How to Place an Esophagostomy Tube in a Cat 

January 2025

In this VETgirl online veterinary continuing education video, we demonstrate how to place an esophagostomy tube (E-tube) in a cat. Placement of these tubes can help with provision of long-term enteral nutrition to our feline patients that are either disinterested or unable to eat. Patients are placed under general anesthesia and positioned in right lateral recumbency with the left neck shaved and aseptically prepared. A 10-14 French red rubber or silicone feeding tube is selected and measured from the intended site of insertion to the 7-8th intercostal space. Curved hemostats are inserted though the mouth and pressure applied downward to the handle, elevating the skin at the intended site of insertion in the lateral neck. Using a scalpel blade, incise over the hemostat tips through skin and esophagus, taking care to avoid the jugular vein. Grasp the distal end of the E-tube firmly and pull this through the skin and orad (“towards the mouth” or “cranially”) until the only the tip of the tube has been pulled out the mouth.

Photo courtesy of VETgirl; Demonstration of hemostats pulling e-tube through the mouth

Next, redirect the tip of the E-tube to aim back towards the esophagus, clamp the distal tip firmly, and advance the E-tube aborad (“away from the mouth” or “caudally”) down the esophagus and beyond the insertion point. Often you will appreciate the feel of the tube flipping as the E-tube advances beyond the insertion point. Advance the E-tube to the premeasured length, secure the tube with a purse string and finger trap suture, and obtain radiographs to assess placement position. Some prefer to confirm placement to modify insertion point prior to securing the E-tube in place. Finally, the E-tube is wrapped or covered with a light bandage or dressing.

Finger trap securing an E-tube in place in a cat

When appropriate (e.g., the patient is recovered, signs of gastrointestinal distress are resolved), the patient can be started on a liquid diet (e.g., Recovery) or a grueled canned food (depending on the size of the feeding tube). Please note for instructional purposes, medical specimens were used.

Royal Canin Recovery Liquid Diet Types

For tips on how to perform the finger trap suture pattern, check out this VETgirl video.
For additional resources on how to place an E-tube, read along with this VETgirl blog or follow along with another VETgirl video.

This specialized education is brought to you by an exclusive partnership between VETgirl and the BluePearl EmERge program. The BluePearl EmERge program is an immersive emergency veterinarian training program, putting you on the fast track to becoming a highly experienced, confident, and capable emergency veterinarian, ready to provide lifesaving care for pets in need. The program gives you everything you need for a successful career in emergency medicine, including the critical, hands-on experiences, immersive training and personal mentorship needed to thrive. The EmERge program is for new graduates or practicing veterinarians interested in transitioning to emergency medicine. For more information about the program visit https://careers.bluepearlvet.com/us/en/emerge-program.

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