Peg Tube Feeding

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Filed Under: Emergency / Critical Care


 

PEG TUBE INFORMATION

THE BASICS:

1. The feeding tube exits from the inside of your Pet’s stomach to the outside body wall on the left side. There are several parts to the feeding tube.

2. At the body wall, there is a cross piece (stent) that is the same color as the feeding tube.  The stent helps to keep the tube in place and prevents it from slipping in or out of the stomach.  Please note where the stent is at the time of discharges.  You will want to monitor the placement of the stent once every 1-2 days to ensure that it has not moved (feel free to mark it with a permanent marker).

3. There is a feeding adapter at the end of the tube that has two ports on it.  The larger port is used for food, and the smaller port is used for medications.

4. Most Patients with a feeding tube have a white stocking around their body that helps to keep the tube in place.  If the tube stays under this stocking, then it is less likely to get caught on something.  You can remove and wash the stocking, you may design your own stocking (t-shirt), or you can purchase baby “onesies” (which work really well).

Diet Selected: _______________________

Total Volume to be administered per day = _______ ml

Diet preparation:
This diet has been selected for your Pet because it meets energy and nutrient requirements, and provided optimal nutrition for your pet's disease.  If you would like to utilize a different diet, please speak with a Veterinarian before making a dietary change, as not all diets are compatible with tube feeding.

1. Combine ___ cans of ____ in a blender with ____ mls or ________ (water, clinicare, vivonex).
2. Store this mixture in a sealed container in the refrigerator for no more than 24 hours.

HOW TO FEED

1. Draw up the desired amount of food that you would like to give in a syringe.  It is always best to have the food or water that you give through the tube warmed to room or body temperature.  The best way to warm the food is by submerging the syringe of food under running hot water for several minutes.

2. Give all medications before feeding.  To give liquid medications, open the small port, attach the syringe of medications, and then slowly push the syringe plunger.  Some medications (tablet, capsule) may be crushed and mixed in with the food.

3. After giving the medications through the tube, you may feed.  Open the large adapter, attach the syringe of food, and then slowly push on the syringe plunger.  Please feed slowly over 10-15 minutes. 

4. Monitor for signs of nausea such as drooling, licking lips, or excessive swallowing.  If you see these signs, please stop the feeding.  If the signs resolve, then you may begin feeding again at a slower rate.  If the signs do not resolve in 1-2 minutes, then stop the feeding.  You may try to feed again at the next feeding time.

5. If your Pet vomits during the feeding, it is ok.  Simply stop the feeding, remove the syringe from the port, and wait for your Pet to stop vomiting.  After 5 minutes, please give 15 ml of water through the tube to clear it of food.

6. It is VERY important that you flush the tube with water after you are done feeding or giving medications.  There must always be a column of water in the tube to try to prevent clogging.  We usually recommend flushing the 15ml of lukewarm water.

TUBE CARE

1. Please monitor the tube site daily.  It should ideally have no redness, discharge, swelling, or pain. Please call the Hospital if you notice these signs.  Local infections around the tube can happen, and are usually easily treated if caught early.

2. Clean the tube site daily.  Please clean the site with a hypoallergenic, non-scented baby wipe once a day (or you may use a clean wash cloth that is damp).  Dry the site well after cleaning.

3. If the tube is plugged / clogged…
a. The food that you are feeding may be too thick (not enough water) or there may be a chunk of food.  If medications were given, it may have been a piece that was not ground down to a powder.
b. Take an empty syringe and aspirate backwards on the tube, then place a syringe of water on the tube, and flush forcefully.  If this unclogs the tube, flush at least 20 ml of water through the tube to clear any obstruction.
c. If this does not clear the clog, take an empty syringe, aspirate back to clear the tube, and then attach a syringe with a carbonated beverage (Coke, Pepsi, Sprite, etc).  Inject the carbonated beverage into the tube, leave it for 5 minutes, and then try to flush water through the tube forcefully, again.
d. If the tube is still clogged, please call us or your Veterinarian for assistance.

WHEN TO CALL THE HOSPITAL

1. If the tube comes out of the body.  This can be a life-threatening emergency for the first 1-2 weeks after tube placement, because, the stomach can leak into the abdomen, and this would require surgery to repair the stomach.  After 2 weeks, it is an emergency because the tube site can close up very quickly. It is imperative to replace the stomach tube quickly, but it is not-life threatening. 

 2. If the tube site is red, painful, swollen, or has discharge.

3. If the tube is clogged, and you are unable to unclog it after the above directions.

4. If your Pet vomits more than 1 time per day or acts painful in the abdomen