Effect of Nasogastric Tube Placement, Manipulation, and Fluid Administration on Transcutaneous Ultrasound Visualization and Assessment of Stomach Position in Healthy Unfed and Fed Horses.
Authors: Epstein Kira Lyn, Hall Mark David
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary Distinguishing pathological gastric distension from normal physiological changes during colic examination has proved challenging, particularly when nasogastric tubes are deployed therapeutically. Epstein and Hall measured stomach dimensions (cranial-caudal and dorsal-ventral) ultrasonographically in 10 unfed and 5 fed horses before and after nasogastric intubation, reflux assessment, and 6-litre fluid administration in unfed animals. Both feeding and nasogastric tube placement significantly enlarged ultrasonographic gastric dimensions in all horses; however, simply checking for reflux did not reliably reduce these measurements, whereas fluid administration consistently and visibly accumulated in the stomach on ultrasound. The practical implication is substantial: increased gastric dimensions alone during colic assessment cannot be interpreted as pathological distension, since tube placement and recent feeding independently enlarge the stomach without indicating impaction or functional distension. Conversely, the actual visualisation of free fluid within the gastric lumen following fluid administration may be a more specific and clinically useful indicator of significant gastric reflux than relying on standard dimensional parameters, allowing practitioners to refine their diagnostic interpretation during colic investigations.
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Practical Takeaways
- •Enlarged gastric ultrasound measurements after nasogastric intubation or recent feeding do not necessarily indicate pathologic distension from colic—interpret findings in clinical context
- •The presence of fluid in the stomach visualized on ultrasound may be a more reliable indicator of clinically significant gastric reflux than measuring gastric dimensions alone when assessing colic cases
- •Be aware that nasogastric tube placement itself increases apparent gastric size on ultrasound, which could confound clinical assessment if not accounted for
Key Findings
- •Fed horses had significantly larger gastric ultrasound dimensions (cranial-caudal and dorsal-ventral) compared to unfed horses
- •Nasogastric tube placement and 6 L water administration increased gastric ultrasound dimensions in both fed and unfed horses without pathologic distension
- •Checking for reflux did not consistently decrease gastric dimensions in either fed or unfed horses
- •Fluid identification in the stomach on ultrasound after water administration was consistent and may be more diagnostically useful than standard gastric dimension measurements for identifying colic with significant reflux