Esophageal feeding tube placement and the associated complications in 248 cats

Abstract

Background Esophageal feeding tubes are commonly used to provide enteral nutrition to cats, but their use is associated with adverse effects. Objectives To evaluate the complications associated with e‐tube placement in cats and to identify factors predisposing to these complications. Animals Cats that had an esophageal feeding tube placed (n = 248). Methods This was a retrospective case review in which clinical records were interrogated across 2 referral centers to identify records of cats that had esophageal tubes placed. Clinical data were collected for signalment, clinical indication, method of placement, time of removal, and any complications. Logistic regression was then employed to assess the odds of an increase in complications, including infection and death. Results For those cats that survived to discharge, tubes were in place for a median of 11 days, ranging from 1 to 93 days. Complications occurred in 35.8% of the cats, with the most common being tube dislodgement (14.5%), followed by stoma site infections (12.1%). Cats receiving glucocorticoids or oncolytic agents (OR = 3.91; 95% CI, 1.14‐13.44) and with discharge at the stoma site (OR = 159.8; CI, 18.9‐1351) were at an increased odds of developing a stoma site infection, whereas those with a lower weight (OR = 1.33; 95% CI, 1.02‐1.75) or (pancreatic [OR = 4.33; 95% CI, 1.02‐18.47], neoplastic [OR = 15.44; 95% CI, 3.67‐65.07], respiratory [OR = 19.66; 95% CI, 2.81‐137.48], urogenital [OR = 5.78; 95% CI, 1.15‐28.99], and infectious diseases [OR = 11.57; 95% CI, 2.27‐58.94]) had an increased odds of death. The duration of time in place and the cat being discharged with the tube in place were not associated with an increased risk of infection or death. Conclusions and clinical importance Owners should be made aware of the potential risks involved and their predisposing factors.

Development of alternating, ipsilateral Horner syndrome and Pourfour du Petit syndrome associated with oesophagostomy tube placement in a cat

“…2 A review of complications associated with O-tubes in 248 cats found that the most common complications were infection of the stoma site, self-removal by the patient or dislodgement. 7 The subsequent swelling and inflammation sustained by the vagosympathetic trunk and surrounding tissue secondary to the tension placed on the tissues during O-tube placement could have led to irritation of the nerve fibres, causing sympathetic hypersensitivity and ipsilateral Pourfour du Petit syndrome. The complete resolution of ocular abnormalities 24 h after O-tube removal further supports the likelihood that the ocular abnormalities were related to O-tube placement.…”

Oesophagostomy tube complications in azotaemic dogs: 139 cases (2015 to 2019)

“…Another potential predisposing factor for infection may be represented by the bandage at the o‐tube stoma (Breheny et al . 2019). In our cohort of patients, the use of haemodialysis was strongly associated with a higher risk of o‐tube related complications (P=0.00; OR: 40.12; 95% CI: 9.18 to 175.2).…”

“…Recent reviews on dogs and cats with o‐tubes for different diseases reported a prevalence of complications raging between 35.9% (Breheny et al . 2019) and 45.5% (Nathanson et al . 2019), with a similar rate in the two species.…”

“…In cats, o‐tube dislodgement was the most frequent complication, followed by stoma infection (Breheny et al . 2019). In both species, the majority of o‐tube complications were considered minor and easy to manage.…”

Characterization of Fungal Colonization of Indwelling Esophagostomy Tubes

“…The cellulitis was refractory to extensive medical management, but it resolved immediately after replacement of the tube. In one recent retrospective evaluation of E-tubes in cats [12], the top two complications identified were tube dislodgement and stoma-site cellulitis. Unfortunately, data regarding tube colonization were not reported.…”