Pneumothorax as a Complication of Nasogastric Feeding Tube Placement in Six Dogs

Objective

To describe pneumothorax as a complication of nasogastric tube (NGT) misplacement in six dogs at a single institution and to discuss NGT placement techniques and pneumothorax prevention strategies found in the human and veterinary literature.

Design

Retrospective case series.

Setting

Private referral center.

Animals

Six client-owned dogs.

Measurements and Main Results

Medical records at a private practice referral hospital were searched for cats and dogs with “nasogastric tube” and “pneumothorax” from January 2013 to May 2022. Data collected from the medical records, where available, included patient signalment, weight, primary disease process, relevant diagnostic test results, clinical signs before NGT placement, size of NGT, personnel performing tube placement, sedation administered before NGT placement, therapies administered for management of pneumothorax, duration of hospitalization, and outcome. Six dogs were included, having developed pneumothorax secondary to NGT misplacement during the 9-year period (incidence = 0.0006). Four of the six dogs received IV sedation before NGT placement. Three of the six dogs displayed clinical signs of pneumothorax, including an abnormal breathing pattern and coughing. Thoracocentesis was required in three of the dogs, and one ultimately required a thoracostomy tube for 24 h. Pneumothorax fully resolved in all patients, and four survived to discharge. Two dogs were euthanized due to worsening clinical conditions unrelated to pneumothorax.

Conclusions

This retrospective study describes the complete resolution of iatrogenic pneumothorax in six dogs after NGT misplacement. Clinicians should be aware of the possibility of pneumothorax during NGT placement and warn clients of the risk. Fatalities have been reported secondary to this complication; however, due to lack of veterinary data, the survival rate is uncertain. Results of this case series indicate that the prognosis may be good for resolution of pneumothorax secondary to NGT misplacement with subsequent discharge from the hospital.