Peer-reviewed guide spotlights nasal feeding tube placement
Bottom line
Today’s Veterinary Nurse has published a peer-reviewed clinical how-to on placing nasogastric and nasoesophageal feeding tubes, focusing on a common supportive-care procedure for dogs and cats that need short-term enteral nutrition in hospital. The article adds practical, step-by-step guidance for veterinary nurses and technicians working in emergency and critical care, where these tubes are widely used because they can often be placed without general anesthesia and can help start nutrition early in patients that are unable or unwilling to eat. Broader guidance from AAHA and Merck supports this approach, emphasizing enteral feeding over parenteral nutrition when possible and noting that nasal tubes are among the easiest short-term options for hospitalized small animals. (aaha.org)
Why it matters: For veterinary professionals, the value is less about a new product or policy and more about standardizing a high-risk, high-frequency bedside skill. Correct placement matters because inadvertent tracheal placement can lead to serious complications, and recent research suggests that structured radiographic checks can improve both accuracy and clinician confidence when confirming tube position in dogs and cats. The publication also aligns with a broader shift away from syringe feeding in hospitalized patients because of food aversion and aspiration risk, and toward earlier, protocol-driven nutrition support. (onlinelibrary.wiley.com)
What to watch: Expect more clinics to pair practical placement training with formal confirmation protocols, especially as newer radiographic guidelines for nasal feeding tubes gain traction in small animal practice. (onlinelibrary.wiley.com)
Key facts
- Article type
- Peer-reviewed clinical how-to
- Topic
- Placement of nasogastric and nasoesophageal feeding tubes
- Use
- Short-term enteral nutrition in hospitalized dogs and cats
- Setting
- Emergency and critical care
- Placement
- Often possible without general anesthesia
- Why it matters
- Helps start nutrition early in patients unable or unwilling to eat
- Confirmation
- Recent radiographic guidelines may improve accuracy and confidence
- Team role
- Veterinary nurses and technicians
A new peer-reviewed article in Today’s Veterinary Nurse puts the spotlight on a procedure many hospital teams perform regularly but don’t always approach with the same level of standardization: placement of nasogastric and nasoesophageal feeding tubes. The piece, “How to Place Nasogastric and Nasoesophageal Feeding Tubes,” centers on short-term enteral support for veterinary patients that are unable or unwilling to eat, a core issue in emergency and critical care. (rcvsknowledge.org)
The publication lands in a practice environment that has increasingly prioritized earlier nutritional intervention in hospitalized dogs and cats. AAHA’s nutrition guidance recommends assisted enteral feeding within 72 hours when intake remains at or below one-third of resting energy requirement, and specifically favors enteral over parenteral support when feasible. Merck’s critical care guidance similarly states that direct enteral nutrition is preferred, warning that inadequate nutrition can contribute to GI dysfunction, organ dysfunction, poor wound healing, hepatic lipidosis in cats, and even death. (aaha.org)
That background helps explain why nasal feeding tubes remain such an important tool. Compared with longer-term options such as esophagostomy or gastrostomy tubes, nasogastric and nasoesophageal tubes are generally used for short-term support and can often be placed without general anesthesia. Merck notes that these tubes are easy to place and well tolerated for trickle feeding, while nasogastric tubes may offer the added benefit of gastric suctioning to help monitor GI function and potentially reduce ongoing vomiting and aspiration risk. (merckvetmanual.com)
The practical details surrounding placement and confirmation are where recent outside research adds useful context. A 2026 Veterinary Radiology & Ultrasound study introduced and validated radiographic guidelines for identifying correct nasoesophageal and nasogastric tube position in dogs and cats. The multi-institutional study included 129 correctly positioned esophageal cases and 127 incorrectly positioned tracheal cases, and found that the guideline improved accuracy and confidence in interpretation. The proposed approach calls for a single lateral cervical and thoracic radiograph that includes the larynx, then assessment using three criteria, including dorsal positioning at the larynx and lack of complete overlap with the tracheal lumen. (onlinelibrary.wiley.com)
That emphasis on confirmation is consistent with existing nursing and technician education materials. A Today’s Veterinary Nurse ICU checklist example advises topical anesthetic, measurement to a predetermined landmark, ventral and medial passage of the tube, and post-placement confirmation steps including aspiration, saline or air checks, and a right lateral radiograph interpreted to confirm placement. Earlier literature has also evaluated capnography as a way to distinguish alimentary from respiratory placement in dogs, showing that concerns about airway misplacement have been part of the conversation for years. (todaysveterinarynurse.com)
Industry reaction here is less about controversy than about reinforcement of best practice. RCVS Knowledge has highlighted nasal feeding tube placement as a practical skill for small animal practice and notes that, in the UK regulatory context, registered veterinary nurses may place naso-oesophageal and naso-gastric tubes, underscoring how team-based these procedures can be in referral and hospital settings. That fits with the broader trend toward protocolized nutrition support delivered by a coordinated veterinary team rather than handled ad hoc. (rcvsknowledge.org)
Why it matters: For veterinary professionals, this article is useful because it translates a familiar procedure into a more repeatable workflow. Hospitals are under pressure to reduce variability in critical-care nursing tasks, and feeding tube placement sits at the intersection of nutrition, patient safety, and technician utilization. The clinical stakes are meaningful: AAHA no longer recommends oral syringe feeding for these cases because of food aversion and aspiration risk, while Merck advises gradual escalation of calories in starved patients to avoid refeeding syndrome. In that context, better placement training and better confirmation practices can directly affect outcomes, efficiency, and confidence on the treatment floor. (aaha.org)
What to watch: The next step is likely wider adoption of standardized confirmation pathways, especially radiographic protocols that explicitly include the larynx, along with more formal nurse- and technician-facing training tools in emergency and ICU settings. If those 2026 radiographic guidelines are validated further in day-to-day practice, they could become a more routine part of how clinics document safe placement of nasal feeding tubes in dogs and cats. (onlinelibrary.wiley.com)