References
How to place commonly used feeding tubes in dogs and cats
Abstract
Nutrition is one of the most important considerations in the maintenance of health and early intervention can play a critical role in ensuring successful patient outcome and management of disease. In veterinary patients, this is reflected by the recognition of nutritional assessment as the 5th vital sign. It is the responsibility of veterinarians and the veterinary nursing team to ensure the early identification of patients in need of nutritional support. Once nutritional intervention is deemed necessary, collaboration is essential to determine the most appropriate method and route of delivery, alongside the patient's nutrient needs and feeding goals. This article outlines a practical, systematic approach to the placement of feeding tubes, a form of nutritional lifeline, frequently utilised in small animal practice.
There are numerous factors involved in the regulation of appetite. In hospitalised veterinary patients, those relating to underlying disease, procedure-induced stress, adverse effects of medications and hospital environment can result in a reduced desire to eat, warranting nutritional intervention (Gajanayake, 2014). The benefits of rapid initiation of feeding are highlighted in current literature, across both the veterinary and human fields of medicine, with enteral feeding methods considered preferable to parenteral nutrition (Lewis et al, 2001; Campbell et al, 2010; Mansfield et al, 2011). A feeding method that utilises as much of the functioning gastrointestinal tract as possible should be adopted, while also ensuring its suitability for the patient's condition and initial hospitalisation period (Gajanayake, 2014).
This article outlines a step-by-step approach to the placement of feeding tubes, frequently utilised in small animal practice. Readers should be aware that published variations to these methods do exist and the methodology used in veterinary practice will be subject to the personal preference of the veterinarian (VS) overseeing the patient's care and treatment. An overview of the advantages and disadvantages of each tube is provided in Table 1. Depending on the geographic location in which veterinary nurses (VNs), or technicians, are practising, the legal right to place a feeding tube will be dictated by the relevant regulatory body in that area. While the placement of certain feeding tubes is reserved only for veterinarians, an understanding by VNs and technicians of the technique used is essential to the delivery of optimal patient care. In the UK, under The Veterinary Surgeons Act 1966 (Schedule 3 Amendment) Order 2002, Registered VNs are permitted to place naso-oesophageal (NO) and naso-gastric (NG) feeding tubes. Student VNs undertaking the small animal pathway of training, and working at the direction of their VS employer, are required to undertake assisted feeding, including managing and maintaining feeding tubes under supervision.
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