Tuesday, March 27, 2012

How to Tube Feed a Weak Kid

By Sue Reith
CarmelitaToggs


The prospect of tubing a weak kid probably sounds pretty frightening if you have never tried it. Perhaps it's because I have been doing it for so long, but I find the procedure very comfortable. I'd like to share with you what I have found works simply and quickly for me.

Having prepared in advance for the possibility that at some point I may need to tube a kid, I have on hand a "Sovereign" brand #10 French Feeding Tube/Urethral Catheter. A #8 tube is smaller (good for tiny puppies) but will do the job, and a #12, though it is a bit larger in diameter than the #10, will work also if the kid is fairly good sized (i.e., a dairy goat kid as opposed to a Pygmy kid). These tubes are often available from veterinarians, kept on hand by them for tubing weak puppies. But if you cannot obtain one locally I will be happy to email information on where to order one from a catalog. This small, semi-rigid #10 catheter is 16" long and 1/8" in diameter. Unlike the supple, pliable rubber tubing I have seen in most catheters intended for human use, this tube is semi-rigid, so while I can bend it into a coil for storage, it won't collapse easily like a rubberband does. In my view, the semi-rigidness of this particular catheter is largely what makes the tubing process so easy. I'd like to reiterate to the reader that a feeding tube is best obtained before it is actually needed, to be kept on hand for emergencies. To wait until the last minute to search for one might prove disastrous.

Now to the process

The first step in tubing a weak kid is to stretch the little guy out flat on its side on a table or other flat surface, with its neck and jaw in a straight line stretching forward as though, if the kid were standing up instead of lying down, it might be looking up at the stars. This allows me to measure accurately from the kid's mouth clear back to its very last rib, which is how far the tube must be inserted in order to tube the contents into the stomach. I mark that distance with a magic-marker on the tube itself, so when I am inserting it I will know when it has reached the correct point. Keep in mind that since the kid's lungs are much closer to the mouth than is the stomach, if the tube inserts easily until it reaches the mark you have made, you can be confident that it is safely in the stomach.

Having determined the type and amount of fluid I want to tube into the kid, and pre-warmed it to normal body temperature (generally by placing the prepared syringe into a container of very warm water), I attach this syringe of warmed fluid to the end of the catheter. I use cooking oil on a cotton ball to coat the tube so it is very slick.

Next, I have a choice of two approaches that can be used for positioning the kid for this procedure:

If the kid is pretty flaccid (weak) I lay it down on that table or other flat surface on its side on a towel and have an assistant hold it flat, with its neck and jawline in the same position it was in while I was measuring the distance to the last rib. Then I gently open its mouth with a forefinger and thumb, and start sliding the semi-rigid tube smoothly and slowly in, along the right side of the throat.
For a sturdier kid, an alternative to lying it on its right side would be to sit it in my lap, facing forward in the same direction I am facing, as though it were a child and we were watching tv together. I elevate the head and neck gently upward towards the ceiling, and then slowly slide the tube down the inside of the baby's mouth on the right side.
In either position I find that the tube slides down the right side of the throat (I am left-handed) easily, with the kid swallowing co-operatively as I do so. Occasionally, if the kid struggles in annoyance at this invasive procedure, its head will move and the tube will start down the left side of the throat. When that happens I know about it right away, because it is headed for the lungs and the kid reacts by starting to cough instantly. The tube itself will irritate the lung area, causing a cough response, so no other test is needed to determine this. In addition, a tube accidentally headed for the lungs will not slide smoothly. If I see these signs, I immediately pull it back out and start over. (By the way, his happens very rarely.)

When the tube is going where it should, the entire length of it will slide easily for the full distance to the place I have already pre-marked on it. When first learning this procedure, if unsure that the tube has actually gone into the stomach it's okay to wait until after it is in place before attaching the filled syringe, so as to be able to blow some air into the open end of the catheter. With one hand gently resting on the kid's stomach it is easy to feel and sense the air being blown into it. Comfortable that the tube is indeed in the stomach, I slowly plunge the liquid contents from the syringe smoothly into it, and if I have chosen the "lying down" position for this procedure, the moment I finish tubing the liquid into the stomach I pull the tube back out rapidly, and quickly move the kid into an upright position, and that's that.

One of the amazing things that I notice upon completion of this process is that the kid, generally fretting and struggling throughout this experience, suddenly takes on a quiet, contented demeanor. It's really quite precious.

I suspect that by now many novices, and perhaps lots of long-time goat owners as well, will be gasping in anxiety over the prospect of performing this procedure. But tubing is really not all that scary! And when you see that little kid take on a new, brighter and more alert expression shortly after having received that dose of nutrition and its accompanying increase in energy level, you will "feel 10 feet tall" and be glad that you have learned this new management procedure.
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