A Nonsurgical Method for the Placement of Transpyloric (Nasoenteric) Feeding Tubes Using Fluoroscopic Guidance in...

Transpyloric tube feeding is a commonly used form of nutritional support when patients are unable to tolerate oral or gastric feeding. Although nasoenteric placement of transpyloric feeding tubes is usually accomplished in humans, anatomic variations in laboratory species have necessitated surgical laparotomy for transpyloric tube placement. We have developed a reliable fluoroscopic technique for the nonsurgical placement of transpyloric feeding tubes in dogs. This technique was developed in an experimental setting and currently is being used in the treatment of canine patients at the Auburn University College of Veterinary Medicine Small Animal Clinic. After nasal passage of a weighted 8-French feeding tube with stylet into the stomach, dogs are placed in sternal recumbency, and the tube is advanced toward right side of the fundus under fluoroscopic visualization. The animal is then placed in left lateral recumbency, and the stomach is insufflated with 20-30 ml/kg air through the tube. The pylorus is visualized as air passes from the stomach into the proximal small intestine, and the tube is advanced across the pylorus and into the proximal intestine. Placement has been successful in anesthetized and awake animals and in dogs with a variety of illnesses. Complications include bile leakage from the externalized opening of the tube, with subsequent cellulitis and retrograde movement of the tube when placement is proximal to the caudal duodenal flexure. This technique can be used in clinical veterinary medicine and nutritional research studies involving canine models and avoids abdominal surgery for the placement of intestinal feeding tubes.