Page 644 - Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice

Enteral Nutrition 631

guides the tube into the ventral meatus. 27 Slightly flexing esophagus is checked for negative suction/gastric fluid.
the head downward may be helpful in directing the tube Placement should always be confirmed with a lateral/
into the esophagus. For small dogs and cats, one should dorsal ventral cervico-thoracic radiograph. Many com-
pass the tube directly through the ventral meatus without mercial feeding tubes have radiopaque markings to con-
manipulating the nose. In other respects, the technique firm the tube’s position. Once in place, the tube is sutured
for cats is similar to that described for dogs. with a pursue string and Chinese finger trap suture pat-
Once the tube is installed, the stylet (if present) is tern (Ethilon or silk suture) (Figure 26-5) or fixed with
removed and the position of the tube in the stomach or cyanoacrylate adhesive (Superglue) just lateral to the nos-
tril in the nasal fold to avoid curling of the tube
(Figure 26-6). Several knots should be placed at the first
suture site and then a Chinese finger trap method applied
for three to four throws to prevent movement of the tube.
A second suture should be placed and secured to the lat-
eral cheek (Figure 26-7). An Elizabethan collar is placed
on all animals to prevent inadvertent tube removal
(Figure 26-8). Topical lidocaine can be administered if
the patient experiences retractable sneezing
postplacement. Although uncommon, mild epistaxis
may be seen if the nasal turbinates are irritated during
placement.
Nasogastric tubes also may be used for perioperative
gastric reflux to remove gastric fluids and decrease the risk
of regurgitation and aspiration pneumonia postopera-
tively. NE tubes may also be temporarily placed for
administration of activated charcoal in acute toxicities. 22
Figure 26-5 Technique for securing a nasoenteric tube with a To prevent occlusion with food or mucus, NE feeding
purse-string and Chinese finger trap suture pattern. Tube should be tubes should be flushed with water before and after each
secured as close to the nostril as possible.
feeding, and kept securely capped so that water remains in
the tube between feedings.

Figure 26-6 Technique for securing a nasoenteric tube. Tube should be secured as close to the nostril as
possible. (From Abood SK, Mauterer JV, McLoughlin MA, Buffington CA. Nutritional support of hospitalized
patients. In: Slatter DH, editor. Textbook of small animal surgery, 2nd ed. Philadelphia: WB Saunders
Co, 1993.)