Feeding Tubes in Cats

A feeding tube is used as a means of getting nutrition into a cat that needs to eat but has either lost their appetite (such as after major surgery) or has physical difficulty eating (such as a fractured jaw). It's important a cat continues to take in nutrition in order to speed healing and to prevent complications due to organ shutdown. 

The vet can choose from different types of feeding tubes depending on whether the cat needs short or long-term support. The simplest option to fit is a naso-esophageal tube which can be placed under local anesthetic and sedation, whilst an esophageal or gastric tube require a brief anesthetic but are wider bore and can be left in place for weeks to months. 

Once in place, a liquid diet is syringed into the tube so that it passes directly into the stomach. 

A naso-esophageal or naso-gastric tube refers to a flexible fine bore tube that is passed via the cat's nose down into the esophagus or the stomach. 

To place one, the vet marks the tube with the distance from the cat's nostrils to the fifth rib. The cat is then lightly sedated and a few drops of local anesthetic dripped up the cat's nose. The tube is carefully inserted into the nose and gently advanced until the marker is reached. The vet then x-rays the cat to check the tube is correctly positioned and then glues or stitches it in place. 

Placing an esophageal tube is more complex and requires a full anesthetic. The advantage is that a wider bore tube is inserted and can be left in place for longer. 

The cat is anesthetized and forceps passed via the mouth into the esophagus. An incision is made in the skin over the forceps, such that the tip of the jaws can grip the feeding tube. The tube is pulled through the skin incision, into the esophagus, and up out of the mouth, leaving one end sticking out of the incision. The tube is then fed back down the gullet into the stomach. The free end sticking out of the incision is sutured in place with a Chinese finger trap. 

A feeding tube is an efficacious way of getting vital nutrition into a cat that is refusing to eat. A major plus factor is that the cat can still eat normally should they desire, and so once that cat regains their appetite the tube is simply removed. 

How easy it is to tube-feed depends on the diameter, or bore, of the feeding tube. Naso-esophageal tubes by their very nature are only wide enough for liquids to pass along. This means using special liquid diets or diluting liquidized foods will be required. An esophageal tube has a wider diameter, which makes feeding liquidized regular food a possibility.

The tube is removed once the cat is eating on their own, which could be days, weeks, or months, depending on the reason for insertion.

Placement of a feeding tube is quick and painless. Most cats are either unbothered by tube placement or recover rapidly. However, it is necessary to prevent the cat dislodging the tube when they groom, so it may be necessary to wear a cone or cover the external part of the tube with a dressing. 

In a cat that doesn't require intensive nursing, it's often possible for them to go home to continue their tube feeding. It is crucial that the stoma site is kept clean and monitored for signs of infection. Should the latter happen then antibiotics are indicated, and in a worst case scenario the tube might be removed. 

Removing a tube is simply a matter of removing the glue or sutures securing it in place, and gently tugging on the tube. The small hole through which the tube passed (for esophageal tubes) normally scars over and heals uneventfully. 

The cost of a feeding tube is rarely charged in isolation because it's usually placed as a result of trauma or sickness. For a nasogastric tube the cost of sedation, plus tube placement, and check radiograph could be $250 - $370. The more complex procedure of placing an esophageal tube involves full anesthesia and could range up to $800. But expect extra charges on top for management of the primary condition. 

A cat that won't eat is a cat on a downward spiral. Lack of nutrition weakens the immune system and slows tissue repair. As if that wasn't bad enough, the cat has a quirky liver metabolism which makes the liver vulnerable to being flooded with fat (sending them into liver failure) when the cat is in a starvation situation.

Tube feeding provides an easy way of getting food into the digestive system, with all the benefits this brings with it. Also, a cat can still eat normally despite the presence of the tube, so it's fine to offer the cat food in a bowl at the same time as tube feeding. Once the cat's appetite has recovered and is eating freely on their own, then the tube is simply removed.

Feeding tubes are mostly needed to support sick or injured cats. A trauma such as a fractured jaw is most commonly the result of a fall from a balcony or a road traffic accident. Thus, prevention is key, with the installation of balcony fencing and maintaining an indoor lifestyle.

For the sick cat, seeking veterinary attention promptly could make the difference between a cat with a minor problem who recovers uneventfully, and a critically ill cat as a result of secondary complications. The cat that is seen early in the course of a disease is more likely to respond to therapy and less likely to need supportive care, including a feeding tube.