When to Use a Feeding Tube

Feeding tubes can be a lifesaving part of caring for sick or injured cats. Feeding tubes are used when cats are either too ill to eat on their own, have lost their appetite, or have a condition preventing them from eating on their own even if they still want to. They’re often used after major surgery or when the cat has had some sort of traumatic injury, but can also be used for cats who are suffering from chronic illness.

Does my cat need a feeding tube?

There’s rarely a straightforward answer to this question, so it’s important to discuss this question with your veterinarian. Malnutrition reduces the body’s ability to fight infections, heal from injuries or surgery, and can lead to hepatic lipidosis, a potentially fatal type of liver disease. Using a feeding tube when your cat is unwilling or unable to eat on their own can mean the difference between life and death, or can at least dramatically improve their quality of life during recovery from their illness or injury.

No fighting with your cat to get them to eat when they don’t want toCan be expensive to have placed
Bitter/disgusting “oral” meds can be delivered directly to the stomach so kitty doesn’t have to taste them at allIncreased risk of developing infection at the tube insertion site
Generally easy to maintain the tube itselfTube may become dislodged and require expensive follow up visits to check and correct the placement
Spending extra time cuddling with your cat while you’re feeding them can be a great bonding experienceEach feeding takes around 20 minutes and cats are typically fed every 4-6 hours, could be difficult to manage that time commitment
E-tubes, the most common type used, can be left in place for weeks or months at a time to aid in recoveryTakes a little longer to prepare meals for tube feeding vs oral syringe feeding (blending food, warming it, filling syringes, cleaning syringes afterwards, etc.)
Supplies used for feeding (syringes, extension lines, etc.) are generally inexpensive and can be reused many times before needing to be replacedThe extra cost of supplies used for feeding might be too expensive on top of all the other treatment costs
Usually does not restrict movement or kitty’s ability to eat on their ownMay require special food which could be more expensive than what you normally feed

My Feeding Tube Experience

In August 2021 my cat Oliver was given a feeding tube. Oliver had major surgery to remove his spleen and had not had much appetite for the week leading up to his surgery. As of the writing of this post section Oliver has been on an E-tube for one month. For the first two weeks after his surgery Oliver didn’t really have any interest in eating on his own. He would eat a couple pieces of kibble or a couple licks of wet food, but not nearly enough to even count as a snack, much less a meal. But tube feedings with Oliver were super easy. By the end of the first month with the feeding tube Oliver was eating enough food on his own that he was down to one tube feeding per day.

Oliver has always been a lazy cat. Even when I adopted him at 1.5 years old he was the type of cat who would easily sleep 20-22 hours every day and the only way to know he was still alive is that he would roll over every few hours. That attitude actually makes him the perfect cat for recovery from a big surgery and for tube feedings, because he has zero motivation to be too active or to walk away from feedings.

Clockwise from top left: 1. Oliver sleeping through a feeding on his self-heating bed; 2. Oliver’s tube insertion site after surgery to debride the area and re-stitch the tube in place; 3. Another feeding; 4. Oliver curled in my lap having breakfast while I was sipping my morning coffee.

Oliver’s feeding tube cost somewhere around $400 to have it put in, but that does not include any other surgery costs. If he were not having surgery to remove his spleen I think the tube alone would have cost somewhere around $2,000 for everything. My biggest concern with Oliver was his risk of developing an infection at the tube site. Oliver has been on steroids for two years to treat symptoms of collapsing trachea, and long-term corticosteroid use weakens the immune system. On top of that, the spleen is a massively important part of the immune system and he just had his spleen removed, which makes him even more susceptible to infection.

Oliver’s tube was placed on a Thursday morning and he was discharged from the hospital on a Saturday of the same week. Three days after coming home from the hospital he had to go back to them to have the placement of his tube checked because he started immediately gagging when I went to feed him a meal. That checkup, which involved xrays to make sure his tube was still correctly placed, cost an additional $450. And then, just 1.5 weeks later, he was back at the hospital again because he developed an infection at the tube insertion site. This visit ended up costing another $1,780 because the sutures holding his tube in place had come out because of how infected his neck was. Oliver had xrays to check the placement of the tube, surgical debridement (cleaning) to remove all the infected tissue, flushing the wound, sending a sample of the infection to the lab for a culture and sensitivity test for proper antibiotic selection, re-stitching the tube in place, and a 10 day course of a broad spectrum antibiotic. Then it was an additional $40 about a week later when the culture results came back and showed that he needed a different antibiotic to treat his infection. He will also need a second culture test after finishing his antibiotics to determine if the infection is gone. That test costs around $300.

At some point Oliver will also have his tube removed, which will incur additional expenses. But, because removal doesn’t usually require surgery, that cost should be fairly small compared to what I’ve paid so far. In his case the tube will ideally stay in until he’s been eating all his meals on his own for at least 2 weeks. But because Oliver has terminal cancer an may not have many more months left in his life, the tube may stay in place forever so that he can be fed through hospice care if he stops eating on his own. Time and whether or not his infection can be completely controlled are what will really make that decision for us.

A time I didn’t get a tube and should have

Hindsight is 20/20, and in September 2021 I also made a mistake by not getting a feeding tube for Kevin. Kevin has truly had a rough go of it lately. As of writing this she has only lived indoors with me for three months and in that time has had three surgeries. Her first surgery was to be spayed (but after opening her up the vet found out she had already been spayed). Her second surgery was for a dental and a biopsy of some suspicious swelling in her gums. Her third surgery was to remove all her teeth because her biopsy confirmed she had stomatitis and her mouth had been constantly inflamed and in pain for the entire month following her first dental surgery.

After surgery to remove all her teeth Kevin has been having a very difficult recovery. She’s been struggling to eat and giving her oral medications isn’t easy for either of us. Kevin was incredibly underweight before her surgery and has lost even more weight since then because of her inability to eat properly. And she’s definitely less trusting of me because on top of inflicting this surgery on her I’m now also giving her some really gross, bitter medications by mouth. Normally Kevin takes pills inside gelcaps so she doesn’t have to taste her medicines. But with her entire mouth sore and swollen I’ve been having to give her medications dissolved in water and there’s no way to hide the taste from her. Only one of her medications is available and effective in a transdermal form so most of what’s she’s currently taking must be given by mouth.

I’ve had other cats who have had all their teeth removed and they recovered very quickly and easily. But none of those cats had stomatitis, and none of them were former street cats. The recovery from surgery with stomatitis is very different because Kevin’s mouth was already inflamed before surgery and the surgery itself has caused even more swelling and inflammation. Had I been thinking properly through what her recovery might be like I would have requested a feeding tube to be placed during her surgery to make recovery easier for her. A feeding tube would allow her to get food and medications without hurting her mouth, and without destroying the remaining trust she has in me to make her feel better.