Percutaneous Endoscopic Gastrostomy

Results are presented of consecutive percutaneous endoscopic gastrostomies (PEGs) performed in 32 feline and 22 canine patients over a 30-month period. Indications for PEG placement were hepatic disease (33%), esophageal disease (32%), oronasal abnormalities (22%), and cranial nerve deficits (4%), with miscellaneous conditions accounting for 9%. The median duration that PEG tubes were in place was 18 days (range, 0-320 days). The suitability of this feeding technique for clinical use was assessed by evaluating mortality, procedure-related and delayed complications, and body weight changes by the end of the PEG feeding period. Fifty-two of 54 PEGs were placed and used successfully. One fatality occurred during tube insertion due to splenic laceration, and one dog died of aspiration pneumonia secondary to pharyngoesophageal dysfunction. Other than splenic laceration, procedure-related complications were benign pneumoperitoneum (1/54) and minor gastric hemorrhage resulting in melena (1/54). Delayed complications occurring 24 hours or longer after the procedure included aspiration (4/54), peristomal infection or excessive granulation tissue (3/54), and tube extraction or migration (3/54). Nineteen of 54 animals showed evidence of inadequate gastric emptying or volume intolerance when food was introduced after PEG placement. This effect was minor and easily resolved. Of the 44 animals for which follow-up body weight information was available, 19 gained weight, six remained static, and 19 lost weight during the PEG feeding period. Percutaneous gastrostomy is a relatively safe, effective procedure and should be given early consideration for medium- or long-term enteral nutritional support in appropriate canine and feline patients.