Veterinary Gastric Intubation

Orogastric Intubation Indications

1. Decompress GDV
2. Administration of activated charcoal or barium
3. Gastric lavage for toxin ingestion
4. Administration of food (typically neonates)

Orogastric Intubation

Gastric tube placed via the mouth (per os) to the stomach

Orogastric Intubation - Measurment

Dogs - Nares to the last rib
Cats - Nares to the 10th/11th rib

Orogastric Intubation - Advantages

Short term feeding - rapid delivery of nutrients.

Orogastric Intubation - Disadvantages

Risk of aspiration, trauma, irritation
Patient tolerance of the procedure is typically low, may be stressful

Gastric Lavage

Use of suction, gravity or siphon to remove stomach contents

GDV

Gastric Dilation - Volvulus
Distention of the stomach with rotation along its mesenteric axis

Bloat

Distention without rotation, dilation can precede GDV

Nasogastric Intubation

Tube placed via the nares to the stomach

Nasoesophageal Intubation

Tube placed via the nares to the caudal esophagus

Orogastric Intubation Contraindications

Not indicated in patient who:
have absent/abnormal gag reflex
are comatose
are recumbent
are vomiting
have GI obstructions
have upper airway disease

Nasogastric Tube Measurment

Canine - Nares to the 8th/9th rib
Feline - Nares to the 7th/8th rib

Nasogastric Intubation Advantages

Easy to place
Usually well tolerated
Inexpensive
Good for 3 - 14 days

Nasogastric Intubation Disadvantages

Diet is limited by tube diameter
Small diameter tube is prone to blockage

Nasogastric Intubation Contraindications

Not indicated for patients who:
require long-term feeding
have head or neck injuries; surgery to nasal cavity, pharynx
have absent/abnormal gag reflex
are comatose/recumbent
are vomiting
have GI obstructions
have upper airway disease

Pharyngostomy

Surgical creation of an artificial opening into the pharynx

Pharyngostomy Indications

Short-term feeding where disease or injury is cranial to the pharynx

Precautions of Enteral Feeding

Clogged tubes caused by too coarse of diet, failure to flush properly
Intestinal pain, abdominal cramps, regurgitation and severe diarrhea can occur if you feed a full ration immediately after placing a tube
Aspiration or regurgitation can occur if you fe

Gastrostomy Indication

Long-term feeding
patients that are vomiting
patients that have respiratory disease, pancreatitis, anorexia
after surgery or trauma to the esophagus

Resting Energy Requirement

RER - the minimum needed to breathe, stay warm and awake
>5 kg - RER = 30 x kg + 70 kcal
<5 kg - RER = 60 x kg + 70 kcal

Maintenance Energy Requirement

MER - amount of energy needed by an active animal to maintain weight and function
MER = RER x 1.8

Illness Energy Requirements

IER - The amount of energy required to heal after injury, trauma, surgery.