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.