Kindred Spirit Kindred Care, LLC.

Shannon Fujimoto Nakaya, DVM


Complementary and adjunct care for dogs and cats with special needs.

Feeding tubes

Life support for the patient that can't or won't eat and/or drink

Written by Shannon Fujimoto Nakaya, DVM


The suggestion of a feeding tube tends to elicit dramatic responses from people. Perhaps it is the infamous cases where a human in a persistent vegetative state (minimal brain activity) has been kept alive for years or even decades. Most people can't envision this type of existence for themselve, much less their beloved animal companions. Perhaps it is because food and eating have such strong social meanings in our society; that we eat not only for survival, but also for pleasure. Perhaps it is the idea that their pet who never turned down a morsel before is actually making a statement about its desire to carry on. But what if a patient appears to be carrying on and enjoying life except for the fact that it can't or won't eat. What if it has severe dementia affecting its ability to swallow? What if it has an oral tumor? What if it has lost its senses of smell and taste so that food no longer sparks and appetite? If the patient otherwise has a good quality of life – it enjoys its walks, connects with its people, breathes comfortably, is physically and emotionally comfortable, and generally seems happy to be alive – a feeding tube could be an option to starvation or euthanasia.

 

Feeding tubes can decrease the amount of time and effort needed for getting appropriate amounts of food, water, and medications into a patient that is otherwise enjoying life.

 

 

There are different types of feeding tubes.  Feeding tubes do not prohibit or prevent a patient from eating or drinking on their own; it just provides an alternative means of getting calories and fluids into the patient. Feeding tubes are named according to where they enter the gastrointestinal tract (GIT). The table below describes the different types of feeding tubes and the advantages and disadvantages of each.

 

Feeding tube

insertion site

advantages

disadvantages

Nasogastric

Goes in the nose and to the stomach.

Insertion does not require anesthesia.

 

Less well tolerated by the patient and usually requires an ecollar to keep them from fussing with it. Very fine tubing only allows for liquid diets.

Esophagostomy

Goes in the esophagus at the lower part of the neck and to the stomach.

Generally easy insertion.

Generally very well tolerated and easy to maintain.

Tube allows for a slurry to be fed with relative ease and speed. Also makes for easier administration of medications.

Easy (at home) removal if desired or necessary.

Short anesthesia required.

Tube exits through a hole in the side of the patients neck. Dressing (like a cervical collar) needs to be changed once or twice a week.

Occasionally tube will get plugged (more in cats) and need to be “roto-rootered.”

Can be awkward, though not life-threatening, if the patient vomits.

Gastrostomy

Goes through the body wall into the stomach.

Cannot vomit the tube out.

Allows for placement of larger tubes which allows for thicker slurries to be adminsitered, making it better for larger animals.

Anesthesia required for placement.

Slightly more difficult to manage, mostly because the tube is thicker and can't be bandaged up so easily. Slightly higher risk of complications as it goes through the body wall and into the stomach.

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Comments on Feeding Tubes

Posted by Trudy on
We had a German Shepherd, Ebonwolf, who at 9 mos. was diagnosed with ME, as the months progressed his esophagus kept enlarging. We used a Bailey Chair for all his meals and still he kept regurgitating his food. In May of 2014 he had emergency surgery as his stomach and spleen had herniated up into his esophagus. Every specialist we saw stated his ME was the most impressive they had seen, ( read: the worst, the largest they had seen). Within 2 months he was regurgitating every meal and losing weight, after talking with a GI specialist we had a PEG tube placed as it was our last resort to keep Ebon fed and healthy. If I had the knowledge I have now, I would have never done this. To eat, to drink, it is so important to a dog. We watched our beloved puppy lose interest in everything. We allowed him to eat ice cubes in hope that it would help. As the Vet said, regurgitating water is far less likely to cause AP, (aspiration pneumonia). It helped a little, but not enough. By the end of July his was regurgitating almost everything we fed him by tube. By then he had lost 30 lbs. from when he was at his healthiest and we could see he had given up. So on July 31, 2014 at 4 am he was put to sleep, he was only 20 months old. All I can say is, think it through before having a feeding tube placed as it takes away one of the most important parts of their life, to taste, to chew, it’s an integral part of them. If it’s temporary, no problem, I would do it again, but if it’s to be the way to feed them the rest of their life, then no, I would never ever do it again.
Posted by shannon nakaya, dvm on
my sympathies for a difficult journey. you bring up a good point. feeding tubes do NOT alleviate regurgitation, nausea, or vomiting. in fact, they can make it worse. feeding tubes in patients with uncontrolled regurgitation or nausea is generally not recommended. feeding tubes into tissues that are not right, whether it is megaesophagus or cancer, is at much higher risk for complications and is also not recommended.

thank you for sharing. although it does not change your dog's journey, perhaps the information will help someone else navigate through a similar situation.

sfnakaya, dvm
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