Inadvertent Intracranial Nasogastric Tube Placement Causing Traumatic Brain Injury in a Neonatal Cat

A 20-day-old, 0.26 kg intact female domestic shorthair kitten was presented for evaluation of labored breathing and decreased appetite. Physical examination and thoracic radiographs were consistent with bronchointerstitial pneumonia, and the cat was hospitalized and treated with antibiotics, oxygen therapy, and nutritional support through a nasogastric tube. Mild resistance was encountered during nasogastric tube placement before advancement to the premeasured length. Lateral thoracic radiographic examination of the thorax, neck, and head suggested the nasogastric tube had entered the calvarium through the cribriform plate and had become coiled. The nasogastric tube was immediately removed, with no acute decline in the kitten's neurologic status; however, the kitten ultimately died secondary to suspected respiratory failure. Postmortem magnetic resonance imaging and necropsy confirmed the presence of severe pneumonia and marked cerebral and midbrain hemorrhage secondary to traumatic intracranial nasogastric tube placement.