TECHNIQUE

Orogastric Tube Placement in Rabbits (Disease Investigation & Management - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords --
Description
  • Ensure all equipment is ready.
  • Sedate the rabbit. See: Treatment and Care - Anaesthesia and Chemical Restraint
    • Sedation may not be needed with collapsed, very weak or very cooperative individuals.
  • Choose a stomach tube of appropriate size
    • Preferably with a larger diameter than the rabbit's trachea, to ensure that accidental endotracheal intubation cannot occur.
    • An 18 to 22 French round-tip rubber catheter is suggested. (J213.9.w1)
  • Measure the distance from the incisors to the last rib on the left side; mark the tube at this length.
    • This indicates how far to pass the tube into the rabbit.
  • Have the rabbit restrained in sternal recumbency, with the body and head supported.
  • Place a gag into the rabbit's mouth (e.g. a pre-made plastic or wooden gag with a hole in the middle to place the tube through, a suitably-sized avian metal gag, a syringe case, or a roll of bandage material)
  • Apply a small amount of lubricant to the end of the stomach tube. 
  • Slightly flex the rabbit's neck.
  • Slowly advance the tube through/past the speculum or gag (as appropriate), down the oesophagus and into the stomach.
    • Resistance to the tube should be minimal.
  • Stop when the tube is advanced so the pre-placed mark has reached the incisors.
  • If at all unsure of the positioning of the tube, inject 5 - 10 mL air into the tube whilst auscultating the cranial abdomen.
    • If the tube is in the stomach, characteristic bubbling noises or turbulent air flow should be audible.
    • If the tube is in the trachea, usually the rabbit coughs and/or condensation is visible in the lumen of the tube.
    • If the tube is backed into the oesophagus, negative pressure should develop. (J213.9.w1)
    • If still unsure or if the rabbit seems distressed, remove the tube, wait, and try again.
    • NOTE: if the rabbit has gastric dilatation, fluid and gas flow from the tube once it enters the stomach.
  • To give medication:
    • Instil the appropriate drugs down the tube.
    • Flush with a small amount of water to ensure all the drug is delivered to the stomach.
  • To feed
    • Attach a syringe of prepared feed (e.g. Critical Care for Herbivores, Oxbow Pet Products)
    • Administer the food down the tube.
  • To empty the stomach
  • To withdraw the tube
    • Leave a syringe attached to the end of the tube (this prevents material leaking from the tube as it is withdrawn and possibly being inhaled).
      • Or crimp the tube. (P113.2005.w3)
    • Withdraw the tube.
    • Remove the speculum or gag.

(B601.2.w2, B602.14.w14, B554.22.w22, J213.9.w1, P113.2005.w2, P113.2005.w3)

Appropriate Use (?)
  • For removing fluid and gas from the stomach of a rabbit with gastric dilatation.
  • For administration of oral medication or food when other methods are not appropriate (e.g. the rabbit will not accept syringe feeding).
  • For gastric lavage in cases of recent ingestion of toxic substances. (J213.11.w1)
  • For administration of activated charcoal in cases of recent ingestion of toxic substances. (J213.11.w1)
  • For feeding on a single occasion. (J213.9.w1)
Notes
  • A large diameter tube, too large to fit into the trachea, ensures that accidental endotracheal intubation cannot occur. 
Complications/ Limitations / Risk
  • Not suitable for repeated feeding. (J213.9.w1)
    • Repeated orogastric tubing is stressful for the rabbit. (J213.1.w1)
Equipment / Chemicals required and Suppliers
  • Sedative

  • Syringes

  • Stomach tubes

    • An 18 to 22 French round-tip rubber catheter is suggested. (J213.9.w1)
  • Medication or pre-prepared liquid feed

  • Gag with a hole in the centre.

  • Lubricant

Expertise level / Ease of Use
  • This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
Cost/ Availability --
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, B554.22.w22, J213.1.w1, J213.9.w1, J213.11.w1, P113.2005.w2, P113.2005.w3

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