An esophagostomy tube, or E-tube, is a feeding tube placed through the skin of the neck directly into the esophagus, which is the muscular tube connecting the throat to the stomach. Its function is to provide nutrition and deliver medications to pets that cannot or will not eat on their own. The presence of the tube does not prevent an animal from eating or drinking by mouth if it chooses to do so.
Medical Reasons for an Esophagostomy
A veterinarian may recommend an E-tube for various medical conditions that cause a pet to stop eating, a state known as anorexia. One common reason in cats is hepatic lipidosis, or fatty liver disease, where prolonged lack of appetite causes fat to accumulate in the liver. Other conditions include chronic kidney disease, which often leads to nausea and appetite loss, and cancers affecting the mouth or jaw that make eating painful or physically impossible.
Pets recovering from significant surgery or experiencing facial trauma, such as a fractured jaw, also benefit from this type of nutritional support. The E-tube is designed for both short-term and long-term use, depending on the underlying health issue being managed.
The Esophagostomy Placement Procedure
The placement of an E-tube is a surgical procedure performed while the pet is under general anesthesia. An area on the side of the neck is clipped and surgically prepared. The veterinarian makes a small incision through the skin and into the esophagus.
To guide the tube, forceps are passed down the mouth into the esophagus to the location of the incision. The feeding tube, a flexible rubber catheter, is then grasped and pulled up through the incision and out of the mouth. It is then redirected back down the esophagus so that the tip rests in the esophagus, not the stomach. The tube is secured to the skin of the neck with sutures, and the site is bandaged.
Caring for the Tube at Home
Home care involves daily cleaning, feeding, and monitoring. The site where the tube enters the skin, known as the stoma, must be inspected every day for signs of infection such as redness, swelling, or discharge. The area should be gently cleaned daily with a cleanser recommended by your veterinarian to remove any crusts or debris. The neck wrap or bandage holding the tube in place may also need to be changed regularly.
Feedings are administered by injecting a liquid or slurry diet directly into the tube using a syringe. Before each feeding, the tube must be flushed with a small amount of lukewarm water to ensure it is not clogged. The food should be injected slowly to prevent vomiting. After the meal is given, the tube is flushed again with water to clear any remaining food and prevent blockages.
Liquid medications can also be given through the tube, followed by a water flush. It is important to crush pills thoroughly and dissolve them in liquid before administration to avoid clogging the tube. Between feedings, the tube must be securely capped to prevent leakage and air from entering.
Tube Removal and Recovery
The decision to remove an E-tube is made once the pet is consistently and voluntarily eating enough food to meet its nutritional needs. The return of a normal appetite signals that the underlying condition has resolved or improved sufficiently. The veterinarian will determine the appropriate time for removal based on the pet’s recovery and the specific illness that was treated. The tube can remain in place for weeks or even months if necessary.
Removal of the tube is a simple and quick process that typically does not require anesthesia or sedation. The veterinarian simply snips the sutures holding the tube in place and gently pulls it out. This procedure is straightforward and can be done during a routine re-check examination.
After the tube is removed, the small hole in the neck, the stoma site, is left to heal on its own. The opening gradually closes over the course of about a week or two. The site will eventually heal completely, usually leaving behind only a very small, minimal scar.