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Feeding Tube Placement: Percutaneous Endoscopic Gastrostomy (PEG) 1111

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Procedures and Techniques

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FEEDING TUBE PLACEMENT: PERCUTANEOUS ENDOSCOPIC GASTROSTOMY Anesthetized dog in right
lateral recumbency, head to bottom (panel 1). The percutaneous endoscopic gastrostomy (PEG) tube is being pulled
until the disk is against the stomach wall (panel 2). After cutting the extremity of the PEG tube, the two parts of the
angled flange are fed over the tube until against the abdominal wall (panel 3). After assembling the two parts, the
disk of the flange is sutured to the skin (panel 4). The PEG tube is then secured to the flank (panel 5). The procedure
is then complete.

Alternatives and Their the stomach and providing enteric feedings
Relative Merits in animals with pancreatitis, for example.
• Pharyngostomy/esophageal tubes (p. 1106): • Parenteral nutrition: not as complete as
do not require an endoscope for placement enteral nutrition; requires a central catheter
and are therefore less costly. They can be used
or removed immediately and usually work RELATED CLIENT EDUCATION
for a few weeks. Their use requires normal
esophageal function. SHEETS
• Nasoesophageal tubes (p. 1107): provide Consent to Perform General Anesthesia
a short-term solution (a few days). They How to Use and Care for an Indwelling Feeding
are easy to place and easily removed by the Tube
animal. They are smaller in diameter, which
can limit the rate of delivery of food. AUTHOR: Eric de Madron, DVM, DACVIM, DECVIM
• Jejunostomy tube: requires surgical or endo- EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
scopic placement. They are used for bypassing Thompson, DVM, DABVP

FEEDING TUBE PLACEMENT: PERCUTANEOUS
ENDOSCOPIC GASTROSTOMY Low-profile PEG
tube (Corflo gastrostomy button). One can see the
balloon that can be deflated for insertion and reinflated
after the button is in place. (Used with permission
from Halyard Health.)

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