Oesophagostomy tube placement in cats

RE: Oesophagostomy tube placement in cats

Evelyn Barbour-Hill — Tue, 07 Jun 2016 18:12:56 GMT

Just pull it out. Cleanse off any big scabs if you like. Nothing else is required.

RE: Oesophagostomy tube placement in cats

Beats — Tue, 07 Jun 2016 15:46:53 GMT

[quote user="Holly Dale"]Silly question but do I just remove it and allow the stoma to heal by second intention? Place a dressing over it for a few days?[/quote]

I just pull it out and clean around a bit. I don't place any dressings personally.

RE: Oesophagostomy tube placement in cats

Holly Norman — Tue, 07 Jun 2016 15:13:09 GMT

I've recently placed my first oesophagostomy tube in a cat after it ingested disinfectant. It's done brilliantly, is now eating independently and I'm about to remove the tube.

Silly question but do I just remove it and allow the stoma to heal by second intention? Place a dressing over it for a few days?

RE: Oesophagostomy tube placement in cats

Mike Dale — Sun, 06 Mar 2016 10:08:18 GMT

We all need reassurance sometimes. The question wasn't to confirm that the position agreed with the textbook image but whether other people's experience concurred with what this text recommended. Be kind.

RE: Oesophagostomy tube placement in cats

Rob Davis — Sat, 13 Feb 2016 11:37:17 GMT

[quote user="Evelyn Barbour-Hill"]For a cat to remove its oesophagostomy tube is extremely rare: I've had it happen once in forty years.[/quote]

We recently had an RTA cat which we allowed home with an oesophagostomy tube in place. Unfortunately it escaped and spent 10 days roaming freely before he came home. Much to my relief, on his return, his interdental acrylic splint and his oesophagostomy tube were still in place and untouched!

RE: Oesophagostomy tube placement in cats

Kara Gibson — Fri, 12 Feb 2016 03:00:50 GMT

I LOVE oesophagostomy tubes! Well done, perfect placement! I find they can last a long time and cats tolerate them really well. Usually I start with 1/3 cats calorific requirements on day 1, 2/3rds on day 2 and full on day 3. Usually give in 10-20mls amounts.

I use these tubes:

https://www.pattersonvet.com/ProductItem/078098524

They are perfect for cats and dogs and I've never had one block even with blended food as long as flush with lukewarm water before and after feeding. I think the longest I have had one stay in for is 3 months.

RE: Oesophagostomy tube placement in cats

Anthony Todd — Thu, 11 Feb 2016 17:15:39 GMT

[quote user="sajackson"]

Just wondering - why ask if u can see it's in the right place?

[/quote]

As someone who has had much more stick than you could dream about, I just wonder what your point was, or why you asked?

You don't know "it's in the right place" just because you can see it.....

Actually, now that the flow has continued, you are correct and justified [got to be careful on here or you get jumped on]

Sounds as if it pays to use a dedicated, marked tube for the purpose so you don't shove one where you shouldn't and can find all of it if you do....

RE: Oesophagostomy tube placement in cats

Gillian Mostyn — Wed, 10 Feb 2016 18:51:31 GMT

[quote user="Martin Atkinson"]I would initially use any suitable bit of tubing I had lying around - old stomach tube/red rubber tube/old drip line/dog catheter etc etc[/quote]

Martin- you are the first to criticise your 'bargain basement' neighbour, and yet you cut corners and costs where few others would. FFS....feeding tubes aren't expensive! Curious what you use as ng tubes (or, more cotrectly I hope, no tubes.)

Apart from anything else, proper feeding tubes have radio dense markers so that they can be seen easily on radiographs. A necessity for anything you are putting into the GIT, in my opinion. I have had an occasion when a dog vomitted, chewed then swallowed. Nice to know what's going on with your tube without having to withdraw it...

RE: Oesophagostomy tube placement in cats

Evelyn Barbour-Hill — Wed, 10 Feb 2016 14:28:18 GMT

Oesophagotomy tubes may be more "invasive" but nasogastric tubes are far more unpleasant for the cat and by their necessarily fine gauge are very limiting as to the food that can be given. For a cat to remove its oesophagostomy tube is extremely rare: I've had it happen once in forty years.

Dog catheters are much too stiff and even the largest available is too small a gauge, and are difficult to connect a syringe to. I'm appalled at the idea of using drip tubing: too stiff, and nasty sharp edges to the end you are passing down the oesophagus.

RE: Oesophagostomy tube placement in cats

Stuart Jackson — Wed, 10 Feb 2016 11:36:02 GMT

[quote user="Hannah Wynne Richards"]

It is Ignore Stuart

Wynne

[/quote]

I have said sorry, but my point is perfectly valid and to say to ignore my advice is harsh

RE: Oesophagostomy tube placement in cats

Martin Atkinson — Wed, 10 Feb 2016 09:08:10 GMT

[quote user="John Flynn"]Best tube for oesophagostomy tube in cats - any favourites?[/quote]I would initially use any suitable bit of tubing I had lying around - old stomach tube/red rubber tube/old drip line/dog catheter etc etc then if it was going to stay in longer may buy a dedicated O tube and replace but I haven't had to yet. In fact I rarely place them, I find naso-gastric tubes less invasive can be easily replaced and are tolerated well for up to a week which is all I usually need.

RE: Oesophagostomy tube placement in cats

Stuart Jackson — Mon, 08 Feb 2016 15:29:23 GMT

Oops sorry, just thought the label directions and xray would have been enough to re-assure you.

RE: Oesophagostomy tube placement in cats

Thomas Johnson — Mon, 08 Feb 2016 10:16:56 GMT

[quote user="Daniela Fiore"]

I placed an oesophagostomy tube in a little cat patient today. Textbook said to the level of 8th or 9th rib. Just wanted to check really if people would generally place them a little closer to the stomach? Many thanks in advance.

[/quote]

Looks lovely Daniela, well done!

RE: Oesophagostomy tube placement in cats

Hannah Wynne Richards — Mon, 08 Feb 2016 08:27:35 GMT

Thanks Andrew

Wynne

RE: Oesophagostomy tube placement in cats

Andrew Kent — Sun, 07 Feb 2016 20:06:05 GMT

[quote user="Emily Rainbow"]Does anyone feed them as a CRI or just do multiple feeds? [/quote]

I have occasionally tried this in cases with poor gastrointestinal motility (for example acute gastroenteritis/parvo type cases) that are intolerant of any great volume. The idea in those cases is one of microenteral nutrition perhaps helping with enterocyte recovery.

But, as Evelyn says, the great problem is that they basically require constant monitoring to prevent problems and so actually giving a small volume every hour (for example) might be better than true constant rate infusions.

Andy

RE: Oesophagostomy tube placement in cats

Evelyn Barbour-Hill — Sun, 07 Feb 2016 17:03:25 GMT

[quote user="Emily Rainbow"]

Does anyone feed them as a CRI or just do multiple feeds?

[/quote]

An interesting thought, but I'm not quite sure why you would want to. Did you have a particular case in mind, Emily?

It seems to me that constant infusion would need almost constant supervision, lest there be disconnection, or blockage, or regurgitation. Also, the very low flow rate might mean the food suspension turns into sludge within the tube, or that it settles out as sediment in the reservoir.

RE: Oesophagostomy tube placement in cats

Emily Rainbow — Sun, 07 Feb 2016 16:40:33 GMT

Does anyone feed them as a CRI or just do multiple feeds?

RE: Oesophagostomy tube placement in cats

Evelyn Barbour-Hill — Sun, 07 Feb 2016 16:29:04 GMT

[quote user="John Flynn"]

Best tube for oesophagostomy tube in cats - any favourites?

What is volume per feed that others use?

[/quote]

Red rubber, Ch14 or 16 (I think Ch is the same as FG, not absolutely sure), rounded tip, two eyes.

When you cut it to size, a Luer syring nozzle fits nicely into the cut end.

All the plastic ones I've seen (but I haven't seen them all, so would be interested in what other people have used) are too stiff for my taste. Certainly I'd think a dog catheter much too stiff.

Volume at each feed depends much on the individual cat. If you work it up over a couple of days you may be surprised at the volumes that some cats tolerate well. I'd be disappointed if an average cat could not take at least 50ml per feed. Some large cats I have worked up to 105ml, not counting the before-and-after water. I guess 70ml would be most usual.

Obviously you can't just scloosh it in. You have to give it slowly to give the oesophagus and the cardiac sphincter time to do their thing. With experience you recognise the cat's signs that you have given it a little too fast, at which you stop for a short while. Get the cat comfortable on your lap and have sympathy and patience.

RE: Oesophagostomy tube placement in cats

Andrew Kent — Sun, 07 Feb 2016 13:26:34 GMT

[quote user="Hannah Wynne Richards"] Where do you buy MILA tubes?[/quote]

I believe that direct medical supplies are the UK distributor for MILA products, but you can see what is available on the MILA site.

Dechra veterinary products actually also have some nice O tubes - page 25 of the catalogue and I think they can just be ordered through a normal wholesaler so perhaps simpler!

Andy

RE: Oesophagostomy tube placement in cats

Hannah Wynne Richards — Sun, 07 Feb 2016 13:06:01 GMT

Where do you buy MILA tubes?

Wynne

RE: Oesophagostomy tube placement in cats

Andrew Kent — Sun, 07 Feb 2016 13:00:40 GMT

[quote user="Daniela Fiore"]I asked because I was worried and hadn't placed one before. my apologies, I had thought that was what this forum was for :([/quote]

Hi Daniela,

That's exactly what the forum is for, ignore the unhelpful comments! The tube looks good - great job!

[quote user="Stuart Jackson"]Just wondering - why ask if u can see it's in the right place?[/quote]

Doesn't everybody want a little reassurance sometimes that they have done a new procedure correctly?! I know I do. That should be encouraged!

[quote user="John Flynn"]

Best tube for oesophagostomy tube in cats - any favourites?

What is volume per feed that others use?

[/quote]

I usually use the MILA tubes, but I think there are lots of good O tubes out there, I'm much less fussy about them than PEG tubes for example.

I would be a little worried that a dog catheter might be uncomfortable to use as an O tube as they are quite firm - but I guess for short term use it would be ok?

Volumes depend on what type of food you are using - I usually build up over a few days and then split total calorific requirement into about 5 feeds through the day. I usually suggest that the maximum volume of each feed would be 10ml per kg.

Andy

RE: Oesophagostomy tube placement in cats

Hannah Wynne Richards — Sun, 07 Feb 2016 12:55:55 GMT

It is Ignore Stuart

Wynne

RE: Oesophagostomy tube placement in cats

Daniela Fiore — Sun, 07 Feb 2016 12:53:16 GMT

I asked because I was worried and hadn't placed one before. my apologies, I had thought that was what this forum was for :(

RE: Oesophagostomy tube placement in cats

Rob Loxley — Sun, 07 Feb 2016 12:02:19 GMT

I'd use the largest Ryle's NG catheter that seems sensible - bigger the better as need less watery food and less risk of blocking. Urinary catheters usually have a luer fitting with again limits what you can easily get down. Has anyone tried the adjustable oe tubes from IMS Euro?

RE: Oesophagostomy tube placement in cats

Stuart Jackson — Sun, 07 Feb 2016 11:01:59 GMT

Just wondering - why ask if u can see it's in the right place?