Below are from owners who have needed to have a feeding tube placed. Thought this might help those who are considering having this done, but not quite sure what to expect. The first part contains miscellaneous valuable information then there are some owners stories.
“Our ME dog had a feeding tube placed on 14 Jul. He was unable to get any food/water from his esophagus to his stomach. The surgery went well and he is healing wonderfully from the surgery. The problem is that his saliva pools in his esophagus. He already had pneumonia that never was resolved before the surgery. I fear now that it has progressed because of the constant presence of fluid in his esophagus. He reguritates several times a day. If not doing so, he still needs to be held vertically for some time (15-30 minutes) after the tube feeding. That may also help w/ the pooling of saliva, ie. holding vertically, even in between feedings.”
“Your dog needs a tube. It might prove only to be temporarily necessary, if it is an acutely inflamed esophagus, which a tube would allow to heal, or it might prove he needs a permanent one. But for the few that cannot be managed only with gravity feeding, it is a lifesaver. Truly a lifesaver. Unless you dawdle too long. It sounds as if you are really there now. I have tried to do what I can to eliminate a sadly undeserved but popular bias against feeding tubes by including a segment in Bailey’s DVD of Jake the chocolate Lab and his feeding. He is a healthy, happy dog. What we humans quickly learn is that dogs are happy when they have a full tummy. As much as we feel sorry that they have to skip the oral aspect of a meal, dogs “get over it” and just go on with no apparent thought about “feeling deprived”. Tubes are not perfect or without their own issues. But for some dogs, they are a lifeline and not such a complicated one. Challenges include great care being necessary the first two weeks post-surgery, as the tube can dislodge easily before it “seats” and the skin heals (a K9 Topcoat helps to keep the dog itself away from the tube – no messing with it), inflammation and a mild infection can develop where the tube enters through the skin, the human has to get used to feeding through it, cleaning it, etc, and so forth. If you have tried Carafate for a few weeks, you have tried Cerenia, and you’ve done a course of triple therapy, you need to get him to someone who can evaluate him for the tube this week. Dehydration can quickly affect muscle function, heart conduction, and cause other, life threatening problems.”
“Have you had your tube fed dog treated for bacterial overgrowth? This is a treatment used for HPylori but our dogs seem to get other, similar infections that wreak havoc with dogs with mega-e. It might also play a role with managing the tube. Go very slowly with this new device. Don’t overfeed!!! And if something seems off, go immediately to the DVM! A new tube can dislodge, spewing contents into the peritoneum. Peritonitis and resulting sepsis are horrible.”
“Buddy was able to pull his feeding tube out. Last night he was taken to hospital for another operation. The doctors had to clean out his stomach. Now they have put another tube into his neck with the tube going down through his esophagus. Buddy has survived that operation, but is now very tired again. It
must be said, I did question the placement of the first tube. Now I must be determined that he not be able to scratch the new tube out when he gets some strength back. What is the best way to impede scratching of the tube? I don’t want to have to resort to one of those cones forever. Is there some kind of bandage we can put around the neck to protect the tube from his paws? I saw a video of one ME dog with a kind of padded girdle around the waist. I assume the girdle was used to protect the feeding tube. I also asked my colleague, ‘how will we be able to progress to mouth feeding with the tube going down through the esophagus?” He replied that the esophagus is wider than the tube so we will be able to do mouth feeding. I assume with the tube now in the neck we will have to do all feeding in the Baily chair.”
“Definitely consider the tube if nothing else is working!!!!! We just had one put in for a 7 year old Lab that we have in foster care. IT HAS MADE ALL THE DIFFERENCE!!!!!!! He now can keep every meal down. It’s very easy to do so don’t worry about the mechanics of feeding her with it. For us………it saved Salvation’s life!!!!”
“How to cover a tube in the neck? Here are four ideas:
1. Can you get a large human cervical collar at a medical supply in C.R.?
2. Maybe you can make a wide neoprene collar with a velcro attachment. Neoprene is used in wetsuits for divers… maybe can find it online. I think they make these for horses too, as kind of a safe strap for pasture.
3. Another possibility is a Pro-Collar… essentially a ‘wearable pillow.’ These can be purchased at large pet stores in the US (and online) or you can make your own.
4. Finally one board member found that airplane neck pillows can be velcro-attached to the necks of her dogs… maybe too small for a Golden Retriever?”
“I found a website that sells the kind of neoprene collar (for horses) that might work for Buddy. There are pictures of it, it’s called a Jowel- Sweat, and it comes in different sizes. You could probably just cut it if it is too wide. Here’s the link: http://www.horse.com/item/Jowel-Sweat/BHA14/”
“It is the K9 Topcoat (not to be confused with the K9 FloatCoat) that is used to keep the dog from accessing the tube. For the first two weeks after the surgery, while you are by the dog’s side 24/7, this may not be necessary. Or it might. But afterwards, unless your dog doesn’t care about the tube, you really should use the topcoat. As I recall, it comes in different fabrics and design, but it really outperforms t-shirts and other makeshift designs for keeping the tube inaccessible. You may also want to get the soft collar from www.bonafido.com for comfort and for keeping the dog’s head away from the tube. Dislodgement of the tube is a real risk after surgery, so you stay right there with the dog, but the proper accessories will allow you a little sleep during the process!”
“xxxxxxx wears a strip of stretchy mesh round his tummy to keep the tube in place and out of his way. It’s called Surgifix and vets use it to keep catheters and so on in place, so you should be able to get some. It looks a bit like a string vest, but is much stretchier. It comes in long lengths and you just cut of what you need and it goes round the dog’s waist, rather like a belt. When Theo goes out he wears a fleece dog sweater [Hotterdog obtainable on line]. This keeps his tummy clean.”
“As i had a few minutes of free time on my lunch break, i was able to find a “Neck Guard” that may assist you in protecting Buddy’s feeding tube. It can be found at : http://www.oasisoriginals.net/petgear.html”
“I need to know how to make it easier to suck the food into the syringe. My neck and arms are killing me. I can’t get them pushed in and I can’t suck the food up: a group member stating that they used a cake decorating syringe they can take a lot more food with a single filling and can be loaded from the other (non nozzle)end, also they are designed for a higher viscosity (thicker) fluids. I only heard about this when Happy was of his tube already otherwise I would have tried it myself, maybe that will work for you. I believe that it should be a pretty liquidy blend. Generally, with the syringes, you have the plunger pushed all the way in, then put the tip into whatever you want to suck up and pull back on the plunger. This draws the stuff up into the tube. It may be that you need to add more water to his food to get it to a consistency that it can be drawn up. If that is still to difficult, you can try this: Take the plunger out, Cover the tip of the syringe with your finger and pour the food into the plunger from the top. Don’t overfill as you will still need to get the plunger back in to push the food into the tube. You may need to use a sharp knife to “shave” the sides of the rubber on the plunger down just a bit so it slides more easily.”
“The food needs to be sufficiently liquid to be able to be syringed up easily – about the same consistency as cream. This needs to be warmed to blood temperature before it’s given to xxxxx, this will make it even more liquid. Another trick is to smear a little vegetable oil, or similar, on to the rubber part – this makes the syringes much smoother to use.”
“There has been a discussion recently about size of syringes and feeding tubes. I have an 8 year old lab that has had a feeding tube since 12/09, and his “permanent” tube was put in about 3 months ago. (March 2010). With the temporary tube, I was able to use the 60cc syringe with a catheter tip, but the current tube uses the luer tip syringes. The type of feeding tube that Salvation has gives you the option of using a tube that goes from the syringe and actually locks into the opening of the feeding tube. The syringe end of this tube is bigger and will accommodate the catheter tip syringe, and it then tapers down to the end where it attaches to the tube. I have opted not to use the extension tube. It seemed like one more thing to wash many times a day, as well as increasing the chance that some small particle would get stuck between the syringe and the feeding tube. I have not found a problem with using the smaller tip syringes, unless as someone else mentioned that the blended food is too cold. If it has been refrigerated, I simply warm it up in the microwave. I do blend all the food in a Vitamix, which does a great job. Now, as far as some tips for getting the syringes to work better: As Sal gets 8-10 60cc syringes per meal, several meals a day; we are getting it down pretty well. New syringes always work the best. We get about a week out of a syringe – I order them online, a couple boxes (20 syringes to a box) at a time. They run about $1 each. After each meal, they are washed in warm, soapy water, and the plunger is taken out of the tube to dry. If you leave the plunger in the syringe, it will “stick” to the syringe, and even if you are able to break it loose again, it will not work smoothly. Each time I fill a syringe, I coat the rubber part of the plunger with some type of oil – olive oil, flax oil, corn oil, something that will help make sure it is easy to work. I even do this with brand new syringes the first time I use them. I keep a small juice glass with about an inch of oil in it, and carefully dip the end of the plunger in the syringe. Then put the plunger into the syringe. I try to always wear an old sweatshirt, as I always manage to drip oil on myself during this process. After the syringe is together, I then fill it by sucking the food into the syringe. I figure if I can get the food in through the small tip, then I will be able to get it out. Sometimes when I am filling a syringe, I will find a chunk of something that blocks the tip. Wipe that off, then you should be able to continue filling the syringe. I wipe the tip of the syringe with a paper towel before putting it in the tube. The down side to this method is that sometimes I get oil on the tube and it is hard to hold onto. I found that if I used a paper towel around the end of the tube, it solved that problem. Last, once a syringe is worn out, usually signaled by the rubber tip coming off the plunger, I throw it away. The first time it happened to my husband when he was feeding Sal, he was pretty sure he could put it back together – I convinced him it wasn’t worth the trouble, and that it would just come
apart again the next time it was used.”
“We went to the medical supply place and got gauze tubing in his size, or the cotton tubing too, then we cut leg holds in it and slipped it over his head like a t-shirt. It comes in all sizes (I don’t know how big your dog is, but it would probably go in size up to about 20 lbs., I guess if he is bigger then a small t-shirt would work the same, just cut out the sleeves.) and then we used one round of “vet wrap”, which sticks to itself to secure it loosely only wrap around enough to make it stick. Ketel was a young puppy and was very active when he felt good and we tried all kinds of stuff to make it work, that was the best.(and the vet wrap comes in cool colors.”
“The tube will not prevent regurge or aspiration, will not prevent AP and will not cure the ME….but what it will do is give your pup much needed nutrition to better deal with AP or other future problems. And whether it is temporary or becomes a permanent tube, at least you know that Willy is getting nutrition, staying strong and becoming more healthy.”
“As for the quality of life question, The quality of life will actually be better with the tube because your dog will now be getting food and nourishment. They can still play, roll around and have fun. Jake is a lab who still goes hunting with me even with his feeding tube. There is a video on you tube of him. His only limitation is no swimming anymore. This is totally manageable if you choose to go down that road.”
“Common mistakes early on: some other mistakes that I made for the first few days. When you pull up the food in the syringe, you must leave room to pull the plunger back after you attach the syringe to feeding tube to remove the air. There is always air in the tube that you don’t want to push into his stomach. So I fill the 60cc syringe up to 50cc and leave the rest of the room to pull all the air out of the tube at EACH time I attach the syringe. Pull the plunger back and you can see the air come through the food. Perhaps my food is thinner but it seems to drop down and leaves about an inch of air at the top of the tube. Check for air in your case! Also the syringes “breakdown” a lot quickler than I thought meaning the rubber on the plunger wears out. Some folks use multiple syringes at each feeding, I use one at a time and keep filling the one up. When it becomes too hard to push the plunge I get a new one. All the sucking up and pushing down can actually be hard on your hand! I found that spraying the rubber plunger with PAM helps prolong the life of the syringe and acts as a lubricant. Others rub the rubber in cannola or flax see oil. You can buy a whole box of syringes on line at a time which is more cost effective. In terms of food, I used Iams MAX CAL for the first week or so. FOr a small volume it had a lot of calories, 330 per can I believe. After he could handle more volume I switched to dry food that has 500 cals per cup. MAX CAL was expensive. If you use MAX CAL or A/D you still have to add water to it to get it through the tube easily.”
The first week with the tube was horrible, no doubt about it, but it has gotten SO MUCH EASIER over time. I feed her Iams low residue canned food from the vets.
“Kind of tubes: just ordered an extension tube directly from Corpak med systems which makes the CUBBY (the type that Nemo will get in soon)but you will need to know who your manufacturer is. Kimberly Clark also makes a popular one one called MIC-KEY. They also come in different lengths. What kind did they put in? The extension tubes comes at right angle or straight depending on your situation he has is a passport. According to the surgeon it does not have an extension. I am going to double check with his Vet tomorrow just to double check because it makes no sense that there would not be an extension. It is impossible to get the syringe in there. His body has to be in the perfect position and he can’t move. So it takes one to hold him and another to work the tube. It figures they give me the one tube with no extension. feeding tube is a Kimberly Clark / Ballard MIC-KEY Low Profile Gastronomy Tube. His is 24Fr and I don’t know the length. He had a different one initially but I don’t remember what it was other than a low profile tube. This one is much better and one that I would recommend.”
“K9 Topcoat for him. These are excellent for covering the tube and keeping him away from it. Of course, you will need to be with him 24/7 for a couple of weeks to ensure it seats properly. If it dislodges, it can cause peritonitis under the wrong circumstances. This is rare, but possible, so you need to stay with him until it seats.”
“Go for the tube quickly, Kim. They do save lives, and often, we see that a temporary tube will allow a badly inflamed esophagus to heal. That doesn’t mean that function will return (in a tiny percentage of cases, it will!), but many times, the dog can resume oral feeding (still in the Bailey Chair), and the tube can be removed. Other dogs just continue to do well but have a permanent tube placed. The point is that for now, you NEED to get food and liquid into your dog’s stomach, and this is the way to do it directly, when the esophagus is not cooperating. The chair can only do one thing: it uses gravity to do what peristalis used to do. If there is no “straight shot” in a vertical position for whatever is in the esophagus to get to the stomach (usually because of deformed and very flaccid, enlarged esophagus), then you have to put it directly into the stomach via the tube. No, it isn’t perfect, and has a few of its own challenges. But for some dogs, it is the difference between life or slowly starving to death. I wouldn’t hesitate to do it.”
“Placing a feeding tube:
As mentioned earlier, he had some inflammation around the site so that’s why she presses down on the tube when filling the balloon. The other video is the testing of the balloon of his tube.
Balloon testhttp://www.youtube.com/watch?v=dcEj4J6XeYQ
Replacing tube http://www.youtube.com/watch?v=BcX_AMTJuxg
Bill, Deb and Jake”
“Some things I learned along the way are:
1. Make sure the food isn’t too thick, otherwise the syringes are really hard to push
2. Spray the syringe plunger with a little Pam or roll it in a little oil before you start. They will work a lot smoother.
3. Don’t fill the syringe too full. Leave a little room to pull back and get rid of any air bubbles in the hose.
4. Take your time. Too fast will make your dog nauseous.
5. Occasionally run some flat Coke thru the extension hose to clean it. (not while attached to your dog)
6. Buy extra non-sterile syringes on-line from AllegroMedical.com. They are reasonable, fast and run specials all the time.
7. A K-9 TopCoat is a great investment, especially if he is around other dogs.”
“T-shirt rubbing site raw: Maggie had the regular long PEG tube for about the first four months before transitioning to the low profile tube. She has pretty sensitive skin, and the t-shirts rubbed her raw, too. Sometimes we used a long Ace bandage to hold it in place and give her a break. Also there is that stretchy open mesh that you can get at surgical supply or at the vet’s that can be fashioned into a tank top of sorts and hold everything in place. As far as bathing, I don’t see why not, as long as you don’t submerge him. I’d just go easy with the shampoo around the stoma, but I don’t think a rinse down will be a problem. We bathe Maggie about every two to three weeks with the hand held shower, and have never had a problem. You could always put a little Neosporin or Intrasite Gel around the opening to seal it off if you’re worried about water getting in.”
“Regarding an alternative to the T-Shirt, my Boy Beau sports a home made Sporan that my wife made for him. It is a pocket sized pouch sewn on 3 sides with the top closed with velcro. There is a hole on the Stoma side for the tube to be drawn through and is coiled up inside. The pocket is held in place with two laces that loosely go around his body and tie off at the top. Beau is a hot dog (no pun) and this is a great solution that has worked for us. We have a few so they can be changed and washed regularly.”
“Beau and his PEG Tube pouch that my wife made for him. Also, a few additional pics in his Bailey chair and others.
https://picasaweb.google.com/101722818710761260545/BigBoyBeau?authkey=Gv1sRgCOWG1oDS9dLBwgE“
Owners story: “Our Olivia had a temporary tube for several months while she recovered from a severely ulcerated esophagus…it was put in as a “last-ditch” effort when the vets at Tufts had exhausted all their alternatives. Within a day of getting the tube, and getting good nutrition, she perked up enormously. And while you are concerned about the time and commitment, we found that using a feeding tube was actually pretty easy once we understood the basics….and did not try to feed too much at one time. It was a bonding time for both of us….she would lay on the couch quietly while I administered the food and she seemed to understand that it was important to relax and behave during this time. She was just a year old, so she was full of puppy spunk…..but she seemed to know that the feeding tube was important. So it might not be as difficult to adjust to as you think. You mentioned that Mingus did not take to the Bailey Chair….Olivia did not either, initially……but I found that it was the only way to cut down on the time I had to actually sit right in front of her and hold her paws or keep her still. We eventually had her sit in the chair in a normal sitting position, but elevated the front of the chair so she was essentially vertical, the same as if her paws were elevated. That way, she would remain seated, I could feed her and then be free to walk around, wash dishes, do computer work and other things without monitoring her or worrying about her escaping from the chair. Also, just as a reminder…..when I took Olivia back again to discuss getting a second feeding tube when she started to have more severe bouts of AP last winter, the vets reminded me to have reasonable expectations….the tube would not eliminate her ME, would not necessarily totally eliminate regurg, and would not necessarily stop the AP….but it WOULD mean that she would get more nutrition, gain some weight and be better equipped to handle and future bouts of AP. And, of course, there can be complications, as with any surgery. But with a young dog for whom getting enough food is a major issue, it can be a lifesaver and is really not as difficult as you might think. If you are even thinking of getting a tube, sooner rather than later is better. They have to be strong enough to withstand the procedure and it does involve sedation. However, once you get it you will most likely be amazed how easy it is to manage. No more complex than anything else we do for our ME dogs. You might even be able to eventually get him back to eating by mouth. With our Olivia she only needed her tube about 3 months and then was able to eat normally for several years. (This was before her ME.) Anyway, it can be a bonding experience for you and your dog as the feeding times are usually very calm and quiet with your dog lying on his side while you syringe in the food…I always found it relaxing for both of us.”
Owners story: “Clousseau was at death’s door in May, and the vet who admitted him (his REAL vet was in theatre at the time) watched my dog collapse in front of me and did nothing but stand back to “give me a moment to say goodbye”. My vet called me later and basically pushed me until I agreed to have him put in a feeding tube the NEXT day. This is what saved Clousseau’s life. As I have said before, it made it possible for me to look past the immediate crisis of pneumonia, starvation and imminent death, not to mention suffering. These issues cloud the real condition your dog is in. I know this sounds strange, but what I mean is that for a 9 year old Great Dane, Clousseau is very healthy – no heart, joint or any organ problems (for now, and hoping this will last a long time!). He just – can’t – eat normally. Once I got past that issue, I could look at his REAL condition and base my decision on that. But while he was in crisis, I could not see or judge this. He needed to be stable and with a fighting chance before I could make life decisions. It does involve work, and you do need to be vigilant about just about everything in your routine with him. But it becomes easier as you work out what works, and what not. This group is certainly worth gold, and so is a vet who won’t give up as long as you don’t, and then some. He still regurgitates sometimes – I would estimate a few days every 2 weeks or so, mostly when I am not careful and he gets to water or leftover food. He has NOT had another bout of AP, knock on wood. He lost some weight recently, I think because I changed his food and was not vigilant about calorie intake. But he runs and plays with the other dogs as much as any older dog would, and he went to be measured for his permanent tube yesterday. I asked my vet yesterday how many ME cases he had seen, and he said, about 6 in the past 5 years – all older dogs, all euthanased, all too late too save, so weak they could not stand anymore. All the owners had waited too long and then either did not land up in the right consultation room, or it was too late anyway. Clousseau is the only dog who got to him soon enough, and who got the right treatment soon enough. But as always, this kind of decision is heart-wrenching and very personal. I was also hesitant about having the tube fitted – I saw it almost as a kind of sentence, but nothing could be further from the truth. I would do it again in a heartbeat. But had it not been for this vet, I would have waited too long and lost Clousseau sooner than his time.
Cleaning a tube:
The vets always remarked on how clean Clousseau’s stoma was. On recommendation of my supervet, I used a surgical product called “intrasite gel”. “Intrasite is a colourless transparent aqueous gel, which contains 2.3% of a modified carboxymethylcellulose (CMC) polymer together with propylene glycol (20%) as a humectant and preservative. When placed in contact with a wound, the dressing absorbs excess exudate and produces a moist environment at the surface of the wound, without causing tissue maceration.”
http://www.dressings.org/Dressings/intrasit.gel.html I used to clean the area around the stoma with “hibiscrub”, an antibacterial shampoo, rinsed it with a solution of Savlon antiseptic liquid and warm water and then gently pressed as much intrasite gel as I could with my finger into the stoma. For dressing, I used round cottonwool face wipes, the kind you use to remove makeup. I cut a little x in the middle to get it over the exterior stopper so that it was flush with the side of his body, and then wrapped a bandage criss-cross over the tube and his middle to keep the tube facing upwards and lying still in one position. This was still a temp PEG tube, not a low profile one. Whenever his stoma became moist and gungy, I used this product and within a day or two he was all dried out and clean.
Owners story: “When Theo first had his tube he was being fed a product called Enteralcare, which I believe is available in the US [I live in the UK]. He came home from the hospital with enough supplies to last for a couple of months, but, once it was gone we had to get inventive. Enteralcare is extremely expensive – especially for us since it has to be imported]. The mixture we have had the most success with, and have been using for about 9 months now, is Hills ID, pureed with coconut milk, rice milk and canned pureed pumpkin. We gave up on mixing the food with water very early on because we weren’t getting the calories that Theo needed. Hills AD is also a possibility – it’s a recovery food, so highly nutritious – but the high fat content gave Theo pancreatitis, so for us that was a no no. Using the coconut milk, which has 165 kcal per 100 ml, has meant that we have been able to decrease the sheer quantity of food necessary to provide adequate energy. This is mostly in the form of fat, but since it’s a medium-chain fatty acid, it is easily digested and tolerated. The pumpkin puree is invaluable for producing nice, firm stools. We recently had full blood work done on Theo to ensure that this rather weird diet was OK, the only problem area they encountered was calcium, so this will probably mean a supplement. It would be possible to increase his calcium intake significantly by adding a raw egg at each feed and we have tried this -gradually working up from 1 egg per day to the full 3. Unfortunately, his GI tract was not happy with this! So, our recipe for a daily batch of food is: 3 cans of ID, 2 x 400 ml cans of coconut milk and about 350 ml of rice milk with added calcium to give a syringeable consistency, plus 100 grammes of pumpkin. This batch lasts for slightly more than 3 feeds and gives around 1600 calories per day. Each feed takes approximately 15 minutes – you will find, over time, that you can speed the process up a bit. I think the recommended rate is 1 ml per second. Final point! Before the tube was fitted in December, 2009, Theo weighed 47 pounds [he was emaciated] he now weighs 59 pounds. So he has gained about 1 pound every month on average. He could still take a few more pounds, but is now nicely covered.”
Owners story: We are about 6 weeks on from Molly’s initial diagnosis and almost 5 weeks into tube feeding. She was very sick with AP and continually regurging and losing weight so our only option to keep her going was to go ahead with a feeding tube. It was the best decision we could have made, as she got stronger and started gaining weight immediately and was more like the old Molly we love. She was in the specialist hospital battling the AP and once they put the feeding tube in we were able to bring her home a couple of days later. We went in every day and became comfortable with the tube and feeding, the Dr’s there were very supportive and answered every question, and believe me we had a million! The only thing I wish I had known more about was the option of a low profile feeding tube, she has a peg tube which has a long dangly tube which we tuck into a stretchy shirt she wears. Manageble but a low profile tube would be so much easier long term. I think thats something we will switch to if she continues down this road and she still needs the feeding tube. She’s doing so well with the tube that I’m nervous to try vertical feeding! Luckily our own Vet who was initally a bit negative about the diagnosis seems to be much more supportive and happy to hear what I’ve learned from this group (I don’t know how we would have survived without it!) and is being so helpful now. So good luck, don’t be daunted by the tube feeding if that is the best option for your baby. It’s very manageable, I make up a days supply of food and then just draw up the right amount at each feeding. We use Eukanuba which is what she was on before she got ME, I mix in water, Yakult (probiotic drink which combats what I can only descibe as killer (smelly not painful) gas, we nearly had to evacuate the house/street) and coconut milk which has helped a bit with weight agin. Last week she weighed in and had gained a 100gms, our first gain not loss so very exciting. Hopefully the gain will conitnue otherwise might try mixing in baby cereal next. You will learn as you go! She started out on Hills AD which is a critical care food but it is quite fatty, she does seem better back on her normal food. I just soak her daily allowance of Eukanuba overnight and then put it through a food mill, mix in the other bits and pieces and then use a hand blender to liquify it. She is on 5 feeds a day at the moment which is a bit restrictive but it’s worth it just seeing her happy and well. Long term our goal is to reduce feeds when we can. It’s all about getting the calories into less feeds and not increasing the volume of each feed to much. It will all seems a bit much at first but you will get into a routine, it feels like this has become our normal now. We struggled at first with the single use syringes as they got very stiff rather quickly. We’ve since found Medicina 7 day enteral home use non sterile syringes which has made our lives much easier. Using a bit of spray oil also helps alot. Now that Molly is off the Hills AD and back on her usual Eukanuba I just use a food mill to mush it then add in the probiotic and coconut milk and then use a hand blender. I make up a days supply at a time. We’re off to the vet today to see if she has gained any weight The upright time is to prevent food from refluxing back up into the esophagus after feeding. Here again, each dog will have different needs. I feed Maggie the same way as Rose feeds Molly, propped up on the arm of a sofa with pillows, and then she usually takes a little nap there. I know Becky tube fed Nemo while he was in the Bailey chair and kept him there for a while after. For Maggie, the sphincter between her esophagus and stomach is unusually small, so our method seems to work fine, and we’ve never had an incident of reflux after a meal, but you may find that Marley benefits from a little vertical time after feeding. You’re going to have a learning curve on managing the tubes. ”
Owners story: “First night was rough and very painful for him. First feeding went well, no glitches, no choking. I fed him lying down (front propped up) and then put him in his chair for 50 minutes. Everything seemed perfect and I was pleased. An hour later, he started regurgitating and it went on for about six hours. I don’t know if I fed him too fast, wrong position, or if he was sick from the surgery and pain meds. From then on, the rest of the feedings have gone well and food has been staying down. His pain seems to be resolved and he’s back to being a happy boy. He did regurgitate once tonight, nothing actually coming out. It seems his stomach really doesn’t hold what it “ought” to and my vet wonders if he’s really ever had a full stomach. She said he also had more gas than she’d have expected when she did the surgery. So for right now, we’re feeding four to five times a day and I think it’s going well. I love that he can sleep with me again (couldn’t do that when he was spewing 24/7) and that he’s getting back to normal. I’m trying to figure out how to get enough calories into him with floating him away. I’ve mixed several different types of food and have settled on Wellness canned Lamb and Sweet Potato. The calorie content is pretty high and it blends to a smooth consistency. I am able to get the most food into the least volume with that program. I have no idea how you guys are getting the dry blended and through the tube without feeding gallons in volume! I’m wondering how long each of you spends in each feeding, meaning how slowly do I feed? Also how many ml’s in total (per pound) are you feeding each time? By calculations of stomach capacity, I’m not coming close to what he ought to be able to handle before I see what I believe to some discomfort. P.S. I should have added that I am feeding him (still by tube) in his chair now. He is currently sitting for 45 minutes.”
Owners story: Sabot has had his PEG tube for over 3 months now and is doing really well. In the beginning, we had trouble keeping weight on him, but have found the right solution and now he’s back up to 78 pounds! He was 90 at diagnosis and got as low as 64 (he was in danger with ribs and hip bones clearly visible, it was NOT looking good). He’s had a couple bouts of AP even after the tube was placed (he got into the trash once and into his brother’s kibble another time), but he’s still able to bounce back quickly once the antibiotics get in his system. All in all, our boy is doing so well. Still so full of life, so happy. I can’t believe we resisted the feeding tube as long as we did. I wish we had done it sooner. It is the BEST decision we have made since this whole mess began. Life is so much better and easier for the whole family and we are better able to get the amount of calories into him that he needs. He enjoys his feedings and I think he knows he’s being fed. Sabot hasn’t had one single regurge incident(aside from the trash and kibble he wasn’t so supposed to have). He is happier, feedings are faster and easier, and he’s finally back up to a healthy weight. This dog truly hated the Bailey chair and never stopped trying to weasel out of it (he required 45-60 minutes in the chair after eating), so that alone was a big improvement in his quality of life. I would not hesitate to make this decision again and HIGHLY recommend a tube to anyone whose dog is not responding well to vertical feedings. It does NOT have to be an end-of-life decision! The tube has saved my boy, and his surgeon thinks we can expect AT LEAST another 2 quality years with him.”
Owners story: “If you are considering a feeding tube, it is better to do it sooner, rather than later. Since Sapphire already has AP, that may complicate things, since it will compromise the outcome. That said, when my Maggie could no longer get food or water down to her stomach, and had lost a third of her weight, I had a tube inserted, and it saved her life. She will have to eat via tube for the rest of her life, and the truth is that feeding her by tube is much easier than by mouth. What you put in gets to her stomach, and stays there, food, water or meds. She has gained back all her weight and is a happy active girl today. Someone has to be with her for the first week, at least, so the stoma has a chance to heal. There are ways to protect the tube from being pulled out or damaged. Maggie has removed her tube a couple times on her own, and depending on how long it is out, it can be a simple re-insertion, or a more complicated procedure, if the stoma has closed up. She won’t bleed to death. They tack the stomach to the muscle on her left side, and then create an opening (the stoma). Eventually she has gotten so she doesn’t bother it at all. Once the stoma healed, I had a low profile tube inserted, and the vet specialist showed me how to change it out myself. It’s very simple. Food can be either kibble or canned food blended with water and any meds to a thin milkshake consistency. Many “tubers” strain the food to remove any small chunks that might block the syringe. You can give just plain water by tube to supplement the water in the food, if necessary. Your vet will show you exactly how to feed. Many tube fed dogs benefit from some vertical time after feeding to prevent regurg. Some don’t, since each case is different.”
Owners story: “I owe my dogs life to this group and my vet specialist who placed a food tube into my wolfdogs stomach nearly two years ago. Mojo is fed 200 grammes of Acana wild prairie blended with water Three times a day His calorie intake is approximately 2200 Kcal Daily from the 600 Grammes.
Other than feeding him by tube and syringe he now leads a normal life , ( with a little extra care to make sure food is unavailable for him to reach) is happy, runs around, plays with other dogs etc. My ONLY regret is not getting the tube inserted as soon as possible as it has taken over 18 months to replace the weight he initially lost, 43kilos to 21.44 kilos . He is now back to 40 kilos. This has been Achieved with Acana and or Orijen kibble soaked for 12 hours then blended with more water to a melted ice cream consistency… then sieved and left in a bottle for a few or more hours.. I tend to be 1 day ahead with his food which gives it plenty of time to dissolve any lumps. Once you get into an organized method tube (peg) feeding takes very little time, maybe 15 minutes per feed maximum , plus a little time before bed presoaking his food for the next day – ( another 5 minutes – 3 containers 200grammes of food in each add water and cover – blend next day , sieve and drain into 1.5 litre bottles – another 10 minutes = three feeds) Mojos only medication now is 10 mg metaclopramide twice daily prior to his first and third feed I hope this helps anyone considering tube feeding for their loved ones, as without it my boy wouldn’t be with us anymore.”