Vet360 Vet360 Vol 05 Issue 01 | Page 31

NUTRITION Article reprinted with permission of DVM360 – March 05, 2018 DVM360 MAGAZINE is a copyrighted publication of Advanstar. Communications inc. All rights reserved Don't Forget Nutrition! Placing Oesophagostomy Tubes in Cats This simple procedure ensures adequate nutrition for post-surgical feline veterinary patients—which can speed recovery time and minimise hospitalisation. By Marc Hirshenson, DVM, DACVS, American College of Veterinary Surgeons DVM360 MAGAZINE Adequate nutritional support is an essential, yet often overlooked, aspect of postsurgical care. Ill patients frequently present with decreased appetite, anorexia or weight loss related to their underlying condition. These signs may be related to pain or structural disease of the mouth (e.g. oral tumors) or generalised feelings of illness due to systemic disease (e.g. lymphoma, renal disease). The negative effects of malnutrition are well-established and include decreased wound and fracture healing, decreased immune response and organ dysfunction. Enteral nutrition can hasten recovery time, decrease hospitalisation stays and avoid unwanted sequelae such as hepatic lipidosis. Oesophagostomy tube placement in cats is a technically simple procedure, requiring minimal anaesthetic time, and it carries a low risk of complications. i. Oesophagostomy tubes have a larger diameter than naso-oesophageal or nasogastric tubes, allowing for administration of blenderised diets and medications. ii. Compared to gastrostomy or jejunostomy tubes, oesophagostomy tubes can be easily removed at any point. iii. Causes less discomfort than a naso-oesophageal tube. (Ed) Required Equipment Here’s what you’ll need to place an oesophagostomy tube in a cat: • Surgical preparation materials: clippers, scrub, sterile gloves • Scalpel blade • Curved haemostatic forceps • Red rubber, silicone or polyurethane tube (minimum 10-F; often greater than 14-F—depends on size of patient) • Tube adapter (i.e. “Christmas tree”) and injection cap • Nylon suture • Bandage material. Patient Considerations Oesophagostomy tubes are placed under general anesthesia. Consider the anaesthetic risk to the patient and perform appropriate preanaesthetic diagnostics as necessary. Patients with oesophageal disease are not candidates for oesophagostomy tubes. Patient preparation Anaesthetise the patient with endotracheal intubation. I personally prefer to place the patient in right lateral recumbency so I can place the oesophagostomy tube on the left side of the cervical region; however, Issue 01 | MARCH 2018 | 31