Cabinet vétérinaire des Mangettes

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ENDOSCOPY &  RHINOSCOPY

 

Our practice is equiped to carry out respiratory and digestive endoscopy examinations. Endoscopy is a procedure with which we can get a direct look at the digestive and respiratory systems using a small camera. The procedure also allows us to take biopsies if needed for the relevant histological examinations. There is a large benefit to associated an ultrasound examination with an endscoping evaluation of the digestive or respiratory system.
We can hereby suggest the following procedures ;

 

RESPIRATORY SYSTEM

 

  • Rhinoscopy (nasal passage and sinuses)
  • Laryngo-pharyngoscopy ( the throat ; larynx and pharynx)
  • Tracheoscopy (the windpipe ; trachea)
  • Bronschoscopy (lung tissue ; small and large bronchi)

 

 

DIGESTIVE SYSTEM

  • Oesophagoscopy (oesophagus)
  • Gastroscopy (stomach)
  • Duodenoscopy (duodenum)
  • Coloscopy (Colon)

Our practice has two endoscopes fixed to a computer to project the images onto a large screen.

 

THE ENDOSCOPE

The endscope is made of three parts. One part linked to the endoscopy column, a handle that allows us to turn the endoscope extremity and a long tube which enter the natural passages of the body. Instruments can be inserted into the long tube to perform biopsies or retrieve foreign bodies.
The gastroscope has a large diameter to enter the digestive tube. The camera is situated at the end of the tubing and fairly large instruments can be introduced to perform biopsies and retrieve big foreign bodies. This type of endoscope is used to examine the digestive system.

The fibroscope has a smaller diameter to enter the respiratory tracts. The images are numerical and converted to a video format on the screen. The image quality is therefore not as good as the image quality of the gastroscope but the small tubing allows us to enter areas of tiny diameter such as the sinuses and bronchioles of our small patients. The fibroscope is therefore the prefered choice for respiratory system evaluation.

 

DIGESTIVE TUBE ENDOSCOPY

Patient preparation
Digestive System endoscopy allows us to examine the oesophagus, stomch , duodenum and colon.
For an endoscopy of the oedophagus stomch or duodenum the animal needs to be starved for 12 to 24hours and not allowed access to water for 4hours prior to the procedure. For a coloscopy the animal oftern needs to be starved for longer and requires 2-3days of a specialised diet prior to the procedure (chicken+gruyère cheese+water). A laxative prior to the examination is often also recommended.
For digestive endoscopy a general anesthetic is required to immbolise the animal completely, despite the procedure not being painful. The anesthesia also allows for intubation of the respiratory tract to provide the animal with oxygen and avoid any aspiration of digestive contents into the respiratory system.
The animal will be laid down on his or her left side and complete anesthetic monitoring is put in place.

 

 

OESOPHAGEAL ENDOSCOPY

Oesophageal can be indicated for oesophagitis (oesophageal inflammation), foreign bodies, stenosis (lumen narrowing) or neoplasie. Certain motility abnormalities can also be detected.
Oesophageal biopsies carry important complications and are limited to masses or abdnormal tissue proliferation.
Foreign bodies can sometimes get stuck in the oesophagus and this occurs 80% of the time in small breed dogs, especially terriers. It is important to respond quickly as the animal will present smptoms with acute onset and complications from such cases are frequent. Mostly however, oesphageal endoscopy is used to diagnose strictures causing stenosis (a circular tissue remnant that narrows the oesophagel diameter. Diverticuli formation or oesophageal rupture can also be diagnosed.
If post foreign body retrieval there is a stenosis the endoscopic procedure can also help by using a balloon catheter to dilate the stenosed tissue. This may require between 3 and 10 sessions.

 

GASTIC ENDOSCOPY (GASTROSCOPY)

Gastroscopy allows for stomach mucosa examination, retrieval of foreign bodies and to take biopsies of any abdnormalities detected. Anatomical and functional abnormalities can also be identified such as delayed gastric emptying.

The most frequently diagnosed gastric pathologies include chronic gastritis (inflammation), mucosal erosion, foreign bodies, gastric emptying abnormalities, gastric ulcers and neoplasia. Pylorus (the junction between the stomach and the intestine) abnormalities are often identified ; ulcers, neoplasia, hyperplasia o atrophy. Biopsies can be easily carried out here and 4 to 8 samples are usually required.
Using an endoscope we can also place a gastric feeding tube which can be left in place over several weeks. This can be useful in cases of jaw fractures or oesophageal pathologies.

 

SMALL INTESTINAL ENDOSCOPY

Small intestinal endoscopy is indicated for chronic digestive systems or in acute cases which are not responding to therapy. We do however recommend an abdominal ultrasound prior to small intestinal endoscopy as it helps to localise a lesion which may be inaccessible to endoscopy. In the cases biopsies are then carried out via laparotomy (surgical opening of the abdominal cavity) or laparoscopy.

 

COLOSCOPY

Symptoms including defaecation difficulty, bloody stools or chronic diarhoea can be the indications for a coloscopy. In over one third of colon abnormalities vomiting can also be a symptom. Coloscopies are also generally carried out under general anaesthetic and biopsies can easily be caried out.

 

INDICATIONS FOR BIOPSIES

Biopsies are small pieces of tissue that are obtained from an organ. The tissue is then sent to a pathology laboratory for examination under the microscope (histology). This allows us to determine the nature of a lesion or differientiate between suspected pathologies.
Scientific publications have concluded that there is a 70% correlation between the laboratory diagnosis and what is observed by the person carrying out the endoscopy. This shows us that we can get a good idea of the pathology using an endoscopic evaluation but a biopsy is a prereqquisite for accurate diagnosis.

 

COMPLICATIONS

Apart from the anaesthetic risks associated with all surgeries potential complications can arise from taking biopsies

 

  • Upon removal of a foreign body there can be some soft tissue trauma
  • Vomiting can be triggered during endoscopy soi t is important to place an endotracheal tube
  • Hyperinflation ; the organs are distended with gas during endoscopy in order to allow for correct visualisation. If the organs are over distended the nit can cause bradycardia and decreased arterial pressure.
  • Perforation ; This occurs very rarely and usually only happens if the underlying tissue is already severly damaged
  • Hemmorhage ; some minor bleeding always occurs but this stops quickly and no suturing is necessary.

 

 

RESPIRATORY ENDOSCOPY

Endoscopic examination of the respiratory system allows for dynamic evaluation of the structures within the respiratory tract as well as allowing one to carry out biopsies for catolog and bacteriological examinations.

 

PATIENT PREPARATION

Patients will undergo a general anesthetic for this procedure. For the lower respiratory tract it is not possible to intubte the animal and therefore oxygen is supplied through the nose. Adequate anesthetic monitoring ensures correct cardiac function and blood oxygenation is maintained.

 

ENDOSCOPY OF THE PHARYNX & LARYNX

The pharynx is the area between the upper digestive tract and the respiratory apparatus. Frequesntly we can find inflammation or foreign bodies here, or neoplasia.

The soft palate is the continuation of the hard palate which can be seen at the front and top of the mouth. Endoscopic examination of the soft palate allows for evaluation of its length and thickness which can cause obstructive respiratory symptoms (frequently seen in brachycephalic dogs).
The larynx is the « voice box » made up of cartilage structures. Their role is to open during inspiration and close during expiration and to close during deglutition so that food does not enter the respiratory tract. Dynamic evaluation of the larynx can be performed during endoscopy and paralysis of laryngeal cartilage movement can be observed.

 

TRACHEOSCOPY

The trachea is a tube that consists of several cartialge rings that join up by a membrane. The trachea allows air to get into the lung.
Endoscopy of the trachea allows for evaluation of tracheal diameter, shape, masses, parasites or foreign bodies but also to evaluate any damage after trauma (for example a dog bite to the throat).
If the trachea appears collapsed the degree of collapse can be evaluated and graded 1-4. This occurs commmonly in small breed dogs.

 

BRONCHOSCOPY

The trachea divides into two bronchi (left and right) which supply the lung tissue. The bronchi divide into smaller and smaller divisions known as bronchioles. The evaluation of the bronchi is slightly limited according to the size of the animal. The bigger the dog the further the endoscopy examination can be used.
During bronchoscopy we can see inflammation, secretions foreign bodies and neoplasie. Some tumours will not be seen if they are too deep within the lung tissue or surrounded by hemorrhage.
During the examination a broncho-alveolar lavage can be performed. This is a procedure during which a small amount of saline is injected into the bronchi and recuperated to allow for a cytology examination. The cytology can indicate parasitic or bacteriological infections or other abnormal cells.

 

COMPLICATIONS

Bronchoscopy is contra indicated if the animal suffers from a cardiac pathology, severe respiratory disease or coagulopathies.

 

RHINOSCOPY

Rhinoscopy allows for the examination of the nasal cavities. This can be a useful diagnotic tool or recurrent sneezing symptoms, nasal secretions (bi or unilateral), epistaxis (nose bleed) or reverse sneezing. The exam is often competed with radiographs and CT scans or a MRI.
The most frequent diagnoses include tumours (30% of cases), inflammatory rhinitis, foreign bodies, aspergillosis (nasal fungus) and fistules (abnormal communication between the nose and mouth).

 

CONCLUSION :

Endoscopy is fairly easy to carry out and complication levels are low. Further complimentary examinations may be required to reach a final diagnosis but the evaluation of tissues and structures via endoscopy allows for a non invasive examination and the procedure is a very useful diagnostic tool.
Please ask us if you have any further questions.

 

Storz Endoscope

 

Olympus Endoscope

 

Gastroscope

 

Fibroscope

 

œsophage normal

 

vue de l’estomac d’un chat

 

pylore

 

epilet

Un epilet dans le nez d’un chien