Nasogastric intubation in the horse

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.

Equipment

• Appropriate-sized nasogastric tube
• Lubricant
• Bucket half-filled with warm water
• 400 ml nylon dose syringe

Procedure

The horse should be adequately restrained in stocks or in the stable. The veterinarian may need a twitch or chemical restraint. The NGT should be immersed in the bucket of warm water to make it clean and flexible. Some veterinarians may lubricate the end of the NGT for a smoother, atraumatic passage. The veterinarian should stand on the horses left and place the right hand over the nose. The veterinarian's right thumb can be used to reflect the alar fold of the left nostril, without obstructing the airflow to the right nostril. The NGT is introduced ventrally into the ventral nasal meatus. The tube is advanced slowly and the veterinarian should not use force if there is resistance. Once the tube is at the level of the epiglottis in the pharynx, there may be some resistance. Most horses swallow the tube immediately, but if this is not the case then the veterinarian should carefully bump the epiglottis with the tube or blow down the tube.