Contributors: Ed Hall, James Simpson

 Species: Feline   |   Classification: Techniques

Introduction Requirements Preparation Procedure Aftercare Outcomes Further Reading

Introduction

Uses

  • A minimally invasive method of visualizing and examining the mucosal surface of the gastrointestinal, respiratory and urinary tracts.

Advantages

  • Minimally invasive technique.
  • Well-tolerated by the patient.
  • Requires only light anesthesia.
  • Good visualization of the mucosa.
  • Able to collect biopsy samples Endoscopy: sampling equipment for histological examination.
  • Follow up procedures well-tolerated and permit progress to be monitored.
  • Minor surgical corrections possible.
  • Foreign body retrieval possible.

Disadvantages

  • Not possible to examine the entire gastrointestinal tract.
  • Lesions deeper than the mucosa will be missed.
  • Limited ability to carry out surgical corrections.
  • Equipment is expensive.
  • Requires high level of technical skill.
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Technical Problems

  • Difficult to carry out.
  • Considerable patient preparation is required.
  • Must ensure the gastrointestinal tract is empty.
  • Induction of general anesthesia.

Decision Taking

Risk assessment

  • Variable depending on which procedure is being carried out and skill of operator. May include:
    • Ruptured viscus.
    • Hemorrhage.

Requirements

Personnel

Veterinarian expertise

  • Most require high level of operator experience.

Anesthetist expertise

Nursing expertise

  • Require to have high level of understanding regarding the equipment and procedures to assist veterinary surgeon and for cleaning and maintaining equipment.

Materials Required

Minimum equipment

Ideal equipment

  • video endoscopes provide the best image for examining tissues.

Minimum consumables

  • Source of clean water.
  • Endoscope disinfectant.
  • Cleaning brushes.
  • Containers and formol saline for samples.

Preparation

Pre-medication

  • Use suitable medication appropriate for patient being examined.

Dietary Preparation

  • Nil by mouth for 24 hours and no water 2 hours prior to gastroscopy.

Restraint

  • Light general anesthesia.

Other Preparation

  • Large intestinal tract examination requires starvation, bowel cleansing Bowel cleansing solutions solution and enemas Enema.
  • Respiratory and urinary tract requires no special preparation.

Procedure

Approach

Step 1 - Standard

Step 2 - Specific

  • Examine the mucosa carefully while advancing the endoscope.
  • Collect biopsy samples from abnormal lesions.
  • Collect biopsy samples from normal tissue for comparison.
  • Following examination ensure stomach is deflated prior to endoscope removal.
  • Remove endoscope carefully.

Aftercare

Immediate

Monitoring

  • Standard post-anesthesia observation.

General Care

Potential complications

  • Hemorrhage from biopsy sites.
  • Perforation of viscus.
  • Gastric dilation.
  • Iatrogenic damage from passage of endoscope.

Outcomes

Prognosis

  • Procedure unlikely to affect patient adversely.

Reasons for Treatment Failure

  • Poor operator competence, unable to examine tissues thoroughly.
  • See complications.
  • Poor preparation of the patient.
  • Incorrect examination.

Further Reading

Publications

Refereed papers

Other sources of information

  • Thomas D, Simpson J W & Hall E J (eds) (1996) BSAVA Manual of Canine and Feline Gastroenterology. 1st edn.
  • Tams T R (1990) Small Animal Endoscopy. Mosby Books, St Louis.