked and re-dressed twice daily to monitor for signs of infection or dislodgement . An O tube can be removed from the conscious patient at any time and requires no sutures on the stoma as the wound heals by second intention .
Figure 2 . Oesophagostomy feeding tube in a dog .
Figure 1 . Naso-oesophageal feeding tube in a dog .
Oesophagostomy tube
Oesophagostomy ( O ) tubes ( Figure 2 ) are placed with the patient under general anaesthesia . Sterile preparation is required before a small incision is made in the lateral mid-cervical region of the neck for placement of the O tube . Complications can occur during the insertion of this type of feeding tube , and care must be taken to avoid anatomical structures such as the jugular vein .
O tubes can be used for the administration of medication , but tablets should be thoroughly crushed ( if permitted in the manufacturer ' s guidelines ) or a liquid
Figure 3 . Radiograph showing incorrect positioning of an oesophagostomy tube , in which the tube can be seen twisting back on itself .
54 Veterinary Nursing Journal