One of the best parts of my (Perry Jameson) job is getting to use the endoscope. It is challenging, rewarding and it involves a great level of hand-eye coordination.
Endoscopy can be used to make a diagnosis as well as to perform a treatment. Here are examples of the many things that we have been able to do with endoscopy over the past year:
- Dilation of esophageal strictures: Comet is a German shepherd puppy who was failing to gain weight, and regurgitating. He was diagnosed with a congenital esophageal stricture. He was underweight and unable to pass any food through his narrowed esophagus.
Endoscopy was performed to identify the stricture. We then inserted a balloon catheter and applied pressure to dilate the stricture, basically tearing it open. That allowed us to pass the endoscope into his stomach and place a temporary stomach tube. Then we could feed him through the stomach tube, getting him the nutrients he so badly needed to grow.
We treated the stricture several times with balloon dilation until his esophagus was no longer narrow and food was able to pass through.
- Removal of foreign objects: I can’t tell you the number of crazy things that dogs and cats will manage to eat, inhale or snuffle up their noses.
One of the funniest was a little Brussels griffon whose parent had made him a bowl of fettucine because he wasn’t feeling well. The little one ate the fettucine and then developed a hacking/clearing of his throat and nasal discharge. We were able to pass the scope over his soft palate and see two fettuccine noodles and remove them.
In the esophagus, we primarily find bones but commonly remove coins, socks, toys and even underwear from the stomachs of nosy dogs.
Obtain biopsies: Endoscopy is a less invasive way than surgery to biopsy the nose, GI tract and urinary tract. Less invasive typically means faster recovery and less pain. General anesthesia is still required in all of our scoping procedures but not as deep as for a surgical procedure.
- Evaluate airway function: I wish you could just ask a dog or cat to open up and say “ahh” to get a good look in the back of their throat. Unfortunately, that’s not the case with most pets.
Part of this is conformational. It’s hard to see in the back of throats in dogs with long snouts or dogs with “smushed” faces. If we are worried about airway function, we can use injectable anesthesia so that we can video the opening and closing of the airway when the dog breathes and coughs. This will often help dictate what treatments are best.
- Obtain samples of fluid from lower airways: The scope can be used to sample fluid from the lower airways to diagnose and guide treatment in cases of pneumonia and even to evaluate for cancer and fungal infections.
Certainly, the most immediate gratification comes when we can identify and remove a foreign body, but simply using the scope to safely get a diagnosis or administer a treatment is a treat for me.
Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to firstname.lastname@example.org.