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Endoscopically guided nasojejunal tube placement in dogs for short‐term postduodenal feeding
Authors:Kinga Pápa DVM  Roland Psáder DVM  Ágnes Sterczer DVM  PhD  Ákos Pap PhD  DSc  Minna Rinkinen DVM  PhD  Thomas Spillmann Dipl Vet Med  Dr Med Vet
Institution:1. Department and Clinic of Internal Medicine, Faculty of Veterinary Science, Szent István University, H‐1078 Budapest, Hungary,;2. MáV Hospital, H‐1062 Budapest, Hungary, and;3. Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Fi‐00014 Helsinki, Finland
Abstract:Objective – To evaluate a method for endoscopically guided nasojejunal tube placement allowing short‐term postduodenal feeding and chyme withdrawal in dogs. Design – Pilot study. Setting – University teaching hospital. Animals – Three healthy Beagle dogs with jejunal nipple valve fistulas. Interventions – After the dogs were anesthetized, an 8 Fr, 250‐cm polyvinyl chloride catheter was advanced through a gastroscope into the jejunum. Correct jejunal placement was established using endoscopic visualization and confirmed by fluoroscopy and radiography. The proximal end of the tube was pulled out through 1 nostril and sutured to the skin of the forehead. Thereafter, jejunal feeding was administered for 4 days. Follow‐up examinations included daily confirmation of the tube's position using radiography, physical examination, and blood analyses. Withdrawal of jejunal chyme was performed after jejunal and oral feeding. Measurements and Main Results – Fluoroscopic examination confirmed that endoscopic visualization alone allowed correct jejunal placement. During a 4‐day postduodenal feeding period, repeated radiographic examination revealed stable positioning of the tubes within the jejunum with minor cranial displacement. The tubes were functional throughout the study without causing identifiable problems. Repeated physical examinations and blood analysis showed no abnormalities. We were able to administer the daily caloric requirements as a liquid diet. Jejunal chyme was successfully withdrawn via the tube. Conclusions – Endoscopically guided nasojejunal tube placement was shown to be a minimally invasive, well‐tolerated method for short‐term jejunal feeding in healthy dogs. This technique is a viable option for dogs requiring jejunal feeding but not laparotomy. The feasibility of chyme sampling is another unique application of the procedure.
Keywords:endoscopy  enteral nutrition  enteral tube insertion  nasoenteric feeding tubes
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