Esophageal feeding tube placement and the associated complications in 248 cats

• Published in: Journal of veterinary internal medicine Vol. 33; no. 3; pp. 1306 - 1314
• Main Authors: Breheny, Craig R., Boag, Alisdair, Le Gal, Alice, Hõim, Sven‐Erik, Cantatore, Matteo, Anderson, Davina, Nuttall, Tim, Chandler, Marjoie L., Gunn‐Moore, Danièlle A.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-05-2019; Wiley
• Subjects: Animals; Anorexia; Antimicrobial agents; Bacteria; Body Weight; Cat Diseases - surgery; Cats; Cellular biology; Complications; Conflicts of interest; Death; Enteral nutrition; Enteral Nutrition - adverse effects; Enteral Nutrition - methods; Enteral Nutrition - veterinary; esophagostomy; Esophagostomy - adverse effects; Esophagostomy - veterinary; Esophagus; E‐tube; Feeding; Female; Gas discharge tubes; Glucocorticoids; Health risks; Illnesses; Infections; Male; Nutrition; Oncolysis; Ostomy; O‐tube; Pancreas; Parenteral nutrition; Postoperative Complications - etiology; Postoperative Complications - mortality; Postoperative Complications - veterinary; Retrospective Studies; SMALL ANIMAL; Veterinarians; Veterinary medicine; esophagostomy; O-tube; E-tube
• ISSN: 0891-6640; 1939-1676
• DOI: 10.1111/jvim.15496

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.