Assist Feeding / Syringe Feeding

How Much to Feed * My Favorite Videos * Feeding Tubes * Working With a Feeding Tube
Step-by-Step Feeding Instructions * Care and Cleaning * Pre-Filled Syringes

The Assist Feed website has some great links and information on how, when, and why to assist feed a cat. They also have handy resources about the supplies needed and where many of them can be purchased (and some where they’re free!).

Tanya’s CKD site also has a lot of helpful information about getting your cat to eat and tips on assist feeding.

Willows Veterinary Centre has answers to some common questions about feeding tubes.

If you are working with a feeding tube you can skip to that section.

Key Points

  • Never, ever, under any circumstances force food, liquid, or medications into the mouth of an unconscious cat, or a cat who cannot swallow
  • Cats who are assist fed, particularly those who are syringe fed by mouth, can develop an aversion to the food used in this process. It’s best to avoid using their favorite food for assist feeding so that you don’t accidentally ruin that food for them. An exception to this is if your cat is like Jasper (in the first video below) and enjoys assist feeding
  • Have all your supplies ready to use before you start
  • This is a messy process, have more towels ready than you think you will need
  • A baby bib can be used on docile cats to help keep them clean in the syringe feeding process. Cats who fight against feedings may need to be fully wrapped in a towel to keep them clean and to protect you from any scratches they might try to give
  • Pre-filling the syringes with room temperature food is much easier than filling them with cold, refrigerated food
  • Some pharmacies will give you free oral medicine syringes in various sizes if you ask for them – no need to buy them!
  • If you are buying syringes, this Innovet syringe is a popular choice
  • If your cat is taking any anti-nausea or pain medications you may want to give those about 20 minutes prior to a feeding so that they have time to begin working before your cat needs them

How Much to Feed

Perhaps the most important part of assist feeding your cat is knowing how much food they should be getting.

Vet Calculators has a simple tool you can use for free to figure out how much food your cat needs. To use their calculator:

  1. Enter your cat’s current weight in either pounds or kilograms
  2. Change their BCS if you want to. BCS is their body condition score. This is optional so you don’t need to worry about it.
  3. Click the button that has a cat picture on it (this calculator defaults to dogs as the species to use)
  4. Select a value from the “Select Cat’s Criteria” drop down list.
    1. Neutered Adult assumes your cat is at their ideal weight and will give the amount of food needed for maintenance
    2. Weight Gain assumes your cat is underweight and will calculate a calorie amount to help them gain weight
    3. Weight Loss assumes your cat is overweight and will calculate a weight loss calorie amount
  5. At this point the calculator gives you the total number of calories to feed per day. To find out how many cans of food that translates to, enter the number of calories per can of food.
    1. If you are thinning your food with baby food instead of water you may need to adjust the number of cans you feed up or down

Once you know how many cans of food you have to feed the next step is figuring out how many milliliters of food it takes to get to that amount. There are two ways to figure out how much to feed:

  1. Blend up one day’s worth of food, fill your syringes, and see how many milliliters it amounts to.
  2. Use a calorie calculator to do all the math for you. This calculator is pretty neat because it will also calculate several foods for you and give you a list that you can print or save.

My Favorite Videos

This video is probably my favorite assist feeding video ever. Jasper and his mom make it look super easy.

This video is for syringe feeding a dog, but it has a really nice method for filling the syringe with food that you might like. Cat’s don’t pant, so the actual feeding method displayed may not work for you.

Here’s a vet tutorial:

And here are some videos with regular people showing how they feed their cats.

This next video also has a lot of great links in the description for different products and information. I really like this video because the person doing it says that this was very early on in the syringe feeding process with them and their cat. Since both of them were new to the process it is a fairly good display of what it may be like with you and your cat when you are just getting started.

Feeding Tubes

Feeding through a feeding tube is really similar to oral feeding. A lot of the same principles on speed and amount apply.

  • Start slowly – give smaller amounts more frequently before moving up to the max amount
  • Some people use around 5 ml of water to wash everything through the tube
  • Feeding approximately every 4 hours is ideal
  • If you are giving medications that need to be separated from supplements that are in your pre-filled syringes you can do that by adding them to plain baby food
    • Baby food is a little better than plain water because you are also getting calories into your cat along with the medications

There are 4 different types of feeding tubes that can be used in cats.

Naso-esophageal (NE-tube) tubes are very small tubes that are run from the nose down into the stomach. These kinds of tubes are used if the cat is expected to need the feeding tube for 1 week or less, or for cats who can’t tolerate anesthesia to have other kinds of tubes placed. These kinds of tubes can be easily dislodged, and require an entirely liquid diet because of their small size.

Esophageal (E-tube) tubes are the most common type of feeding tube used in cats. These are surgically implanted in the throat and dump food into the esophagus, allowing it to follow the normal path to the stomach. These tubes allow for thicker food to be used than the NE-tube can allow. E-tubes can be used long term and generally make it very easy to supply food, water, and medicines to a cat.

Gastrotomy (G-tube) tubes are implanted in a cat’s side and dump food directly into the stomach. The G-tube is not commonly used in cats because tube placement is more difficult than the E-tube, but for cats with esophageal injuries or disorders the G-tube is a great option. The G-tube can also be used in cats who developed any kind of injury or infection around the insertion site of an E-tube.

Jejunostomy (J-tube) tubes are implanted in a way that dumps food directly into the intestines, completely bypassing the stomach and normal digestive processes. This type of tube is only used in a hospital setting and you will never be sent home with this kind of implant. The J-tube requires special equipment to constantly deliver very small amounts of food to the intestines.

Working With a Feeding Tube

The information below was written about using an E-tube, but also applies to a G-tube. If you’re using an NE-tube you’ll need to thin the food more than with the E or G tubes, and some of the site cleaning/maintenance steps will not apply to you.

If you have an E-tube your vet may fasten the bandages too tight around the tube. You can probably loosen them a lot. A Kitty Kollar is a great, washable neck bandage that can be used to hold the tube in place. You can extend the use between washings by covering the Kitty Kollar with the “tube” part of a large sport sock. If you use the sock covering you can simply change out the sock bit and not need to wash the Kitty Kollar itself as often.

Here is a good video on feeding a cat with an esophageal feeding tube.

Step-by-Step Tube Feeding Instructions

The following steps are copied directly from University of Missouri’s Veterinary Health Center

Step 1: Check that the tube is in place. Remove the end of the tube from the neck wrap. Before each feeding, attach an empty syringe (10 cc) to the external feeding port and pull back on the plunger. If the tube is in place, the plunger should move back to its starting position on its own (negative pressure), and you may proceed to step 2. If the plunger does NOT move back to its starting position, DO NOT PROCEED WITH FEEDING. The tube may be displaced, and you should call a veterinarian for further instructions.

Step 2: Flush the tube with water. Give 10 mL of lukewarm water through the tube. If there is no cough, gag, retch or discomfort, prepare an extra syringe with lukewarm water to use for flushing the tube when the feeding is complete. If coughing or gagging DOES occur, DO NOT PROCEED WITH FEEDING. The tube may be displaced, and your pet needs to be brought to a veterinarian to check the placement of the tube.

Step 3: Warm the blended diet. Keep opened containers of the blended diet refrigerated between feedings. Before each feeding, slightly warm the expected feeding volume (see above under diet information for amount) to room temperature. The best way to warm the food is to fill the syringes with the amount of food to be fed and place them in a container of warm water or run under warm water. Due to the risk of overheating, it is NOT recommended to use the microwave. If you do use the microwave, warm the food in a bowl and mix well before pulling it into a syringe. You can test the temperature on your wrist like checking the temperature of a baby bottle. The food should be room temperature to lukewarm, not hot or cold.

Step 4: Feeding. Attach the syringe to the feeding port. This will require you to remove the cap on the port, but keep the cap in easy reach. Once the syringe is attached, you will likely need to flip the tube clamp to the open position. After that is done, you can begin slowly pushing the plunger on the syringe to administer the food. It is important to feed the liquid diet slowly (i.e., each meal over 20 minutes) since the food is not going directly into the stomach but instead into the esophagus. If the pet begins to act nauseated during the feeding, it is time to stop or at least slow down dramatically. If they become too full, your pet will likely throw up! If you determine that the volume of food you are to give at each feeding consistently makes your pet nauseated, please call your veterinarian to discuss modifying the feeding schedule.

Step 5: Finishing. Once the food syringe is emptied, re-close the clamp on the tube. Now, detach the food syringe and attach the extra syringe of water. Again open the clamp, and flush the tube with 10 mL of water. You can give the water a bit faster than you did the food. Once you are done, close the clamp, remove the syringe, and re-attach the cap on the end of the tube. Tuck the tube back into the neck wrap so that your pet can’t easily pull the tube out. Rinse out the syringes so that they are ready for next time, and you are done until the next meal.

Care and Cleaning of Feeding Tubes

Clogs

In the event that the feeding tube clogs, use Coca Cola Classic to unclog the tube. Infuse about 5 mL of cola into the tube and let it sit for 10 minutes, then flush the tube with water according to the feeding instructions above. If you are unsuccessful at unclogging the tube in three successive attempts, consult a veterinarian.

Cleaning the Entrance Site

Examine the skin on your cat’s neck every single day around where the tube is inserted. Check for discharge, swelling, redness, or a foul odor. You will need to make sure the fur on your cat’s neck is short enough for you to properly inspect the site. Your vet will shave the area before placing the tube. If your cat’s fur grows particularly fast, or if your cat is wearing the tube for a long time you may need to perform touch-up shaves to keep the hair short enough for the site to be visible.

A small amount of swelling and discharge may be normal, and can be gently cleaned by blotting (NOT rubbing!). You can use gauze, paper towel, or reusable towel/cloth, just make sure that what you’re using is clean, warm, and moist.

Contact your veterinarian immediately if you notice:

  • green or yellow discharge
  • a foul smell
  • increased swelling or redness
  • pain

You will need to keep the entrance site for the tube clean, dry, and loosely covered.

According to Kitty Kollar: Your vet may give you products to clean the site. Or, you may use Betadine® or Chlorhexedrine® solution 10% to water 90% to gently wipe or pat the area when you change the bandaging. Bandages or coverings should be placed loosely so that the site can breathe, and never let the area stay wet or moist. Do NOT use Triple Antibiotic ointment (“Neosporin”) unless directed by your veterinarian. Some cats have adverse allergic reactions to one of the ingredients. Your veterinarian can prescribe a different ointment if it is needed, but usually just keeping the site clean is adequate. Never use alcohol or peroxide for cleaning.

Pre-Filling Syringes

The information in this section mostly applies to preparing food for use with feeding tubes, but can also be used for oral feedings.

Supplies you will need:

  • large bowl
  • fine metal strainer
  • a Magic Bullet or equivalent type of blender (if you are making very large batches you can use a regular blender)
  • as many feeding syringes as you can acquire
    • get them in various sizes and you will have more flexibility in your feedings
    • be sure to compare prices between your vet, online suppliers, and even local pharmacies
    • many local pharmacies will give you oral syringes in various sizes for free, so be sure to ask for them!
  • mini rubber spatula
  • all meat baby food – NO GARLIC, NO ONION
    • This will be used to thin the food to get the right texture
    • You can use plain water instead, but baby food will also add more calories, and calories are what we are after
  • a can of classic Coke (Coca Cola) soda (regular, not diet)
    • this can be used for dissolving any clogs in syringes or in a feeding tube
  • storage containers for holding the prefilled syringes
    • one for the fridge and one for the freezer
  • a narrow mug or glass for warming syringes
  • whatever food you’ll plan to use and whatever supplements need to be added
    • If you are also giving medications you will add those during the meal, not during this preparation step

Making the food:

Empty the cans of food you are using into your blender and then add enough baby food to get the food into the right liquid consistency.

I used the baby food instead of water as it sufficiently liquidizes but, unlike water, also adds calories

If you are adding any supplements or medications to the batch of food you can add them now and blend until consistent, pausing and using your mini spatula to clean the sides of the blender as needed.

Once the food is blended, put your mesh strainer over your bowl and pour the contents of the blender through it. Use the spatula again to clean out the blender into the strainer, and to push the food through the strainer as needed.

Once the food is strained you can fill all your syringes with it.

Put some of the filled syringes into the refrigerator, but no more than 3 day’s worth. Put the rest of the syringes into the freezer.

After you have used up the syringes that were in the refrigerator you can start using the ones from the freezer. Before going to bed you can move syringes from the freezer to the refrigerator for the next day’s feedings. Sitting in the fridge overnight is enough time for most syringes to thaw completely. Just before feedings you can warm the syringes by putting them in a narrow mug with hot tap water for about 5 minutes.