{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:04:29Z","timestamp":1789736669052,"version":"4.0.1"},"reference-count":18,"publisher":"American Veterinary Medical Association (AVMA)","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize the incidence of complications confirmed via endoscopy following nasogastric intubation in horses at a referral institution and determine associated risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records of patients having received \u2265 1 nasogastric intubation within 3 days prior to endoscopic examination between March 2021 and March 2025 were identified. Signalment, history, clinicopathologic data, nasogastric intubation procedures, reason for endoscopy, treatment, and outcome were recorded. Complications were categorized by region (nasopharyngeal, esophageal, gastric). Clinical complications were defined as those prompting endoscopic examination, whereas subclinical complications were observed incidentally during endoscopy performed for other reasons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>94 cases met the inclusion criteria. Of these, 25 of 94 (26.6%) had a complication observed on endoscopy, with the majority (68%) being subclinical. Horses with nasopharyngeal complications were the most likely to have clinical signs (60%), followed by those with esophageal complications (33%) and gastric complications (0%). Horses with complications had lower body weights (median, 430 kg; 95% CI, 365 to 482 kg) and increased numbers of band neutrophils than those without complications (median, 518 kg; 95% CI, 486 to 548 kg). Intubation prior to referral, number of intubations performed, and presence of an indwelling tube were not associated with complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Subclinical complications after nasogastric intubation occurred in a quarter of endoscopically examined cases not exposed to general anesthesia. Clinical complications were uncommon. Smaller horses may be more at risk for subclinical complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Clinical complications are uncommon after routine nasogastric intubation; however, endoscopy after nasogastric intubation may identify incidental subclinical complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.26.03.0206","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:27:27Z","timestamp":1785328047000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["Retrospective endoscopic assessment of complications associated with nasogastric intubation in horses at a referral hospital"],"prefix":"10.2460","volume":"264","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8952-8087","authenticated-orcid":true,"given":"Alexandra S.","family":"Fielding","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3785-5830","authenticated-orcid":true,"given":"Breanna J.","family":"Sheahan","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"2","key":"ref1","series-title":"Equine Vet Educ","first-page":"65","article-title":"Challenges and complications of prolonged nasogastric intubation in equine patients","volume":"37","author":"Byrne CA","year":"2025","unstructured":"Byrne CA. Challenges and complications of prolonged nasogastric intubation in equine patients. Equine Vet Educ. 2025;37(2):65-67. doi:10.1111\/eve.14066"},{"issue":"8","key":"ref2","series-title":"Equine Vet Educ","first-page":"398","article-title":"Guttural pouch perforation caused during nasogastric intubation","volume":"27","author":"Gillen A","year":"2015","unstructured":"Gillen A, Cuming R, Schumacher J, Taylor D, Munsterman A. Guttural pouch perforation caused during nasogastric intubation. Equine Vet Educ. 2015;27(8):398-402. doi:10.1111\/eve.12368"},{"issue":"11","key":"ref3","series-title":"J Am Vet Med Assoc","first-page":"1991","article-title":"What Is Your Diagnosis? Upper airway obstruction in a horse caused by pharyngeal perforation during nasogastric intubation","volume":"198","author":"Rashmir-Raven AM","year":"1991","unstructured":"Rashmir-Raven AM, DeBowes RM, Gift LJ, Douglass JB. What Is Your Diagnosis? Upper airway obstruction in a horse caused by pharyngeal perforation during nasogastric intubation. J Am Vet Med Assoc. 1991;198(11):1991-1992."},{"issue":"6","key":"ref4","series-title":"Can Vet J","first-page":"554","article-title":"Sinusitis associated with nasogastric intubation in 3 horses","volume":"55","author":"Nieto JE","year":"2014","unstructured":"Nieto JE, Yamout S, Dechant JE. Sinusitis associated with nasogastric intubation in 3 horses. Can Vet J. 2014;55(6):554-558."},{"issue":"1","key":"ref5","series-title":"Can Vet J","first-page":"76","article-title":"Postoperative sinusitis and pneumonia following exploratory celiotomy for treatment of colic in horses","volume":"64","author":"Tyma JF","year":"2023","unstructured":"Tyma JF, Epstein KL. Postoperative sinusitis and pneumonia following exploratory celiotomy for treatment of colic in horses. Can Vet J. 2023;64(1):76-80."},{"issue":"2","key":"ref6","series-title":"Equine Vet Educ","first-page":"e36","article-title":"Removal of a fragmented nasogastric tube from the transverse colon of a horse undergoing exploratory celiotomy for colic","volume":"33","author":"Guerra M","year":"2021","unstructured":"Guerra M, Kilcoyne I. Removal of a fragmented nasogastric tube from the transverse colon of a horse undergoing exploratory celiotomy for colic. Equine Vet Educ. 2021;33(2):e36-e38. doi:10.1111\/eve.13195"},{"issue":"2","key":"ref7","series-title":"Equine Vet Educ","first-page":"e52","article-title":"Pharyngo-oesophageal fistula as a consequence of nasogastric tube placement","volume":"37","author":"Ba\u00f1uelos-Arteagoitia N","year":"2025","unstructured":"Ba\u00f1uelos-Arteagoitia N, Valli C, Pereyra SA, De Rijck M. Pharyngo-oesophageal fistula as a consequence of nasogastric tube placement. Equine Vet Educ. 2025;37(2):e52-e57. doi:10.1111\/eve.14043"},{"issue":"3","key":"ref8","series-title":"J Am Vet Med Assoc","first-page":"483","article-title":"Complications of nasogastric intubation in horses: nine cases (1987-1989)","volume":"201","author":"Hardy J","year":"1992","unstructured":"Hardy J, Stewart RH, Beard WL, Yvorchuk-St-Jean K. Complications of nasogastric intubation in horses: nine cases (1987-1989). J Am Vet Med Assoc. 1992;201(3):483-486. doi:10.2460\/javma.1992.201.03.483"},{"issue":"6","key":"ref9","series-title":"Equine Vet J","first-page":"434","article-title":"Laryngotracheal lesions following routine orotracheal intubation in the horse","volume":"21","author":"Heath RB","year":"1989","unstructured":"Heath RB, Steffey EP, Thurmon JC,  Laryngotracheal lesions following routine orotracheal intubation in the horse. Equine Vet J. 1989;21(6):434-437. doi:10.1111\/j.2042-3306.1989.tb02190.x"},{"issue":"6","key":"ref10","series-title":"Equine Vet J","first-page":"1556","article-title":"Prevalence and degree of orotracheal intubation-related tracheal lesions in horses","volume":"57","author":"Parente A","year":"2025","unstructured":"Parente A, Geburek F, K\u00e4stner S, Iversen C, Hopster K. Prevalence and degree of orotracheal intubation-related tracheal lesions in horses. Equine Vet J. 2025;57(6):1556-1562. doi:10.1111\/evj.14487"},{"key":"ref11","series-title":"J Equine Vet Sci","first-page":"105712","article-title":"Iatrogenic aspiration pneumonia in six horses: a retrospective case series","volume":"155","author":"Vainio KME","year":"2025","unstructured":"Vainio KME, M\u00e4\u00e4tt\u00e4nen MK, Mykk\u00e4nen AK, Huupponen AK, Niinist\u00f6 KE. Iatrogenic aspiration pneumonia in six horses: a retrospective case series. J Equine Vet Sci. 2025;155:105712. doi:10.1016\/j.jevs.2025.105712"},{"issue":"1","key":"ref12","series-title":"Can Vet J","first-page":"83","article-title":"Removal of a nasogastric tube fragment from the stomach of a standing horse","volume":"53","author":"Cribb NC","year":"2012","unstructured":"Cribb NC, Kenney DG, Reid-Burke R. Removal of a nasogastric tube fragment from the stomach of a standing horse. Can Vet J. 2012;53(1):83-85."},{"issue":"3","key":"ref13","series-title":"J Am Vet Med Assoc","first-page":"338","article-title":"Repair of a full-thickness gastric rupture in a horse","volume":"207","author":"Hogan PM","year":"1995","unstructured":"Hogan PM, Bramlage LR, Pierce SW. Repair of a full-thickness gastric rupture in a horse. J Am Vet Med Assoc. 1995;207(3):338-340. doi:10.2460\/javma.1995.207.03.338"},{"issue":"4","key":"ref14","series-title":"Equine Vet J","first-page":"288","article-title":"Gastric rupture in horses: a review of 54 cases","volume":"18","author":"Todhunter RJ","year":"1986","unstructured":"Todhunter RJ, Erb HN, Roth L. Gastric rupture in horses: a review of 54 cases. Equine Vet J. 1986;18(4):288-293. doi:10.1111\/j.2042-3306.1986.tb03631.x"},{"issue":"4","key":"ref15","series-title":"Equine Vet Educ","first-page":"183","article-title":"Aspiration pneumonitis (Mendelson\u2019s syndrome) as perianaesthetic complication occurring in two horses: a case report","volume":"31","author":"Monticelli P","year":"2019","unstructured":"Monticelli P, Adami C. Aspiration pneumonitis (Mendelson\u2019s syndrome) as perianaesthetic complication occurring in two horses: a case report. Equine Vet Educ. 2019;31(4):183-187. doi:10.1111\/eve.12781"},{"issue":"9","key":"ref16","series-title":"Schweiz Arch Tierheilkd","first-page":"401","article-title":"Pulmonary edema at recovery after colic operation with in-situ nasogastric tube in a horse","volume":"153","author":"Veres-Ny\u00e9ki KO","year":"2011","unstructured":"Veres-Ny\u00e9ki KO, Graubner C, Aloisio F, Spadavecchia C. Pulmonary edema at recovery after colic operation with in-situ nasogastric tube in a horse. Schweiz Arch Tierheilkd. 2011;153(9):401-404. doi:10.1024\/0036-7281\/a000232"},{"issue":"5","key":"ref17","series-title":"Ir Vet J","first-page":"303","article-title":"Iatrogenic lipoid pneumonia in an adult horse","volume":"63","author":"Metcalfe L","year":"2010","unstructured":"Metcalfe L, Cummins C, Maischberger E, Katz L. Iatrogenic lipoid pneumonia in an adult horse. Ir Vet J. 2010;63(5):303-306. doi:10.1186\/2046-0481-63-5-303"},{"issue":"3","key":"ref18","series-title":"Vet Rec Case Rep","first-page":"e922","article-title":"Traumatic nasogastric intubation as a suspected cause of laryngeal obstruction in a horse recovering from emergency laparotomy","volume":"12","author":"Gavet M","year":"2024","unstructured":"Gavet M, Junot S. Traumatic nasogastric intubation as a suspected cause of laryngeal obstruction in a horse recovering from emergency laparotomy. Vet Rec Case Rep. 2024;12(3):e922. doi:10.1002\/vrc2.922"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/264\/10\/javma.26.03.0206.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/264\/10\/javma.26.03.0206.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/264\/10\/javma.26.03.0206.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T12:14:42Z","timestamp":1789733682000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/264\/10\/javma.26.03.0206.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":18,"journal-issue":{"issue":"10"},"URL":"https:\/\/doi.org\/10.2460\/javma.26.03.0206","relation":{},"ISSN":["0003-1488"],"issn-type":[{"value":"0003-1488","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,1]]}}}