Placement of a radiopaque polyurethane esophagostomy tube in a yellow-footed tortoise (Chelonoidis denticulatus) using MILA's tunneler device.

Abstract

OBJECTIVE: To describe placement of a radiopaque polyurethane esophagostomy tube in a tortoise using MILA's tunneler device. ANIMALS: A 20-year-old 4.235-kg spayed female yellow-footed tortoise (Chelonoidis denticulatus) was presented for egg coelomitis and feeding tube placement. METHODS: A polyurethane esophagostomy tube (18 French; MILA International Inc) was advanced orally into the stomach. The small end of a tunneler device (MILA International Inc) was placed into the oral cavity and advanced into the midcervical esophagus. The tube exiting the mouth was attached to the opposite end of the tunneler. An incision was made into the left lateral cervical skin and underlying esophagus, allowing the tunneler and tube to be pulled through the incision until the tube was lying linearly. Radiographs confirmed appropriate placement, and the tube was sutured in place and flushed with water to ensure patency. RESULTS: The esophagostomy tube was successfully placed and utilized to provide nutrition for 42 days following treatment. CLINICAL RELEVANCE: Benefits of the MILA esophagostomy tube system in chelonians include the use of polyurethane tubes and the tunneler device. MILA's polyurethane tubes are preferred because of their radiopaque stripe, large luminal diameter, increased flexibility, and long-term biocompatibility, decreasing the risk of placement errors and esophageal injury. The increased length and small diameter of the tunneler device (compared to a Carmalt) allow for ease of placement with chelonian anatomy. These qualities may mitigate commonly observed risks to chelonians such as displacement and obstruction of esophagostomy tubes, gastrointestinal perforation, hemorrhage, and tube site infections.