Introduction

Naso-oesophageal (NO) and naso-gastric (NG) feeding tubes are widely used in veterinary medicine and there is debate about which tube type is superior. Variable methods to confirm correct placement have been reported but not compared. This prospective study aimed to determine the rate of accidental placement of nasoenteric tubes into the respiratory tract; to determine the optimum method to assess correct placement and to compare the complication rates when using NO and NG tubes.

Methods

Animals requiring nasoenteric feeding tubes during hospitalisation were randomised into either NO or NG tube placement. Negative pressure at thoracic inlet and final site, pH measurement of fluid obtained, capnography, direct visualisation of the pharynx and larynx if possible, fluid administration and response, stomach auscultation at the time of water or air administration, ultrasound of the oesophagus and stomach and thoracic radiographs were performed to assess placement and sensitivity and specificity of each technique was calculated using radiography as the gold standard. To compare complication rates between the two groups, novel onset of vomiting or regurgitation in the first 24 h of the tube placement was recorded and compared between the groups. Mann-Whitney U tests and Kruskal-Wallis tests were used to compare groups.

Results

One hundred animals (84 dogs and 16 cats) were randomised but one cat and two dogs were excluded. The tube was placed into the respiratory tract in 3 cases. Sensitivity and specificity of the methods were as follows; negative pressure at the thoracic inlet (91.46%/33.33%) and final site (94.04%/33.33%), capnography (96.55%/33.33%), fluid administration and response (91.89%/33.3%), stomach auscultation (62.66%/100%), ultrasound of the oesophagus (20.69%/100%) and stomach (20%/100%). There was no significant difference in the complication rate in the NO (rate 51.2%) and NG (rate 58.7%) groups.

Conclusions

Nasoenteric tubes are easy and safe to place with a low rate of misplacement. If radiography is not available or is not indicated for the patient, other tests can be used but no test has 100% sensitivity. In this population, we did not identify a difference in complication rate between NO and NG feeding tubes.

Disclosures

Disclosures to report: This work was supported by the PetSavers—a division of the British Small Animal Veterinary Association.