How to manage indwelling feeding tubes in critically ill dogs and cats

Nasogastric (NG) or nasoesophageal (NE) feeding tubes are indicated in cases where short-term (< 7–10 days) assisted feeding is required and where general anaesthesia is contraindicated (Figure 1) (Perea, 2008; van Schoor, 2010). Patients require a functional oesophagus, stomach and small intestines (Wortinger, 2006). These tubes are easy to place and fairly inexpensive (Perea, 2008). The advantage of NG tubes is that gastric content could be aspirated if indicated (van Schoor, 2010). It was previously theorised that nasogastric (NG) feeding tubes were associated with more complications because they would interfere with closure of the lower oesophageal sphincter. However, a recent study showed that complication rates with naso-enteric tubes were quite low and complication rates between NG and NE tubes were not significantly different (Yu et al, 2013). Their use is contraindicated in patients with severe trauma to the nares and nasal turbinates, uncontrolled vomiting or regurgitation, absence of a gag reflex, comatose patients, decreased oesophageal function and severe bleeding tendencies (van Schoor, 2010). Feeding via these tubes can start immediately after placement. The patient will be able to consume food orally with the tube in place and when it is no longer required, the suture or glue anchor can be clipped and the tube removed (Marks, 2010a).