Feeding Tube Dismissal
Your cat has just had a feeding tube placed in the side of their neck. This tube goes directly into their esophagus to facilitate feeding and giving medications until your cat feels well enough to start eating on their own.
· We should have sent home a disposable stretchy sock like material for your cat to wear to cover the tube and the entry site in the side of your cat?s neck. If you need more of these, just let us know.
o If you wish to create something more sturdy, you are welcome to do so. An old stretchy tube sock or a sleeve from an old shirt can be cut to fit and used. Just make sure that it is not too tight on your cat. A commercially purchased cat sweater or shirt can also be used as long as it covers the tube entry site.
· The tube is held in place by a series of sutures around the entry area. If you notice some of these sutures starting to come loose or if you notice the tube is no longer held firmly in place by the sutures, please bring your cat into the clinic as soon as you can.
o If the tube is no longer attached with sutures, but is still in your cat?s neck, please use whatever you have handy and safe for your cat to secure the tube to your cat and keep the tube from coming out of your cat?s neck, such as bandage material, bandage tape, etc.
o If the tube comes out of your cat?s neck and you feel comfortable doing so, you can insert the tube back in, but you only have about 5 minutes after the tube comes out, after that the tissue is already starting to heal closed. If the tube does not slide back in very easily, do not force it, and bring your cat into the clinic as soon as possible.
· It is normal for the tube entry area to have a small amount of drainage from the area, but if the drainage seems excessive, is thick and mucous, or if the skin around the tube entry site seems to be abnormally swollen, please call us or bring your cat in for us to take a look at it.
· You can gently clean around the tube entry site daily if desired, just be careful to be gentle, and do not use hydrogen peroxide or alcohol, as these can degrade the suture too fast and be painful for your cat. Warm soapy water is generally sufficient, or if you have it, a chlorhexadine solution can also be used.
· We will demonstrate how to do this when we dismiss your cat to you.
· Anything you feed through the tube must be in a pureed or finely ground form.
o That means you must use a food designed for tube feeding such as Science Diet A/D or Iams Max/Cal, or if using a moist food not designed for tube feeding, you must puree it with a little water in a blender first.
o If mixing medications in with the food or in water, they must be finely ground into powder, no large chunks, or they will get stuck in the syringe or in the tube.
· Always flush at minimum 12cc of warm water (not hot or cold) unless otherwise directed through the tube before feeding to make sure it is clear, and after feeding, to prevent food from drying in the tube and plugging it up.
· To fill your syringe with food, you can use your fingers, a tongue depressor, a small narrow spoon, or a butter knife. Make sure it is not pointed at the ceiling or wall when you push the plunger in.
· Never push more than 10cc of food at a time to minimize the risk of vomiting. Ideally, feed about 5cc per minute or slower. You can always push some food through, detach the syringe and go and do something else, then come back a few minutes later and give more.
· At minimum, split the total amount of food to give per day into 3 feedings, but if you can split it into 4, 5 or even 6 feedings, then that is even better, and will minimize the risk of vomiting, as well as increase the rate of improvement of your cat.
· Never exceed a total volume of 100cc at a time, and no more than 50cc of that can be food. Your cat?s stomach can only handle a certain volume before it will vomit.
· If your cat does start vomiting, reduce the amount of food that you are giving at a time, and call us to let us know.
· If the tube seems to be stuck and food is not going through, try pushing some water through. If you are pushing hard and nothing is going through, do not force it, bring your cat to the clinic and we will get it cleared.
The calculations below are based on your cat?s health status and level of vomiting by your veterinarian, but roughly, day 1 is ¼ of your cat?s ideal weight maintenance calorie intake (20ml/lb), day 2 is ½, day 3 is ¾, and day 4 is the full amount, which continues on each day until your cat is eating well on their own. The water is based on your cat?s daily water intake needs at 25ml/lb/day, minus the amount of water in the food, which is roughly 70%.
· So, for food: ideal weight in lb x 20 = total maintenance calories per day. A/D is 1.2 calories per ml, and one can contains 150ml, or 180 calories.
· For water: ideal weight in lb x 25 = total amount of water per day minus 70% of the total volume of food = total amount of water to give each day.
If you have any questions or concerns regarding your cat?s feeding tube or feeding issues, please contact us at All Feline Hospital at 402-467-2711 or firstname.lastname@example.org. Once your cat is eating a normal volume for at least a week, contact us to have your cat?s feeding tube removed. While your cat has the feeding tube in place, please still always keep food and water available for them.