Retrospective study of complications associated with surgically‐placed gastrostomy tubes in 43 dogs with septic peritonitis

Abstract

Objectives:To determine the safety of surgically-placed gastrostomy feeding tubes in dogs with septic peritonitis.Materials and MethOds: Retrospective analysis of 43 dogs with septic peritonitis that had undergone surgical exploration and gastrostomy tube (de Pezzer or Foley) placement as part of the surgical procedure. Postoperative recovery times, hospitalisation times, complication rates and overall survival times were documented. results: The most common cause of septic peritonitis was dehiscence of an enterotomy or enterectomy site. Fifteen dogs had a Foley gastrostomy tube placed and 28 had a de Pezzer gastrostomy tube placed. The median time from surgery to the start of enteral nutrition was 16 hours (range 3 to 28 hours). There were no major complications relating to the gastrostomy tube; minor complications occurred in 11 (26%) patients. The overall median time spent in hospital was 5 days (range 3 to 29 days) for patients surviving to discharge and 22 (51%) dogs survived overall.clinical significance: Gastrostomy feeding tubes provide a safe way to provide enteral nutrition to dogs with septic peritonitis; they are associated with a low complication rate in these patients.

Management and outcomes of 13 dogs treated with a modified Heller myotomy and Dor fundoplication for lower esophageal sphincter achalasia‐like syndrome

“…Previous studies with surgically placed gastrostomy tubes have reported a minor complication rate of 26%-75%, a major complication rate of 0%-25%, and an overall complication rate as high as 33.3%. 29,30 In our study, 2/12 dogs developed minor complications, which is similar to previous reports; major complications occurred in 4/12 dogs and overall complications occurred in half the dogs that survived to discharge, both higher than previous reports. 29,30 The high tube complication rate warrants further investigation.…”

“…29,30 In our study, 2/12 dogs developed minor complications, which is similar to previous reports; major complications occurred in 4/12 dogs and overall complications occurred in half the dogs that survived to discharge, both higher than previous reports. 29,30 The high tube complication rate warrants further investigation. The 4 major tube complications in this series of dogs appear to be unrelated in mode of failure.…”

“…However, despite complications, gastrostomy tubes in these dogs allowed improved nutritional support by bypassing the surgical site to support tissue healing. Previous studies with surgically placed gastrostomy tubes have reported a minor complication rate of 26%‐75%, a major complication rate of 0%‐25%, and an overall complication rate as high as 33.3% 29,30 . In our study, 2/12 dogs developed minor complications, which is similar to previous reports; major complications occurred in 4/12 dogs and overall complications occurred in half the dogs that survived to discharge, both higher than previous reports 29,30 .…”

“…Despite surgical intervention and recovery from surgery, dogs with megaesophagus continue to be predisposed to aspiration pneumonia as apparent from the dog that developed aspiration pneumonia approximately 1 year after surgery. 21,29,[33][34][35] The limitations of this study are related to the retrospective nature and reliance on the accuracy of medical records, including the records of 3 dogs that survived to discharge and did not have postoperative VFSS rechecks. Significant geographical distance from the referral institution made rechecks impractical for some.…”

“…One dog experienced leakage around the tube, which has previously been reported as a potential complication of gastrostomy tubes 29,30 . The tube that came loose and required the tip to be cut has been reported as a complication; 29 however, the reason for tube loosening could not be determined because the dog was assessed elsewhere. In that dog, the presumed mode of failure was slippage through the 4 friction sutures used to anchor the tube to the body wall, which has been described as the primary mode of failure for gastrostomy tubes anchored with 4 friction sutures 11 .…”