TECHNIQUE

Pharyngostomy 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
  • Anaesthetise the rabbit. See: Treatment and Care - Anaesthesia and Chemical Restraint
  • Place the rabbit in dorsal recumbency.
  • Shave and disinfect the skin over the larynx (approximately 3 cm square area). 
  • On the left side of the neck, 5 mm from the midline and just anterior to the larynx, make a 1 cm incision.
  • Pass a tube through the mouth into the oesophagus and down to the stomach.
    • A catheter stiffened by a guide wire is suitable. (J495.38.w1)
    • Once the catheter is in place, remove the guide wire. (J495.38.w1)
  • Hold the rabbit's mouth open with tapes over the upper and lower incisors.
  • Grasp the tube with artery forceps through the rabbit's mouth so the tip of the forceps is in the pharynx; push the tube against the wall of the pharynx, creating a visible bulge under the skin incision.
  • Incise the muscle over the bulge carefully with a small scalpel blade; use the hard tip of the artery forceps as a guide.
  • Incise the pharyngeal wall.
  • Bring the oral end of the tube out through the incision.
  • Draw about 10 cm of tube out through the incision.
  • Place an anchoring cuff on the tube close to the body.
  • Place the guide wire into the tube to maintain the tube's diameter during anchoring.
  • Anchor the tube at the incision by suturing:
    • Place a purse string suture round the catheter proximal to the cuff, closing the incision in the pharyngeal wall.
    • Place a second suture just distal to the cuff
  • Make a tunnel through the subcutaneous tissues to the base of the ear by blunt dissection with straight artery forceps.
  • Swab the tube with ethanol.
  • Run the tube up through the tunnel to exit the skin through an incision at the base of the left ear.
  • Anchor the tube with a mattress suture.
  • Trim the tube to provide only about 1 cm protruding from the skin.
  • Fit a 1.2 mm plastic Luer stub adaptor with cap closure.

(B600.2.w2, J495.38.w1)

Appropriate Use (?)
  • To allow daily dosing or feeding if food, fluids or medication cannot be given orally or cannot be given without the animal suffering discomfort or distress. (B600.2.w2, J495.38.w1)
  • Dosing can be carried out easily by a single person and without removing the rabbit from its cage. (J495.38.w1)
Notes
  • No problems were noted in eating, drinking or weight gain when a tube was placed in more than 40 rabbits. (J495.38.w1)
Complications/ Limitations / Risk
  • If the pharyngostomy incision is too far lateral the carotid artery or jugular vein may be severed causing fatal haemorrhage.
Equipment / Chemicals required and Suppliers
  • Equipment for anaesthesia.

  • Catheter, 1.2 mm plastic Luer stub adaptor with cap closure., guide wire, suture material, scalpel and artery forceps.

Expertise level / Ease of Use
  • This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
  • It is recommended that anyone intending to perform this procedure first performs a dissection to ensure familiarity with the local anatomy. (J495.38.w1)
  • Infection can develop along the subcutaneous tunnel; this is not common (two of more than 40 rabbits in a study group). (J495.38.w1)
Cost/ Availability Costs are those associated with anaesthetic, personnel time and consumables.
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 B600.2.w2, J495.38.w1

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