Evaluation of surgically placed gastrojejunostomy feeding tubes in critically ill dogs.

Abstract

OBJECTIVE: To evaluate complications and outcomes associated with surgical placement of gastrojejunostomy feeding tubes in dogs with naturally occurring disease. DESIGN: Prospective study. ANIMALS: 26 dogs. Multiple preoperative, intraoperative, and postoperative variables were evaluated. Daily postoperative abdominal radiographic examinations were performed to determine the presence of the following mechanical tube complications: kinking, coiling, knotting, and migration. Tube stoma abnormalities (erythema, cellulitis, and discharge) were observed daily and recorded by use of a standardized visual analog grading scale. Additionally, presence of complications was compared with median survival times. RESULTS: The most common indication for gastrojejunostomy tube placement was gastrointestinal disease (n = 11), with confirmed septic peritonitis in 8 of 11 dogs. Other indications for gastrojejunostomy tube placement included extrahepatic biliary surgery (n = 6) and pancreatic disease (9). Mean +/- SD surgical time required for tube placement was 26 +/- 14 minutes. Overall, mechanical tube complication rate was 46% (12/26), including coiling (7), migration (4), and kinking (2). Overall minor tube stoma complication rate was 77% (20/26) and included erythema (16), cellulitis (13), and discharge (17). Dislodgement or self-induced tube trauma resulted in accidental tube removal in 2 of 26 dogs, and inadvertent tube damage necessitated premature removal by the clinician in 1 of 26 dogs. Kaplan-Meier median survival time was 39 days with 13 of 26 dogs still alive. CONCLUSIONS AND CLINICAL RELEVANCE: Gastrojejunostomy tube placement affords flexibility in the postoperative nutritional regimen by allowing for postgastric feeding with simultaneous access to the stomach.