Fluoroscopic wire-guided feeding tube placement in 26 dogs

Abstract

OBJECTIVE: To describe the clinical use of a novel, minimally invasive fluoroscopic technique for the wire-guided placement of nasojejunal tubes (NJT) in dogs. DESIGN: Retrospective study (September 22, 2006-October 2, 2010). SETTING: University veterinary teaching hospital. ANIMALS: Twenty-six consecutive dogs with intolerance of, or contraindications to gastric feeding that underwent attempted fluoroscopic NJT placement. No dogs were excluded from analysis. INTERVENTIONS: All dogs underwent attempted fluoroscopic NJT placement using a novel fluoroscopic wire-guided technique. MEASUREMENTS AND MAIN RESULTS: Patient data were collected in concert with information about the NJT placement procedure as well as the maintenance and utilization of the tube. The primary diagnosis in dogs undergoing NJT placement was pancreatitis in 60%. The ability to achieve transpyloric passage of the tube was 92.3% (24/26) and the ability to achieve jejunal access was 78.2%. In the second half of the study period, the ability to achieve jejunal access was significantly higher than in the first half of the study period suggesting that technical proficiency improves over time. Mean duration of the procedure was 35.3±20 minutes. Significant oral migration was a complication of NJT placement in some dogs. The median duration of feeding was 3.3 days (range 0.3-10.5). CONCLUSIONS: Fluoroscopic wire-guided NJT placement is a viable method for sustained postpyloric feeding in dogs. Success in acquiring jejunal access improves with experience. The NJT may be utilized as a strategy to provide enteral nutritional support to the population of dogs with contraindications to, or intolerance of gastric feeding.