Evaluation of a technique for percutaneous endoscopic gastrostomy tube placement in horses.

This study investigates the feasibility and potential complications of percutaneous endoscopic gastrostomy (PEG) tube placement in horses. It concludes that this procedure may be a viable treatment for horses with chronic dysphagia, though systemic inflammation was observed and further research is needed.

Research Summary

• The research involves exploring a new method for treating horses with chronic dysphagia, a condition characterized by difficulty in swallowing, by using the percutaneous endoscopic gastrostomy (PEG) tube placement technique.
• The authors studied the feasibility, maintenance, and complications related to the placement of PEG tubes in 6 adult horses, with four of them being assessed longer by keeping the PEG tube in place for 14 days.
• The PEG tubes were used to provide fluid requirements to the horses, post which the tubes were removed, and the horses were euthanized and necropsied seven days later.

Methodology

• The study began with the placement of the PEG tube via a left intercostal approach after inflating the stomach with air.
• The researchers then confirmed the correct placement of the tube through ultrasonography and gastroscopy.
• Throughout the trial, the researchers carried out physical examinations, complete blood counts (CBCs), and peritoneal fluid analysis before and at different points after the tube placement.

Findings

• All six horses successfully underwent the PEG tube procedure and the four horses who had the tube maintained for 14 days tolerated the water administration process via the PEG tube, remaining clinically stable throughout the experiment.
• However, there were noticeable increases in hematologic and peritoneal variables during the time the PEG tubes were in place.
• Detailed postmortem examinations revealed localized peritonitis (inflammation of the peritoneum) in one horse and body wall inflammation along the track of the PEG tubes in three other horses.

Conclusions

• Overall, while the PEG tube was well-tolerated by the study horses and the fluid requirements were sufficiently met, there were instances of systemic and peritoneal inflammation caused due to the tube.
• Despite these cases of inflammation, the research concludes that PEG tube placement could still be a promising alternative method for managing horses with chronic dysphagia.
• But, due to the potential complications, the study calls for further research to ascertain the feasibility of enteral feeding using the PEG tube approach in horses.