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 25-28 September, 2018 | Singapore
as long as they are eating well, avoid using the tube (medications are okay) for a week then reweigh them.
If the weight is stable (or increased), then it is safe to remove the tube. Because of stoma formation, removal does not require anaesthesia. Remove the suture (purse- string or stay sutures) and pull the tube out. Suturing
is not required for the skin opening. Cleanse minimal serous discharge that may occur for 2-3 days.
Feeding frequency: the number of feedings per day, (and hence intervals), is determined based on the volume of food tolerated per feeding. Start with 6 ml and increase by 6 ml increments to about 36-48/feeding for most
cats. In the uncommon case of the patient who cannot tolerate even 6 ml boluses despite antiemetic therapy, trickle feeding may be instituted. Trickle feeding is a technique in which liquefied food is syringed into an empty fluid bag and administered gravitationally or by pump assistance via an intravenous line attached to the large bore feeding tube or by use of a large syringe filled with food and syringe pump. Renew food and delivery tubing and syringe at 12-hour intervals to avoid bacterial contamination. A promotility agent may be warranted as well.
The success of assisted feeding is measured objectively by weight gain. Subjective measures will include improved coat quality, increased energy, muscle recovery and innumerable other effects that the client will appreciate. An improved QoL is the goal whether recovery from the underlying problem is possible or not.
SUMMARY
Renal diets provide benefit for cats with CKD. It is imperative that the cats eat enough calories and protein to optimize their body and muscle condition scores. Each patient must be assessed individually and monitored. This requires client communication and recheck visits. Cats with chronic kidney disease with higher BCS will live longer, and have an improved quality of life.
USEFUL RESOURCE
Hodshon B, Tobias K. Esophagostomy Feeding Tubes, Clinicians Brief February 2014 (www.cliniciansbrief.com => esophagostomy feeding tubes)
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