This study evaluated the efficacy and safety of a novel technique for placing esophagostomy feeding tubes (e-tubes) in client owned dogs who were unable to voluntarily consume adequate calories and nutrients.
E-tube placement was performed under general anesthesia. The distal end of the e-tube was advanced to the lower esophageal sphincter. A tunneler device was advanced into the esophagus until the tip was palpated dorsolaterally from the jugular groove. Soft tissues were dissected, and the tip was advanced through the skin. The proximal end of the e-tube was connected to the distal part of the tunneler device. The tunneler was pulled caudally, bringing the proximal end of the e-tube outside the patient. Correct placement of the e-tube was confirmed, and the e-tube was secured to the skin. Statistical analysis was performed to compare time of e-tube placement against patient body weight and e-tube size.
30 dogs were enrolled, with a median weight of 19.7kgs (range 2.75-35.5 kgs). Median placement time was 262.5 seconds (range 78-635 seconds). Placement time was significantly (p = 0.045), but weakly (r2 = 0.14) associated with patient body weight. There was no difference in placement time between different sizes of e-tubes (p = 0.33). Median duration of e-tube placement was 21 days. The e-tube was removed in one patient due to infection, and minor complications were observed in 3 other patients.
This study confirms the ease, speed, and safety of a novel methodology of e-tube placement. Further analysis is needed to compare adverse effects and placement time of different e-tube placement methods.
Staff Internist and Director of Extracorporeal Therapies
Friendship Hospital for Animals
Dr. Foster graduated from the University of Pennsylvania School of Veterinary medicine. After working in small animal private practice, he went on to complete an internship at VCA Norwalk, followed by an internal medicine residency at the University of Wisconsin. His training in extracorporeal therapies was achieved from UC-Davis, where he was the first long-distance nephrology fellow under the training of Dr. Larry Cowgill. For four years, he was faculty at the University of Pennsylvania School of Veterinary Medicine, where he reopened an extracorporeal service providing hemodialysis, hemoperfusion, and plasma exchange. He now is a staff internist at the Friendship Hospital for Animals in Washington, DC, where he opened a new extracorporeal therapies service. Dr. Foster is currently a resident in clinical pharmacology, with a research focus on altered drug pharmacokinetics in patients with renal disease. His research interests include nontraditional uses of extracorporeal purification, acute kidney injury, and glomerulonephritis.
Wednesday, June 13
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Thursday, June 14
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