Enteral feeding via a gastrostomy tube is indicated for long-term nutritional support of patients that have functioning gastrointestinal tracts but are unable to ingest adequate calories. Percutaneous endoscopic gastrostomy (PEG) tubes are frequently used but have several inherent disadvantages, including a bulky external portion that is aesthetically displeasing to owners and the potential for the tube to be removed by the animal. These disadvantages were largely overcome with the development of a low-profile gastrostomy device (LPGD). These devices are made of chemically inert silicone, and placement requires an established gastrocutaneous fistula made by a previously placed gastrostomy tube. Little information has been available, however, evaluating long-term use, complications, and owner impressions of these tubes.
In this study, authors reviewed records of dogs that had placement of a PEG tube followed by an LPGD over an 8-year period. Fifteen dogs had 29 devices placed for a variety of disorders. Median duration of placement was 212 days. The most common reason for replacement of an LPGD was persistent leakage through its 1-way antireflux valve. A total of 36 complications was observed: 23 were secondary to the LPGD, 1 was possibly related to the feeding process, and 12 were probably related to the patient's underlying disease. Most complications occurred more than 15 days after placement and did not create a health risk to the patient. Overall, the 14 owners contacted were highly satisfied. In addition, owners had no problems giving prescribed medications via the tube. While the LPGD has the limitation of requiring an established gastrocutaneous fistula for placement, the authors conclude that this device is a viable option for long-term enteral feeding of dogs.
COMMENTARY: Low-profile gastrostomy devices offer the practitioner an excellent tool for managing long-term dietary requirements in debilitated patients. Owners who have become frustrated with traditional PEG tubes (dogs can become very adept at yanking them out) will likely welcome the advantages of a low-profile device. Practitioners who have not used these devices will also be satisfied with the technical ease of placement and maintenance in their patients. A similar study for patient and owner acceptance of such feeding devices in cats would be a useful addition to this study in dogs.
Owner experiences and complications with home use of a replacement low profile gastrostomy device for long-term enteral feeding in dogs. Yoshimoto SK, Marks SL, Struble AL, Riel DL. CAN VET J 47:144-150, 2006.