Great post!
Absolutely agree. Malnutrition is a massive barrier to recovery, and it’s frustrating how often it gets overlooked or addressed too late. In my experience, feeding tubes are underutilized, especially NG or O tubes, likely due to concerns about aspiration, placement difficulty, or a lingering perception that they’re too invasive. But when implemented early and appropriately, they can make a huge difference, even for short-term support. I’ve seen patients recover significantly faster just from receiving consistent nutritional support. I often tell owners and O tube is actually a ticket home in many cases!
We need to normalize feeding tube use, particularly in critical or cachectic patients, and start thinking of early nutritional intervention as proactive medicine rather than a last resort. One missed opportunity I see often is failing to place an oesophageal feeding tube while a patient is already under general anesthesia for another procedure. It’s such a simple addition that can dramatically improve outcomes. And we have to remember how easily oesophageal tubes can be removed if the patient begins eating on their own. There’s very little downside to placing them preemptively.
I’m also a fan of appetite stimulants like mirtazapine and capromorelin, which can be really effective in some cases, especially when used alongside other supportive care. But I think we sometimes rely on them too heavily instead of moving forward with a feeding tube when the situation really calls for it.
Another often-overlooked use is with nasogastric tubes, not only for nutrition but also for gastric decompression in cases like parvovirus. They’re incredibly versatile and valuable tools.
That recent study by Dumont et al. (J Vet Intern Med, 2023) really stood out to me. It reviewed the tolerability of naso-oesophageal feeding tubes in dogs and cats sent home and found that 94% of owners were satisfied with the experience. Complications were mostly minor, and no major adverse events occurred. This data really challenges the hesitation many of us have about sending patients home with these tubes. I’ve routinely discharged patients with NE tubes, but not NGs, so I found this paper quite interesting and a good prompt to rethink that approach.
I am really happy sending patients home with O tubes, but not sure how I feel about the NE tubes! Would love to hear other thoughts on this!
Scott 🙂
