Changes

Passing a nasogastric tube (NGT) is an important therapeutic and diagnostic technique for any patient with abdominal pain. It should be performed in any patient with abdominal pain. It has three functions. Firstly it is used to determine if there is excessive fluid in the proximal gastrointestinal tract (stomach and small intestine). If this is the case, the tube can act to remove this fluid and relieve the visceral pain associated with the distended stomach. This will prevent a fatal spontaneous rupture of the stomach. Secondly, the NGT can be used to remove esophageal obstructions in cases of choke. Thirdly, the NGT can be used therapeutically to administer large volumes of fluids, electrolytes and oral medications.

Passing a nasogastric tube (NGT) is an important therapeutic and diagnostic technique for any patient with abdominal pain. It should be performed in any patient with abdominal pain. It has three functions. Firstly it is used to determine if there is excessive fluid in the proximal gastrointestinal tract (stomach and small intestine). If this is the case, the tube can act to remove this fluid and relieve the visceral pain associated with the distended stomach. This will prevent a fatal spontaneous rupture of the stomach. Secondly, the NGT can be used to remove esophageal obstructions in cases of choke. Thirdly, the NGT can be used therapeutically to administer large volumes of fluids, electrolytes and oral medications.

To obtain reflux, the tube must become a siphon by creating a complete tube of water from the stomach to the end of the tube. This is achieved by filling the tube with warm water using the syringe, and then aspirating a bit of the fluid. The gastric fluid can be encouraged to flow out at a faster rate by quickly pulling the tube out by 10 to 15 cm. Gastric reflux should be collected into a separate bucket so that the volume can be measured and a sample is available for analysis. The tube may need to be left in place in certain conditions whereby more gastric fluid will be produced. This can be achieved by coiling the tube and taping it to the headcollar with zinc oxide tape. The horse should have the gastric fluid repeatedly removed to prevent rupture of the stomach.

To obtain reflux, the tube must become a siphon by creating a complete tube of water from the stomach to the end of the tube. This is achieved by filling the tube with warm water using the syringe, and then aspirating a bit of the fluid. The gastric fluid can be encouraged to flow out at a faster rate by quickly pulling the tube out by 10 to 15 cm. Gastric reflux should be collected into a separate bucket so that the volume can be measured and a sample is available for analysis. The tube may need to be left in place in certain conditions whereby more gastric fluid will be produced. This can be achieved by coiling the tube and taping it to the headcollar with zinc oxide tape. The horse should have the gastric fluid repeatedly removed to prevent rupture of the stomach.

If no reflux is obtained then the medications may be administered. It is important that any oral fluids or medications are warmed to body temperature prior to administration. Ensure that all of the fluids in the tube are in the stomach before removing it. Crimp the tube prior to its removal to ensure that no fluid is deposited in the pharynx.  

If no reflux is obtained then the medications may be administered. It is important that any oral fluids or medications are warmed to body temperature prior to administration. Ensure that all of the fluids in the tube are in the stomach before removing it. Crimp the tube prior to its removal to ensure that no fluid is deposited in the pharynx.  

A normal horse will have less than 2 litres of relfux.  

A normal horse will have less than 2 litres of reflux.  

===Complications===

===Complications===

* Meuller E, Moore J. N, (2008) Classification and Pathophysiology of Colic, Gastrointestinal Emergencies and Other Causes of Colic, in Equine Emergencies- Treatments and Procedures, 3rd Edition, Eds Orsini J. A, Divers T.J, Saunders Elsevier, pp 101-102

* Meuller E, Moore J. N, (2008) Classification and Pathophysiology of Colic, Gastrointestinal Emergencies and Other Causes of Colic, in Equine Emergencies- Treatments and Procedures, 3rd Edition, Eds Orsini J. A, Divers T.J, Saunders Elsevier, pp 101-102

* Rose R.J, Hodgson D.R (2000) Examination of the Alimentary Tract, Alimentary Tract, Manual of Equine Practice, 2nd Edition, Saunders Elsevier, pp 283-285

* Rose R.J, Hodgson D.R (2000) Examination of the Alimentary Tract, Alimentary Tract, Manual of Equine Practice, 2nd Edition, Saunders Elsevier, pp 283-285