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Inadvertent Insertion of a Nasoenteric Feeding Tube Into the Brain of an Anesthetized Persian Cat
Federico Gianolli1, Lea Carisch1, Katrin Melanie Beckmann1
1Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Insights
A rare case of a nasogastric tube accidentally inserted into a cat
Area of Science:
- Veterinary Neurology
- Surgical Complications
- Brachycephalic Animal Medicine
Background:
- Nasogastric tube placement is a common supportive care procedure in veterinary medicine.
- Brachycephalic breeds present unique anatomical challenges for tube placement.
- Complications, though rare, can be severe.
Observation:
- A Persian cat undergoing surgery experienced respiratory distress immediately after nasogastric tube insertion.
- The tube could not be located in the stomach, and neurological signs developed.
- Magnetic resonance imaging confirmed intracranial placement of the nasogastric tube.
Findings:
- This case represents the first documented instance of nasoenteric tube misplacement into the brain of a feline.
- The misplacement occurred despite careful technique in an anesthetized brachycephalic cat.
- Intracranial tube placement led to fatal central nervous system lesions.
Implications:
- Highlights the critical need for vigilance during nasogastric tube placement, especially in brachycephalic animals.
- Suggests the potential for similar, unreported incidents in veterinary practice.
- Emphasizes the importance of advanced imaging for diagnosing suspected tube misplacement complications.
Objective:
To describe the inadvertent insertion of a tube intended for nasogastric placement into the brain of an anesthetized brachycephalic cat.
Case Summary:
A 7-year-old Persian cat underwent a cholecystectomy for emergency surgical management of biliary obstruction, with postoperative placement of a nasogastric tube planned for nutritional support. General anesthesia with spontaneous breathing was administered, and the surgical procedure was performed without adverse events. At the end of the surgical procedure, while the anesthetized cat was in dorsal recumbency, a 5-French polyurethane nasogastric tube with a stylet was inserted into the right nostril. Immediately after insertion, the patient experienced apnea and required hemodynamic and ventilatory support. Because the tube could not be palpated in the stomach, apnea persisted, and the patient ultimately failed to regain consciousness, a CNS lesion was suspected, and magnetic resonance imaging of the head was performed. Lesions consistent with nasogastric tube insertion into the brain were diagnosed, and because the prognosis was believed to be grave, the cat was euthanized.
New Or Unique Information Provided:
Few reports of nasoenteric tube insertion into the brain of humans are available. To our knowledge, this is the first report of a nasoenteric tube insertion into the brain of a dog or cat.
