Enteral Nutrition using Gastrostomy and Esophagostomy Tube in Dogs and Cats

Enteralna prehrana terapijski je postupak koji se primjenjuje uslijed gladovanja duljem od 3 dana ili se isto očekuje u narednom vremenskom razdoblju. Provedba ovakvog načina hranjenja dugotrajan je i često kompleksan postupak koji zahtjeva multidisciplinaran klinički pristup i praćenje pacijenta. Enteralnim hranjenjem putem želučane i jednjačke sonde onemogućava se daljnji razvoj pothranjenosti i istovremeno povećava mogućnost oporavka i povoljniji ishod liječenja. Cilj istraživanja bio je utvrditi učestalost i indikacije kod kojih su u pasa i mačaka postavljanje jednjačka i želučana sonda uz hipotezu da je učestalost provedbe enteralnog hranjenja češći putem jednjačke u odnosu na želučanu sondu. Dodatno, utvrditi duljinu trajanja ovakvog vida hranjenja te duljinu perioda gladovanja koja je prethodila postavljanju jednjačke odnosno želučane sonde ukoliko ga je bilo. Nadalje, utvrditi koji su enteralni pripravci i hrane korišteni za hranjenje, koja je bila frekvencija hranjenja te naposljetku i sam ishod liječenja. Istraživanje je provedeno prikupljanjem arhivskih podataka u razdoblju od siječnja 2015. godine do siječnja 2020. godine iz baze podataka Klinike za kirurgiju, ortopediju i oftalmologiju Veterinarskog fakulteta Sveučilišta u Zagrebu. Prikupljeni su podaci za ukupno 36 pacijenata, pasa i mačaka, kojima je postavljena jednjačka odnosno želučana sonda. Provedenim istraživanjem utvrđeno je da su se sonde češće postavljale u pasa nego li u mačaka. Dodatno, u pasa je jednjačka sonda (66,67 %) postavljana češće nego želučana sonda (33,33 %) dok je u mačaka postavljana samo jednjačka sonda (100 %) što je potvrdilo postavljenu hipotezu. Kao najčešće indikacije za postavljanje sonde pokazale su se traume čeljusti, primjerice fraktura donje čeljusti i rascjep tvrdog nepca, zatim neoplazije usne šupljine i ždrijela te oštećenja jednjaka. Režim i duljina trajanja hranjenja individualno je određen za svakog pacijenta, a za hranjenje korišteni su polimerni tekući pripravci i konzervirana hrana. Komplikacije koje su se javljale su u većini slučajeva bile blage do umjereno teške kao pomicanje sonde i povoja, začepljenje sonde, povraćanje i regurgitacija, dok su od težih komplikacija zabilježene otežano disanje i gušenje te pneumotoraks. Ishod liječenja je kod većine pacijenata bio povoljan dok su razlozi za uginuće ili eutanaziju bile komplikacije ili izrazito loše opće stanje pacijenta.Enteral feeding is a therapeutic procedure which is provided due to starvation that lasts longer than 3 days or it is expected in the following period of time. Implementing this type of feeding is long lasting and often very complex procedure that requires multidisciplinary clinical approach and patient monitoring. Enteral feeding through gastrostomy and esophagostomy tube prevents further development of malnutrition and in the same time it increases the possibility of recovery and a more favourable treatment outcome. The aim of this study was to determine the frequency and indications in which the esophagostomy and gastrostomy tube were placed in dogs and cats with the hypothesis that the frequency of enteral feeding using esophagostomy tube would be more frequent than the gastrostomy. In addition, the aim was to determine the duration of this type of nutritional support and the length of the fasting period that preceded the placement of the esophagostomy or gastrostomy tube. Furthermore, to determine which enteral formulations were used for feeding, what was the frequency of feeding and finally the outcome of the treatment itself. The research was conducted by retrograde data collection between the period of January 2015 to January 2020 from the database of the Clinic of Surgery, Orthopaedics and Ophthalmology, Faculty of Veterinary Medicine, University of Zagreb. Data were collected for a total of 36 patients, dogs and cats, who underwent an esophagostomy or gastrostomy tube placement procedure. The study found that the feeding tubes were placed more often in dogs than in cats. Regarding the type of feeding tube, in dogs the esophagostomy tube (66.67%) was placed more often than the gastrostomy tube (33.33%) while in cats only the esophagostomy tube (100%) was placed, which confirmed the hypothesis. The most common indications for probe placement were jaw trauma, such as a mandibular fracture and cleft palate, then neoplasms of the oral cavity and pharynx and esophageal lesions. The mode and duration of feeding was determined individually for each individual, and liquid preparations and cans were used for feeding. Complications that occurred in most cases were mild to moderate in severity such as probe and bandage displacement, occlusion of the feeding tube, vomiting, and regurgitation, while more severe complications included difficulty breathing, suffocation, and pneumothorax. The outcome of treatment was favorable in most patients while the reasons for death or euthanasia were complications or extremely poor general condition of the patient