Enteral nutrition is usually preferable, as it helps maintain GI structure and function. Nasoesophageal/nasogastric, esophagostomy, and gastrostomy feeding tubes are commonly used in dogs and cats. Considerations for various feeding tubes should be reviewed (Table). Guidance on placement of feeding tubes is available (see Suggested Reading).
Most complications with feeding tubes include tube occlusion and localized irritation at the tube exit site.8,9 More serious complications include infection at the exit site or, rarely, complete tube dislodgment and peritonitis with a gastrotomy tube (proper stoma require 10 days to form). Risk for complications can be reduced by using the appropriate tube, through proper food selection and preparation, and with careful monitoring.8,9
Feedings are generally administered every 4 to 6 hours, and feeding tubes should be flushed with 5 to 10 mL (based on size of patient and tube) of water before and after each feeding to minimize obstruction of the tube. At discharge, the number of feedings should be reduced to 3 to 4 times per day to help facilitate pet owner compliance.
A volume of 5 to 10 mL/kg per individual feeding is generally well-tolerated but can vary by patient. Enteral diets are mostly composed of water (most canned foods are already >75% water); thus, the amounts of fluids administered parenterally (including water from pre- and postfeeding flushes) should be adjusted to avoid volume overload. Premature removal of tubes can be prevented by using special collars (eg, Elizabethan) and wrapping the tube securely. Care should be taken to avoid tightly wrapping the tube, as this could lead to patient discomfort and even compromise proper ventilation.