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Veterinarian Technician October 2012 (Vol 33, No 10)

Equine Essentials: How to Feed Foals Via a Nasogastric Tube

by Jillian Dougherty, DVM, MS, Judy Marteniuk, DVM, MS

    Foals that cannot nurse on their own because of a medical condition (e.g., weakness, neonatal isoerythrolysis, neonatal maladjustment syndrome) can be fed via a nasogastric tube to help ensure proper nutrition. The following technique is appropriate for use in foals of all equid species, including horses, donkeys, mules, and zebras.


    FIGURE 1

    • A measured quantity of mare’s milk or milk replacer (not shown in Figure 1)

    • A feeding bag or a 60-mL catheter-tip syringe with extension tubing

    • A stethoscope (not shown in Figure 1)

    • A nasogastric tube or indwelling feeding tube

    • Supportive padding, pillows, or towels (not shown in Figure 1)

    • A foal nasogastric tube with a guide wire

    • A specimen cup filled with water

    • Suture

    • Superglue

    • 1-inch tape

    • A 20-gauge, 1.5-inch needle

    • Sterile lubricant

    • Self-adhesive bandaging material


    Before feeding a foal through a nasogastric tube, the following must be done:

    • Before the tube is placed, measure it (from the foal’s nostril to just beyond its elbow) and mark it at the end by the nostril to indicate where to stop inserting the tube (FIGURE 2). After the tube has been placed, regularly check that the mark on the tube is near the nostril and that the foal has not pulled out some of the tube.

    Always check tube placement to ensure that the tube is correctly placed in the stomach. Although radiography is the only definitive method of verifying correct tube placement (the ends of many tubes are radiopaque), several other techniques may help to ensure correct placement:

    • Palpate the tube in the foal’s esophagus. This is usually best to do in the throat latch or distal esophagus.

    • Place a stethoscope on the foal’s abdomen and use a syringe to gently introduce air into the tube while listening for bubbling in the abdomen. Caution: Introducing too much air may result in colic!

    • Attach a dose syringe to the tube and gently aspirate (pulling too hard could cause a mucosal lesion). If the tube is placed correctly, aspiration should result in negative pressure.

    If there is any doubt about tube placement, ask the veterinarian or remove and replace the tube.

    To avoid aspiration, the foal must be standing or completely sternal! A foal should never be fed while lying laterally.

    Once correct tube placement has been verified and the foal is in sternal position, feeding can proceed as follows:

    1. Check for reflux if indicated. This can be done with larger nasogastric tubes, but not with smaller indwelling feeding tubes because their small diameter makes it difficult to siphon fluids from the stomach.

    2. Introduce a small amount of water into the tube to ensure that it is patent.

    3. Pour the measured, filtered mare’s milk into the plastic feeding bag or syringe.

    4. Ensure that all air is out of the fluid line.

    5. Attach the fluid line to the tube and allow the milk to flow into the tube via gravity; do not force feed. It is important to keep the foal’s head in a normal position during feeding.

    6. Chase the milk with additional water to clear the tube.

    7. Secure the cap on the end of the tube.

    8. Ensure that the tube is securely fastened to the halter with a plastic tie, tape, or other suitable material. The tube can be secured (1) to the muzzle by wrapping tape around it or (2) to the nostril with sutures or superglue.

    9. After feeding, the foal should remain in sternal position with its head in neutral/normal position for at least 5 to 10 minutes. Keep the foal as sternal as possible by supporting it with padding, pillows, or towels.

    The amount of fluid administered depends on several factors (e.g., the foal’s size, existing medical conditions) and should be determined by the veterinarian on a case-by-case basis.

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