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An esophagostomy is the practice of making an opening directly through the throat and into the esophagus. Through this opening (known as a 'stoma'), a feeding tube is placed. This procedure is usually done because the dog is either unwilling or unable to chew or swallow food (either because of direct injury or loss of motor function).
The first step the vet will take is to place the dog under general anesthetic and shave an area of the neck where they intend to place the stoma. The most common areas for placement of the stoma are the back of the neck and side of the throat. This is to prevent discomfort when the dog is lying down, as well as to prevent things such as a feeding tube from catching on various objects as the dog goes about its daily life. The next step is to make a small incision into the esophagus with a scalpel before suturing the edges shut. At this point, the feeding tube can be fed through the stoma and down into the stomach of the dog, before the animal is awoken.
An esophagostomy is one of the most effective ways to keep a dog fed and healthy when it is otherwise unable to eat. The feeding tube can be used straight after installation, as it bypasses the surgical wound and sends food straight to the stomach. Although this method of feeding is intended primarily to be a short-term measure while an underlying condition is resolved, it can be used long-term in animals that are unable to feed themselves. It is also far more convenient and humane that alternative methods of delivering food, such as force-feeding or intravenous feeding, which can be distressing and deliver sub-par nutrition, respectively.
It can take a couple of weeks for the dog to become fully accustomed to the esophagostomy tube and the associated feeding regimen. Encouragement from the owner and a lot of patience will be needed to prevent them from trying to swallow things independently (although the tube will not mechanically interfere with the process of swallowing food). Painkillers will also need to be administered to the dog to prevent them from being irritated by the stoma in its early days. The vet will most likely want to see the dog on several more occasions, both to check the integrity of the stoma and to treat the underlying issue.
The price of esophagostomy tends to be rather high, at roughly $800 for a relatively healthy dog. Owners of older or more seriously ill dogs may find the costs to be somewhat higher for their procedure and aftercare.
The requirement for general anesthesia can be a worry for some owners of older dogs. Additionally, there is a higher risk of vomiting when a feeding tube has been fitted, as well as a small risk of developing esophageal problems due to constant contact with the tube. However, regular check-ups with the vet can ensure that these problems are either avoided or are nipped in the bud as they start to present themselves, leaving the tube free to do its job and let the dog get the nutrition it needs.
While it would be unreasonable to expect dog owners to micromanage every facet of their pet's lives, there are some things that can be done to prevent the injuries that commonly necessitate the use of feeding tubes. By training their dog to act appropriately around roads and other animals, much of the risk of fractures to the jaws can be avoided (i.e. through car accidents or fighting other dogs). Furthermore, simply keeping an eye on what their pets are picking up with their mouths and taking steps to ensure good dental hygiene can prevent the kinds of oral wounds and abscesses that may require an esophagostomy in order to heal.
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