Esophagostomy Tube Feeding in Cats

By Courtney Barnes, BSc, DVM; Krista Williams, BSc, DVM, CCRP; Ernest Ward, DVM

What is an esophagostomy tube?

An esophagostomy tube is a small rubber tube that is surgically inserted into the esophagus (the muscular tube that transports food from the mouth to the stomach) through the skin of the neck. The esophagostomy tube allows food to be delivered to the stomach, by-passing the mouth and pharynx (back of the throat). This type of feeding tube is not placed directly into the stomach.

An esophagostomy tube is placed in cats that have jaw fractures or other mouth injuries that prevent normal or adequate eating, or in cats with diseases that have anorexia as a symptom and will not eat enough on their own. Your veterinarian will let you know when it should be removed.

How do I feed my cat through the tube?

You will syringe a special liquid diet or a homemade mixture through the tube two to five times per day. This food is formulated to meet your cat's needs and should not cause vomiting or diarrhea. To feed your cat, follow these steps:

  • Prepare the food by combining the recommended canned diet with the recommended amount of water in a blender. Some foods do not need to be diluted. Run the blender at high speed until the food is uniformly mixed.
  • After mixing, if needed, pour the food through a kitchen strainer to remove any chunks or clumps of unblended food.
  • Flush the tube with 5 mL of lukewarm water to ensure it is not clogged. Stop if the cat coughs or gags, and contact the clinic.
  • Using the syringe provided, inject the prescribed amount of food mixture into your cat's feeding tube. Inject the food slowly, about 1 mL per second. Elevate your cat's front feet so that the food easily goes into the stomach. Giving the food too quickly can cause vomiting.
  • After you have given the appropriate amount of food, inject 5 mL of lukewarm tap water through the tube to flush any remaining food from the tube. Replace the cap on the feeding tube.
  • Store any remaining food in the refrigerator. Before the next feeding, warm the food to body temperature under hot tap water or in a microwave oven. If you heat it in a microwave oven, be sure to mix the contents before feeding to minimize uneven heating. To be sure the food is not too hot, always check the temperature prior to feeding by placing food on the back of your hand. It should feel slightly warm.
  • Contact your veterinary hospital if you experience any difficulty when feeding your cat through its esophagostomy tube.
  • Medications may also be delivered directly through the feeding tube and followed with water.
  • To prevent infection, the tube site (stoma) should be cleaned daily with a cleanser recommended by your veterinarian. Change the soft neck wrap or bandage as recommended by your veterinarian.
  • The tube must be capped when not in use.

When and how is the feeding tube removed?

The tube can remain in place for weeks to months. Some cats require several weeks of tube feeding before healing occurs and/or their appetite returns. When directed, you can start offering food. At least twice weekly, while the feeding tube is in place, offer your cat a small amount of its favorite food by mouth so that you know when their appetite is improving. The esophagostomy tube will not hinder chewing or swallowing.

Follow your veterinarian’s recommendations for when to schedule regular re-check examinations. After your cat has been eating well consistently for at least a week, you should book an appointment for a re-check examination and possible tube removal. The decision to remove the tube depends on the condition being treated. Removal of the tube is simple and does not require anesthesia; however, do not attempt to remove the tube on your own. The opening will gradually close on its own after removal.

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