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What kind of stomach intubation do we do for horses?
What are some reasons to stomach tube a horse?
- administer medicine
- release gas or fluid build up (reflux)
- treat colic
- treat choke
What is choke for large animals?
What is DSS?
medicine that absorbs water to break up an impaction
What is mineral oil/
given through the stomach tube to help with an impaction
How do we select a stomach tube for horses?
measure from nose to last rib...about 8 feet long for an average horse and 1/2 inch in diameter
What should the stomach tube look like for a horse?
- clear tube with flared end for attachment to funnel or pump
- smooth beveled end +/- holes on sides
Before trying to stomach tube a horse, what might we need to do?
use some chemical restraint
How do we stomach tube a horse?
- lube end
- pass tube into ventral nasal meatus
- flex head
- chase the swallow reflex
What is the ventral nasal meatus?
- there are three meati in the nose
- the top meatus is very short
- the middle meatus is a little longer than the top on
- the third meatus is the bottom on and is the one that we use to lead the tube into the esophagus
Why do we flex the horses head when we pass the stomach tube? What would happen if we extended the head when placing the tube?
- flexing the head helps lead the tube into the esophagus
- extending the head leads the tube into the trachea
What does "chase the swallow reflex" mean?
pass the tube while the patient is swallowing to help the epiglottis block the entrance to the trachea
How do we know the tube is in the esophagus?
- slight resistance to passage
- visualize the tube in the esophagus on the left side
- negative pressure present when suction is applied to the tube
- ingesta aroma
- audible GI sounds heard coming out of the tube
Why is there slight resistance when the tube is being passed into the esophagus?
due to the friction of the tube against the esophagus
How do we know if there is negative pressure in the tube when we suck on it?
- before the tube reaches the stomach suck on the tube and nothing comes up (no air or stomach contents) there that means it is in the esophagus because when we suck on the tube the esophagus will collapse around the tube
- if the tube is in the trachea then we will get air back when we suck on the tube
What is ingesta aroma?
- smell that will come out the end of the tube once it is in the stomach if there is more pressure in the stomach than in the atmosphere
- if there is not more pressure in the stomach then in the atmosphere then we may need to blow in to the tube first
How can we tell if the tube is in the trachea?
- hear or feel respiratory noises
- no resistance to passage - the tube will slide right down
- shake trachea and you will feel or hear tube rattling
- no negative pressure present when suction applied to tube - will get air
Is the presence of coughing a reliable to sign to know if the tube is in the trachea or not?
no, sometimes horses will not cough if the tube is in the trachea
Once we are certain the tube is in the stomach, what should we do?
- give a little bit of water before giving anything else
- administer medications with funnel or pump
- or release any gas or reflux
If we are trying to release gas or reflux and nothing is coming out what can we do? Why would this happen?
try a siphoning technique because the tube may be clogged with stomach contents or there is not enough pressure in the tube
How do we remove the tube from the stomach?
- blow the end of the tube first
- kink the end or put a cork in the end to prevent aspiration
- remove slowly with head in normal position
Why would forgetting to kink the end or put a cork in the end cause aspiration?
there may be some stomach contents left in the tube and as we are pulling the tube out and passing through the opening of the trachea or in the mouth the animal could breathe in some of the contents
Can we leave the stomach tube in the horse for a period of time?
- yes, since it is in the nose we can leave it in for up to 3 days
- put a cork in the end and tie it to the halter when not being used
What kind of intubation do we do for cattle for stomach tubing?
What are some reasons we would stomach tube cattle?
- administer medications
- release gas or fluid build up (bloat)
- obtain rumen fluid sample
- treat choke
How do we select the stomach tube for cattle?
- can be more liberal with our selection since the oral cavity is not as sensitive as the nasal cavity
- can use equine tube to old garden hose - still need smooth beveled end
- 1/2 - 1 inch in diameter and about 8 feet long
- need a speculum for the mouth
What is the most common speculum used when stomach tubing cattle?
How do we stomach tube cattle and small ruminants?
- place in head restraint
- oral speculum
- lube end
- chase the swallow reflex
How do we evaluate if the stomach tube is placed correctly in cattle and small ruminants?
the same way you do for a horse
What kind of speculums do we use for small ruminants and swine?
- harp speculum (most common)
- syringe case
- roll of tape, wooden block, etc