An orogastric tube is a plastic tube inserted through the mouth and directly into the stomach.
It is sometimes needed for liquid medication administration and for short-term feeding, in addition to removal of stomach contents, and to decompress a patient with gastric dilatation (bloated stomach). The use of the orogastric tube is relatively safe if inserted and used correctly, and it’s effective and simple (Harkin, Simpson, 2018).Proper insertion of the orogastric tube in a canine patient is essential, as the placement of the tube into the trachea instead of the esophagus will fill the patients’ lungs with any administered medications instead of going into the stomach. Start the procedure by being organized and prepared with all the necessary materials, and always monitor the patient appropriately. Pre-measure an orogastric tube from the tip of the nose to the 13th rib and mark this point with white tape (Lee, 2015). While the animal is restrained in sternal recumbency or in a standing or seated position, place a roll of tape or a speculum behind the canine teeth to hold the mouth open. Lubricate the tip of the orogastric tube with water-soluble gel, and use gentle, twisting motions to pass the tube through the tape roll or speculum and into the esophagus until the premeasured length enters the stomach (Lee, 2015).
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If the animal coughs, the tube may have entered the trachea and should be removed and reinserted. Correct placement of the tube should always be verified and can be done by palpation of the orogastric tube on abdominal palpation (Lee, 2015). Before removing the orogastric tube, administer activated charcoal via the tube, and flush it with additional water (Lee, 2013). Kink the tube, to prevent lavage fluid from being aspirated, and withdraw the tube quickly in a downward direction (Lee, 2013). When using an orogastric tube in canine patients, there can be significant complications due to improper maintenance and/or improper feedings. Mechanical complications can include both tube obstruction and premature removal of the tube, or being dislodged from the site of placement (Wortinger, 2010).
Some of the gastrointestinal complications with tube feeding are related to the feeding itself. When food is administered too quickly and in too large of amounts, or at the wrong temperature, it can cause nausea, vomiting or abdominal discomfort (Wortinger, 2010). Metabolic complications are seen with “Refeeding Syndrome”, a potentially fatal shift in fluids and electrolytes that may occur in malnourished patients (Wortinger, 2010). Another complication could be infection, which could occur in tube-fed patients and includes contamination of the internally fed formulas, peristomal cellulitis, septic peritonitis, and aspiration pneumonia (Wortinger, 2010).
The use of an orogastric tube is relatively safe if carried out correctly, and an effective way to administer medications and food, in addition to removing gastric contents and relieving a bloated stomach. Understanding how to properly insert and remove an orogastric tube, along with the possible complications associated with the use of an orogastric tube, is essential to the care and well-being of your patient.