Effect of Nasogastric Tube Placement, Manipulation, and Fluid Administration on Transcutaneous Ultrasound Visualization and Assessment of Stomach Position in Healthy Unfed and Fed Horses

Abstract

Knowledge of the effects of feeding and nasogastric tube placement and manipulation on gastric ultrasound is limited. Given the variability in duration since feeding and the ubiquitous use of nasogastric tubes in horses with colic, the interpretation of gastric ultrasound in horses with colic requires an understanding of these effects. Cranial to caudal and dorsal to ventral ultrasonographic dimensions of the stomach were obtained in 10 unfed horses and five fed horses, before and after nasogastric tube placement, after checking for reflux and after administration of 6 L of water in unfed horses. Fed horses’ stomachs were larger in both cranial to caudal and dorsal to ventral dimension than unfed horses. Nasogastric intubation and the administration of water increased ultrasonographic gastric dimensions in fed and unfed horses. Checking for reflux did not consistently decrease ultrasonographic gastric dimension in fed or unfed horses. Fluid was consistently identified in the stomach with ultrasound after 6 L of water. Increases in gastric ultrasound dimensions found in horses that have been recently fed and/or had a nasogastric tube placed can occur without pathologic gastric distension related to colic and should be interpreted in this context. In contrast, the identification of fluid in the stomach on ultrasound occurs consistently with fluid administration and may be more useful than standard ultrasound parameters of gastric dimensions to identify horses with colic likely to have significant gastric reflux.