Dr. Phil Zeltzman is a traveling, board-certified surgeon in eastern Pennsylvania and Western New Jersey. His website is www.DrPhilZeltzman.com.
AJ Debiasse, a technician in Stroudsburg, PA, contributed to this article.
Anorexia (when your dog refuses to eat), leads to multiple consequences, including:
- Delayed healing
- Weight loss
- Liver complications (e.g., hepatic lipidosis in cats)
To treat anorexia, veterinarians have several choices:
- Warming food
- Hand feeding
- A diet change to convince patients to eat on their own
- Medications that can stimulate your dog’s appetite.
Force feeding can be implemented, but is not ideal. This can cause food aversion (a disgust for that particular food) and delay spontaneous eating (eating without being forced). IV feeding is available, but is usually pretty involved and, therefore, usually done at a specialty hospital. (By the way, IV fluids mostly provide water, not nutrition as many believe.)
If none of these options are successful or possible, a feeding tube can be placed. Feeding tubes are also necessary with specific medical conditions.
What is a feeding tube?
A feeding tube is a soft tube made of silicone or similar material that allows food to be given to a patient while bypassing the mouth. Depending on the solution chosen by your veterinarian, the tube can enter the body and end up in various locations in the gastrointestinal tract. The type of tube chosen depends upon the condition and illness of your dog. The type of food chosen is determined by your veterinarian and is specific to your dog’s needs.
What are your feeding tube options?
Several feeding tube options are available:
Naso-gastric feeding tube
A naso-gastric tube (NG tube) is a flexible and narrow tube that is placed from a nostril into the esophagus (the tube between the throat and the stomach). This is done with minimal sedation and a local anesthetic (numbing agent) in the nostril. The tube is secured with stitches or sutures. This is one of the simplest and least invasive tubes to place, but is not intended for long-term use. Due to its small diameter, veterinarians can only feed a liquid diet in order to avoid clogging the tube.
Esophagostomy feeding tube
Placing an esophagostomy tube (E tube) requires general anesthesia. A small incision is made in the skin of the neck and the tube is placed into the esophagus. The larger diameter increases our feeding options. This tube can be kept in place longer than an NG tube.
Gastrotomy feeding tube
A gastrotomy tube (G tube) also requires general anesthesia. This tube is placed directly into the stomach. The procedure can be done either with the help of an endoscope or during open belly surgery. If properly cared for, a G tube can be left in place for several weeks to several months. When a long-term solution is needed, the regular, long tube can be replaced with a very short tube called a low-profile tube, which sits almost flush with the skin to help prevent accidental removal. Because this tube is much larger than the others, regular dog food can be used, as long as it is “blenderized.”
Jejununostomy feeding tube
If there is concern about the condition of the stomach, for example, if it needs to be bypassed, we can use a jejununostomy tube (J tube). Its placement requires anesthesia and open abdominal surgery. A narrow tube is placed directly into the upper small intestine. Disadvantages of this tube include:
- Possible clogging
- Nutrition restriction due to the small diameter
- Higher probability of becoming displaced
This tube is not intended for long-term use.
Can feeding tubes cause other complications?
Feeding tubes can be an important part of saving your dog, but as with any procedure, complications are possible. Complications of all tube placements can include:
- Infection at the site of placement
- Accidental removal and clogging
The easiest way to prevent accidental removal of a feeding tube is to avoid having the tube get caught by using an E. collar or a similar device around the dog’s neck.
On rare occasions, gastrostomy and jejununostomy tubes can leak into the abdomen and cause a severe infection.
All options and risks should be discussed with your veterinarian. Nutrition plays an extremely important role in your dog's recovery. Fortunately, we have many options to choose from for your dog’s benefit.
Questions to ask your veterinarian:
- What tricks can I use at home?
- Would medications help my dog eat?
- Is a feeding tube a good solution?
If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.
