January 2016

In this VETgirl online veterinary CE blog, we demonstrate how to place an esophagostomy tube (E-tube) in a cat. You can read more about it at our blog here.

The benefit of placing E-tubes in veterinary medicine include the following:

–        Easy to place

–        Have large diameters to feed through

–        Can be removed easily

–        Can be used in by the owners once the patient is discharged for home care

–        Have few serious complications

These should be placed under general anesthesia, with the patient intubated and placed in right lateral recumbency. The left lateral and ventral cervical area should be clipped and an aseptic preparation performed. Care should be taken to identify (and avoid) the jugular vein. For cats, a red rubber or silicone tube can be used, ranging from 10-14 French. The feeding tube should be pre-measured  from the site of placement to the 7-8th intercostal space. A curved hemostat (Kelly or Carmalt) should be introduced per os into the proximal esophagus. Pressure is applied to press the tip of the forceps against the skin caudal to the ramus of the mandible.

A stab incision is made through the skin and subcutaneous tissue over the tip of the forceps being careful to avoid the jugular vein. The forceps is pushed through the small stab incision and the feeding tube is grasped. The feeding tube is then pulled into the esophagus and out the mouth. The tube must be then turned around so it goes directly down into the esophagus. It should be manually pulled out through the mouth and turned directly back down the esophagus.  The feeding tube is advanced to the previously marked position and secured using a purse string and Chinese finger trap suture. This should be secured in place with a light bandage and a lateral neck/chest radiograph should be performed to ensure proper placement.

P.S. When in doubt, we ideally no longer use these spring-loaded mouth gags (as demonstrated in this older video), so if you have them in your clinic, consider accidentally throwing them in the recycling bin. That’s because they have been associated with blindness. Check out this reference here.

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  1. Richard says:

    I have had two cats which had (one still has since he’s only been on it for a day at this point) with esophagostomy tubes placed in them. The first was a girl which was naturally slighter in build. She could take 10ml each time with shorter intervals (8 – 10 seconds). The boy (the one who’s still on the tube) seems to gag and vomited everything out on the first feeding, based on that speed so now I’ve slowed it down to 5ml every 15 – 20 seconds and he seems fine with that. Has kept everything in so far and is actually showing an improvement after 4 feedings, 39 hours after tube placement.

    What I’m wondering is whether it’s the individual patient’s tolerance or the tube was cut too short with the end higher up the esophagus than the first patient?

    • vetgirl says:

      Due to the volume of emails we receive as a continuing education platform, not a consulting platform, we are unable to respond to individual medical questions. We recommend speaking to your primary care veterinarian or your local specialty hospital for individual case advice.

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  3. Kenia Andrade says:

    Minha gatinha está internada e querem cobrar a sonda nasogastrica e a anestesia à parte, podem fazer isso?

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