Yesterday we learned the theory of how to place an esophagostomy tube. We saw a video of a tube placement on a cadaver dog, but haven’t actually gotten hands-on experience in this area yet. (We may all get to do so before we graduate, though.)
What’s an esophagostomy tube? It’s a feeding tube that goes in through an incision in the animal’s neck, into the esophagus. It is used for animals that will not or cannot eat normally, but can keep food down. So you might use it in an animal with bad facial fractures which cannot move its jaw; you would not use it in an animal which had uncontrolled vomiting (all the food would come right back up).
How do you place it? Put the animal under general anesthesia. Put some forceps into the animal's mouth, into the esophagus. Make an incision in the animal’s neck, right over the esophagus. Poke the foreceps through the esophagus and out the hole in the neck. (Dr. Libbe said at this point: “This part seems kind of scary at first, but it does work!”) The forceps are strong enough to poke through the esophagus and make a hole, but not strong enough to poke through the skin and muscle, which is why you make the incision.
Take the feeding tube and thread it in through the hole in the neck, grab it with the forceps, and pull in out the animal’s mouth. Now you have a tube from outside of the mouth to outside of the neck — not so useful! So turn the mouth-end of the tube around and thread it back down the esophagus in a little loop. When it passes the incision you’ve made, it will lie a little further down the esophagus, and now it is in place: you have a tube passing from outside the neck to inside the esophagus. Suture the tube in place, and you are all done.
What I did yesterday: Two hours of zoo medicine lecture (reptiles). Lunch! (I exercised outside; it was a lovely day. I also did my ethics reading.) Two hours of small animal medicine and surgery lecture (nutritional support). Two hours of ethics lecture/discussion (euthanasia). Home!
Saturday, August 28, 2010
Subscribe to:
Post Comments (Atom)
Poking through the whole through the esophagus does sound scary.
ReplyDeleteHow do the animals react to the feeding tube? How long does the tube stay in?
I can't remember if that lecture covered how animals tolerate a feeding tube, so I'm not going to try to answer that one, sorry!
ReplyDeleteThe tube stays in as short a time as possible; it is better for the animal to be eating on its own. The animal can eat on its own with the tube in, so you can watch to see when the time is right. On the other hand, you really don't want to pull the tube after one successful meal and then have the animal stop eating again (so that you'd have to place another tube in an already-damaged esophagus -- I don't even know if you would try that). So you want to be very sure before you pull the tube. Hope that answers your question.