The esophagostomy or E-tube is an easy way to feed a cat that isn’t eating. It’s also a great way to easily deliver oral medications. While some owners initially are uncomfortable with the concept, once one becomes familiar with the E-tube and sees how non-invasive and helpful it is, the idea of placing an E-Tube becomes much more acceptable.
And, as your pet begins to feel better, regular eating can readily take place without disturbing the E-tube and the tube can be used to supplement feeding and for medication.
How to Use the the E-tube
Have everything ready before beginning. You will need:
- A syringe full of the liquid food in the appropriate amount. The diet should be warmed but not hot. Do not microwave the diet or you may get hot spots that are too hot. To warm the food, microwave a tall glass of water and insert the syringe of food in the warm water and let it sit until the food is at least room temperature, and ideally close to body temperature.
- A small glass or cup of tepid water.
- Any medication you should be giving at this time.
Clear the tube by squirting 6 cc of tepid water through it to be sure it is not clogged. Next, hook up the food syringe and slowly deliver the food to the patient. Follow the food with a chaser of 6 cc of tepid water to clear the tube. Give any oral medications that are scheduled. Discuss with your veterinarian before giving the medication through the tube, as medication may form chunks that can clog the tube. If you end up giving medication through the tube, it is all the more important to clear the tube with 6 cc of tepid water after.
Periodically, you will need to change the wraps on the feeding tube and clean any discharge or crusting from the tube exit site.
Be sure to allow time for digestion between feedings. How much time depends on your pet’s feeding plan. Be sure you understand the schedule provided by your veterinarian.
Are you giving the food too quickly? Rapid distension of the stomach is a stimulus to vomit. Try going slower.
Is the food too cold? Try warming the food to body temperature (around 100°F). Use a thermometer in the warming water bath to be sure the temperature is where you want it.
If these two solutions do not work, the tube may have slipped too low inside the esophagus. If the tube is dipping into the stomach, the patient may vomit. The doctor can take an x-ray to see if this is the case and then easily reposition the tube. If none of these things seem to be happening, the patient’s primary disease may be progressing. Your veterinarian will need to evaluate your pet more comprehensively.
A clogged tube can be a challenge. First try to force 6 cc or so of tepid water through the tube by pushing. If the clog does not give way, try hooking up a syringe of 6 cc or so of water and alternately push and pull back creating a “toilet plunger” effect. Continue fairly rapid push-pull action until the tube is cleared.
Note: some people feel that incubating 6 cc of cola soda in the tube overnight is helpful in dissolving a clog. Whether or not this works is somewhat controversial but it may be worth a try as the tube will be useless if it cannot be unclogged.
Crusting or pus at the tube exit site?
The patient’s body does not like having a foreign body sticking out of it and frequently there is some inflammation at the exit hole. True infection is unusual, and most of the time simply cleaning the area with gauze or a moist tissue is sufficient to solve the problem.
Esophagostomy tubes can stay in place for months without needing to be replaced. Hopefully your pet’s condition will have resolved before that time, although in some cases an E-tube is used in terminal patients to aid in their quality of life. Assuming your pet needs a tube for the short-term, your veterinarian can easily remove the E-tube. The hole left behind will simply heal on its own.