InfusionFox
Nutrition

Tube feeding (NG / E-tube)

Bolus tube feeding plan for hospitalized dogs and cats with NG, NE, or E-tubes. Computes per-feeding volume ramped over a 3- or 4-day refeeding schedule from a diet you select or enter manually.

Bolus per-feeding volume

Computes per-feeding volume in mL for NG, NE, and E-tubes, ramped over 3 or 4 days from RER = 70 × BW0.75. Default per-feeding cap is 10 mL/kg; volumes above the cap are flagged with a clear percent-of-cap indicator so you can adjust feeding frequency.

Appears on the printable schedule header. Leave blank for a write-in line.
NG / NE tubes accept liquid diets only. E-tubes accept blenderized canned diets and liquids.
Optional. If above 5, the calculator estimates ideal weight and computes RER on the ideal rather than current weight.
Optional. If set, overrides the BCS estimate. Use this when you have the patient's documented lean weight.
Diet
Catalog values populate the fields below when a named product is chosen. Pick “Other” to enter your own.
Added to the can to make a blenderized slurry. Default 50 mL; adjust to taste based on tube bore and slurry viscosity.
Schedule
Range 3–6. Default 4 (every 6 hours).
3-day: 33% → 67% → 100% of RER. 4-day: 25% → 50% → 75% → 100%. Use the 4-day ramp for severely malnourished patients.
Awaiting input

Enter a patient weight to see the result.

Reference

Protein targets

Recommended protein density in tube-fed enteral diets per Chan, Silverstein 4th ed Ch. 126:

Patient Protein % of energy
Dogs 5–6 g / 100 kcal 25–35%
Cats 6–8 g / 100 kcal 30–40%
Protein-intolerant (hepatic, severe azotemia) 3–4 g / 100 kcal —
Reference

Formulas and ramp schedules

Resting Energy Requirement

$$\text{RER} = 70 \times \text{BW}^{0.75}\,\text{(kcal/day)}$$

RER is the standard initial target for inappetent or refeeding patients. When ideal body weight differs from current weight (BCS > 5/9 or explicit IBW provided), RER is computed on the ideal weight to avoid feeding through adipose tissue.

Worked example with current inputs

Enter a patient weight to see the worked example.

Refeeding ramp

Gradual reintroduction of calories over several days reduces refeeding-syndrome risk and improves tolerance. Default is the 3-day ramp; pick 4 days for severely malnourished patients (extended anorexia, hypophosphatemia on intake, marked weight loss).

Day 3-day 4-day
1 33% RER 25% RER
2 67% RER 50% RER
3 100% RER 75% RER
4 — 100% RER

Per-feeding bolus volume

Default cap is 10 mL/kg per feeding. Some patients tolerate up to 40 mL/kg, but volumes above the default trigger a warning so you can choose to increase feeding frequency. A bolus should be infused over 15–20 min and patients should be monitored for 30 min after each feeding for regurgitation or vomiting.

Tube selection

NG / NE tubes are typically 3.5–5 Fr in cats and 6–8 Fr in dogs, narrow enough that canned diets occlude the lumen regardless of blending. E-tubes are 12–14 Fr and accept blenderized canned diets with adequate water. The calculator hard-disables canned diets on NG / NE tubes.

Discontinuation

Plan to remove the tube once voluntary intake reaches roughly 75% of RER on its own. Avoid offering food during the first few days with the tube in place to reduce food-aversion risk, especially in cats.

Sources

References

  • Chan DL. Enteral nutrition. In: Silverstein DC, Hopper K, eds. Small Animal Critical Care Medicine. 4th ed. St. Louis, MO: Elsevier; 2023. Ch. 126.
  • WSAVA Global Nutrition Committee. Feeding Guide for Hospitalized Dogs and Cats. World Small Animal Veterinary Association Global Nutrition Toolkit; 2013. PDF.