Use of feeding tubes in 112 cats in an internal medicine referral service (2015–2020)

Abstract

Objectives The aims of this study were to describe diseases, complications and outcomes associated with the use of feeding tubes in a population of sick cats with appetite disturbance managed at an internal medicine referral service. Methods Clinicopathological data from cats receiving nasoenteral (NE) or oesophagostomy (O) tubes were studied. Cats were categorised according to their underlying disease and divided into subgroups (NE or O tube). The following factors associated with survival were analysed: disease category, type of tube and return to appetite. Results Included in the study were 112 cats, representing 118 cases. Of the 118 cases, 98 (83%) and 20 (17%) received NE or O tubes, respectively. The most common underlying conditions were digestive (13.5%), hepatobiliary (11%) and upper urinary tract (11%) disorders. Hepatobiliary (50%) and upper respiratory tract (30%) conditions were predominant in the O tube group. Digestive (15%) and upper urinary tract (12%) diseases were more common in the NE tube group. Complications following tube placement occurred in 22/118 cases (18.6%). The global survival rate was 73% and did not differ between NE (71.4%) and O tube (80%) groups ( P = 1.00) or disease categories ( P = 0.61). Return of appetite before feeding tube removal occurred in 56 cases (47%), within a median of 3 days (range 1–30) and was not associated with mirtazapine administration ( P = 1.00). Appetite returned earlier for cats with NE tubes (3 days, range 1–17) than for those with O tubes (33 days, range 5–60; P <0.05). Voluntary food intake was positively associated with survival (odds ratio 15.17). After discharge and feeding tube retrieval, return of appetite was observed in 67% of cases. Conclusions and relevance Feeding tubes were predominantly placed for the management of appetite disturbance in cats with digestive, hepatobiliary and upper urinary tract diseases. While complications were frequent, they were mostly mild, easily managed and did not preclude feeding tube use. Return to appetite occurred in a large proportion of cats during or after assisted enteral feeding and was associated with survival.

Tolerability of naso‐esophageal feeding tubes in dogs and cats at home: Retrospective review of 119 cases

“…4 However, in our study, the median total duration of NFT placement was 8 days, and some animals tolerated the tubes up to 22 days. Moreover, some other studies evaluating the use of NFT report duration times longer than current recommendations, up to 17 days in cats 15 and 18 days in dogs. 16 Spontaneous return of appetite while wearing NFT at home was observed in 62.2% of cases, showing that a large majority of animals were able to eat despite the presence of feeding tubes, and similar ranges (50%-60.8%) are reported in the literature.…”

“…Moreover, some other studies evaluating the use of NFT report duration times longer than current recommendations, up to 17 days in cats 15 and 18 days in dogs 16 . Spontaneous return of appetite while wearing NFT at home was observed in 62.2% of cases, showing that a large majority of animals were able to eat despite the presence of feeding tubes, and similar ranges (50%‐60.8%) are reported in the literature 15,17 . However, NFT seemed to generate stress or discomfort in several animals, as 60% of dogs and cats who remained anorexic while wearing NFT recovered spontaneous appetite after tube removal.…”

“…Our retrospective study describes the use of naso-esophageal feeding tubes at home in dogs and cats. Few studies report the use of such tubes in both species, [15][16][17][18][19] and only 1 study reports limited data in cats with suspected acute pancreatitis discharged with NFT in place. 18 Our study provides evidence that NFT can be well tolerated at home without life-threatening complications.…”

“…16 Spontaneous return of appetite while wearing NFT at home was observed in 62.2% of cases, showing that a large majority of animals were able to eat despite the presence of feeding tubes, and similar ranges (50%-60.8%) are reported in the literature. 15,17 However, NFT seemed to generate stress or discomfort in several animals, as 60% of dogs and cats who remained anorexic while wearing NFT recovered spontaneous appetite after tube removal. However, discriminating implication of the underlying disease and NFT discomfort as the cause of anorexia can be challenging for owners and veterinarians, and the decision to remove NFT in anorexic animals should be a case-by-case decision.…”

“…These rates were either similar or lower than those reported by other studies. [15][16][17][18][19] Therefore, complications related to NFT does not seem to occur more frequently at home than under the supervision of medical staff during hospitalization. Although the overall complication rate of 65.5% seems quite high, all of these adverse effects were considered minor complications with minimal impact on the quality of life and no lifethreatening adverse effects were reported.…”