Patients at Creekside Veterinary Hospital have access to one of the most progressive means of non-invasively diagnosing and treating diseases, Endoscopy. But their owners may be confused about what endoscopy is and what it means to their pet's veterinary care and treatment.
Endoscopy in general means looking inside the body for medical evaluations or treatments using an endoscope. An endoscope has a rigid or flexible tube (depending on the procedure), a light to illuminate the area, a lens, an eyepiece and can have additional medical instruments to aid in procedures. Special video cameras allow viewing of the exam or procedure on a television screen as well as recording of the exam.
Veterinarians use endoscopy for many procedures that once required more invasive surgery, as well as for diagnosing medical problems. Veterinarians can use endoscopic techniques to remove health-threatening, non-food items from an animal's esophagus or stomach, spay female dogs, evaluate the respiratory, gastrointestinal, or urinary system, as well as internal organs. Endoscopes can be used to take biopsies, perform minor and major surgical procedures, and remove urinary stones, and much more.
Endoscopic procedures are minimally invasive, complications are rare, and pain and recovery time is reduced as compared to other more invasive surgical procedures. Some procedures, including evaluation of the digestive system and respiratory system, are nonsurgical and require no incisions, with a very quick recovery from anesthesia.
Different Types of Endoscopy
This procedure involves insertion of a camera through the esophagus. It is used when dogs or cats have difficulty swallowing, regurgitation, or a foreign body in the esophagus. Many patients have x-rays prior to endoscopic evaluation of the esophagus, because general anesthesia is required for esophagoscopy.
Another condition that requires esophagoscopy is stricture formation. This circumferential narrowing of the esophagus can occur after a foreign body has been removed or when an animal has severe gastroesophageal reflux that erodes the lining of the esophagus and results in scar formation. In this case, balloon dilation is required to open the esophagus and allow food to pass. Generally multiple episodes of balloon dilation are required to restore normal swallowing function.
This procedure involves passage of a camera and endoscope through the esophagus into the stomach and duodenum (the first part of the small intestine). It is used to remove foreign bodies from the stomach and to obtain biopsy samples from dog or cats with chronic vomiting with or without diarrhea and weight loss. It is the best tool that we have for evaluating the lining of the stomach, and we can provide information on the presence of ulcers with this technique.
This procedure involves passage of a camera and endoscope through the rectum into the colon. It is indicated for animals that have fresh blood in the stool or excessive straining to pass stool. Dogs and cats that require this procedure are fasted for 1-2 days and are given medications by mouth that helps evacuate the intestinal tract of feces so that we can see the lining of the colon. It is generally performed after non-invasive tests, such as stool testing and abdominal ultrasound have been performed and have failed to yield a diagnosis.
Rhinoscopy is used to examine the nasal cavity. Rhinoscopy includes two procedures: Anterior rhinoscopy and Posterior rhinoscopy. In anterior rhinoscopy, the rhinoscope is advanced through the nose to examine the nasal cavity. In posterior rhinoscopy, the rhinoscope is advanced through the mouth to examine the back of the nasal cavity above the soft palate. Rhinoscopy is often performed in conjunction with CT scan and dental examination to further evaluate patients with nasal, sinus or nasopharyngeal disease and to increase the probability that lesions are not missed. Rhinoscopy can be used to diagnose inflammation, foreign bodies, tumors, and fungal infections.
Uses of Rhinoscopy
In addition to allowing visual examination of nasal cavity, rhinoscopy can be used to:
- Identify the cause of clinical signs such as sneezing, nasal discharge, epistaxis (nosebleeds), stertor (snoring sounds) and stridor (inspiratory noise and wheezing).
- Obtain tissue samples (biopsy) for cytologic and histologic evaluation. Samples are evaluated for inflammation, infection, fibrosis and cancer. Biopsy can aid in characterization the extent of disease. This generally takes three to five days.
- Obtain samples for culture.
- Treat nasal, sinus or nasopharyngeal problems, such as removal of foreign body or nasal polyps, and introduction of medication into the nasal cavity or sinus to eradicate fungal infections.
Video otoscopy allows the veterinarian to magnify and examine the external canal and tympanic membrane (ear drum) in a patient's ear. The video otoscope is a small, cone-shaped camera that is placed in a patient's ear canal allowing the vet to visualize and assess the presence and extent of disease. Depending on the nature of the patient, sedation may be necessary during examination. Video otoscopy is frequently used to help determine what may be contributing to a patient's ear disease. It can allow the clinician to see whether there is swelling or even if a growth is present in the ear. Likewise, the magnified field of view helps to collect samples for culture and biopsy when necessary. Video otoscopy is also utilized during irrigation (flushing) of the external ear canal and middle ear. This allows the doctor to assure correct placement of cleaning tools and adequate removal of debris from the ear canal. An added feature of the video otoscope is that it has the ability to take pictures of your pet's ear canal to illustrate what the vet is seeing, and document the severity of disease so treatment response can be assessed in the future.
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