Inadvertent Insertion of a Nasoenteric Feeding Tube Into the Brain of an Anesthetized Persian Cat

Objective

To describe the inadvertent insertion of a tube intended for nasogastric placement into the brain of an anesthetized brachycephalic cat.

Case Summary

A 7-year-old Persian cat underwent a cholecystectomy for emergency surgical management of biliary obstruction, with postoperative placement of a nasogastric tube planned for nutritional support. General anesthesia with spontaneous breathing was administered, and the surgical procedure was performed without adverse events. At the end of the surgical procedure, while the anesthetized cat was in dorsal recumbency, a 5-French polyurethane nasogastric tube with a stylet was inserted into the right nostril. Immediately after insertion, the patient experienced apnea and required hemodynamic and ventilatory support. Because the tube could not be palpated in the stomach, apnea persisted, and the patient ultimately failed to regain consciousness, a CNS lesion was suspected, and magnetic resonance imaging of the head was performed. Lesions consistent with nasogastric tube insertion into the brain were diagnosed, and because the prognosis was believed to be grave, the cat was euthanized.

New or Unique Information Provided

Few reports of nasoenteric tube insertion into the brain of humans are available. To our knowledge, this is the first report of a nasoenteric tube insertion into the brain of a dog or cat.