Nasogastric intubation in equine

Nasogastric intubation in equine

1. Nasogastric Intubation in Equine Arvind Sharma

2. Indications to determine if gastric distension is present. to administer lubricant oils in cases of colic due to simple intestinal impaction. is helpful in identifying diseases affecting the stomach or upper small intestine.

3. Gastric decompression a gastric reflux in the form of gas and fluid is obtained back from the stomach through the Nasogastric tube and as a result the relieving of excess gas and fluid from the equine stomach is known as gastric decompression. greater the volume of gastric reflux, the more proximal the lesion. There is no correlation between the amount of fluid obtained and the need for surgical or medical management.

4. Assessment of Reflux The pH of 6.0 or more is an indication of reverse flow of intestinal secretions into the stomach lumen. Fluid containing feed material - gastric dilatation or stasis as the cause of colic Yellow green fluid - bile reflux originating distal to the common bile – pancreatic duct. Brown or reddish fluid - mucosal damage with haemorrhage ( small intestinal strangulation or haemorrhagic gastroenteritis) Repeated reflux of fluid suggests small intestinal strangulation or duodenojejunitis.

5. procedure A large diameter tube (20mm OD, 12mm ID; or 16mm OD, 8mmID) Tetanus toxoid prophylactic injection (5-10ml IM) or if possible an Anti- tetanus serum (1500-3000 IU IM). tranquilization/sedation of the animal should be avoided because it causes the relaxation of the epiglottis and tracheal muscles and increases the chances of passage of the tube into the trachea. In such cases sometimes the sedatives depress the cough reflex also. mild sedation with Xylazine (0.2-0.5mg IV) can be given in fractious patients.

6. Angle of the neck

7. Procedure .. Restrain in standing position in a crush or even in the open using ear and lip twitch. The head should never be extended forwards but is allowed to remain in the same position in which the animal carries it while standing. Lightly coat the tube end with lubricant or oil. Stand lateral to the horse. Insert the tube into the ventral medial aspect of nostril.

8. Procedure… Directing the tube ventromedially minimizes the trauma to nasal turbinates and therefore decreases the incidence of epistaxis. If epistaxis occurs during intubation, wait for 5-10 minutes and then proceed using the other nostril. minor complication and does not warrant discontinuing the procedure. Confirm that the tube has entered the esophagus by palpation of the tube in the oesophagus. Palpate the left side of the neck dorsal to the jugular groove.

9. Thank you Rohtang Pass , Gateway to Lahaul Valley, Himachal Pradesh