Correction of a Complication of the Use of a Nasoesophageal Feeding Tube in a Southern Tiger Cat (Leopardus guttulus)

Abstract

Background: The southern tiger cat (Leopardus guttulus) is a vulnerable wild felid whose occurrence is restricted to the Atlantic Forest biome of Brazilian South and Southwest regions. Various strategies must be used to improve the conservation of species of felids, including preservation of forests and greater therapeutic support for animals in poor health condition. Enteral nutrition through a nasoesophageal tube is an option for patients in poor or critical condition; however, this procedure carries the risk of accidental ingestion of the tube. The objective of this work is to describe a conservative approach for the management of ingestion of a linear foreign body in a Leopardus guttulus patient.

Case: A young female southern tiger cat was taken for veterinary treatment. The patient had an estimated age of nine weeks, 0.846 kg of body weight, and exhibited cachexia, hypothermia, severe dehydration, and apathy. During the examination, blood samples were taken, and initial treatment commenced with fluid therapy, antibiotic therapy, and anti-inflammatory therapy along with administration of analgesics and a gastric protector. Since the patient did not want to eat, it received a nasoesophageal feeding tube under mild sedation. The patient was positioned in sternal recumbency, its head was tilted up, and a no. 6 nasoesophageal tube was ventromedially inserted through the right nostril. The tube was later confirmed to be correctly positioned at the ninth intercostal space by a radiographic study. The feeding tube allowed administration of drugs and microenteral nutrition with a hypercaloric diet; this minimized handling of the patient, which preserved its wild behavior. After the seventh day of treatment, a piece of the tube was found lying at the bottom of the cage. Since ingestion of the remainder of the tube by the patient was suspected, it was taken to the diagnostic imaging division. At the ultrasonographic exam, the stomach exhibited hypermotility and was filled with a moderate amount of mucous content. The stomach wall was thin, and its stratified structure was preserved. Ultrasound imaging did not reveal any alterations suggestive of obstruction or inflammation such as free liquid, thickened wall, or loss of the stratified structure of the layers of the stomach. A hyperechoic tubular structure compatible with the feeding tube used was detected in the fundus of the stomach. After verification of the presence of the tube-derived material in the digestive system, the medical team opted for a conservative therapy consisting of administration of fibers, to increase intestinal motility. The patient was followed up daily by means of imaging exams. The patient did not exhibit signs of intestinal obstruction during the follow-up period. Two days after commencement of the conservative therapy, the remnant of the feeding tube that had been ingested by the patient was expelled along with the feces.

Discussion: In spite of the accidental ingestion of the feeding tube by the patient, the use of this device was effective to provide nutritional and pharmacological support to the Leopardus guttulus cub, leading to its recovery. Managing malnutrition is fundamental for the recovery of any patient. Inappetence is alarming especially in felines, which quickly develop hepatic lipidosis during extended periods of anorexia. The conservative approach used, with the aid of serial imaging exams, was enough to treat ingestion of the linear foreign body by the patient.