TECHNIQUE

Nasogastric and Naso-oesophageal Tube Placement in Rabbits (Disease Investigation & Management - Treatment and Care)

Rabbit with naso-oesophageal tube. Click here for full page view with caption.

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords --
Description A nasogastric tube may be placed for repeated feeding of an anorectic rabbit. The most important limitation is that only liquids can be administered; the tube diameter does not permit passage of adequate long indigestible fibre.
  • Choose a catheter/feeding tube of appropriate size (5 - 8 French, depending on the size of the rabbit).
  • Pre-measure the tube against the rabbit (end of nose to last rib on the left side).
    • End of the nose to the seventh rib for a naso-oesophageal tube. (B539.1.w1, J29.15.w2)
  • Mark the point on the tube to which the tube should be inserted.
  • Instil several drops of topical local anaesthetic solution onto the mucous membranes of the nares.
    • Ophthalmic solution suggested, e.g. proparacaine, Ophthain Solvay Animal Health. (B602.14.w14)
    • Or place lidocaine gel around the nares. (J29.15.w2, J213.1.w1)
  • Wait several minutes for the local anaesthetic to take effect.
  • Apply a small amount of lubricant (or lidocaine gel) to the end of the catheter.
  • Elevate the rabbit's head while first inserting the tube; this makes insertion of the tube easier. (B539.1.w1)
  • Introduce the catheter into the ventral nasal meatus and advance it ventromedially. (B601.2.w2, J29.15.w2, J213.1.w1)
    • Keep the rabbit's head in a normal flexed position once the tube is inserted to help ensure the tube goes into the oesophagus, not the trachea. (B539.1.w1, J213.1.w1)
    • If the rabbit objects, stop, withdraw the tube, and place more local anaesthetic drops into the nasal opening.
  • As the catheter advances into the oesophagus, have the rabbit's neck partially flexed. (B601.2.w2)
  • Advance the tube to the pre-marked point.
  • Secure the tube in place:
    • Attach a piece of butterfly tape to the tube.
    • Suture or tissue glue the tape to the top of the rabbit's head, between the ears. 
    • A drop of tissue glue can be used also to secure the tube on the furred skin above the nares. (J213.1.w1)
  • Take a lateral radiograph to confirm correct placement of the tube.
    • An alternative method is to auscultate for gastric bubbles while injecting 10 - 20 mL of air through the tube. (J213.1.w1)
  • Place a catheter adapter over the end of the tube to close it off, ensuring gastric contents cannot leak. (J213.1.w1)
  • Consider placing an Elizabethan collar on the rabbit to prevent it pulling the tube out with its feet.
  • Use:
    • Flush with water before and after each feed or dose of medication, to avoid tube obstruction
    • Use liquid feed which can easily pass through the tube, e.g. banana flavour Ensure (Abbott Laboratories), pureed vegetables, soy-based enteral formulas.
    • Commercial rabbit pellets, ground up and mixed with water can be used. (B539.1.w1)
    • Critical care diets can be used.
    • For more information on suitable feeds see: Food and Feeding for Mammals - Convalescent diets / Nutritional support

(B539.1.w1, B601.2.w2, B602.14.w14, J29.15.w2, J213.1.w1, P113.2005.w2)

Appropriate Use (?)
  • For feeding anorectic rabbits. (B601.2.w2, J213.1.w1)
  • For oral (gastric) administration of fluids, food and medication when syringe feeding is not possible, e.g. due swallowing problems, after extensive surgery, or in anorectic individuals which will not tolerate frequent handling. (B601.2.w2)
  • Naso-oesophageal rather than naso-gastric tubes reduce the risk of gastric reflux, oesophagitis and stricture formation. (J29.15.w2)
Notes
  • Often easiest to place with the rabbit awake as it will usually swallow the tube when it reaches the pharynx. (P113.2005.w2)
  • Use an open-ended tube. Cut additional holes along the tube near the tip to reduce the chance of the tip blocking. (J213.1.w1)

Complications/ Limitations / Risk
  • Not recommended for rabbits with dyspnoea of respiratory tract origin, because rabbits are obligate nasal breathers. (B601.2.w2)
  • The small diameter of nasogastric tubes limits the thickness of feed, so that fibrous material including e.g. Critical Care for Herbivores (Oxbow Pet Products) or pureed pellets in water, cannot be given. (J29.15.w2, J213.1.w1)
Equipment / Chemicals required and Suppliers
  • Suitable feeding tube/catheter:

    • Red rubber catheter, 5 French (P113.2005.w2)

    • Catheter/tube, 5 - 8 French, depending on the size of the rabbit. (B601.2.w2, J29.15.w2)

    • 3.5 to 5.0 French paediatric feeding tubes. (J213.1.w1)

    • 3 or 4 French tube. (B539.1.w1)

    • Polyurathane or silicone tubes withstand stomach acid and do not stiffen or crack. (J29.15.w2)

    • Red rubber and polyvinylchloride tubes are relatively inexpensive. (J29.15.w2)

  • Local anaesthetic solution or gel.

Expertise level / Ease of Use
  • This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
Cost / Availability
  • Inexpensive.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (See: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).
Author Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referee Tiffany Blackett BVetMed MRCVS (V.w44)
References B601.2.w2, B602.14.w14, J29.15.w2, J213.1.w1, P113.2005.w2

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